Multiple opioid overdoses following use of cocaine

​Six people recently presented to hospitals in Sydney and Western NSW with opioid overdoses after using what they thought was cocaine.

Last updated: 30 March 2026
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​Know the​​ risks

  • Opioids such as heroin may be sold as or found in cocaine, methamphetamine and MDMA.
  • Small amounts of opioids can cause life-threatening overdose.
  • This risk is higher in people who have never or rarely used opioids.
  • You cannot always tell the difference between heroin, cocaine and methamphetamine by appearance.
  • The risks of overdose are increased if you:
    • use a high dose, or re-dose when you are not getting the desired effect.
    • use with other drugs (for example alcohol, benzodiazepines, ketamine, GHB or opioids).
    • use drugs alone.
    • use a new batch.
  • Fentanyl and nitazene test strips do not detect heroin or many other opioids.​​

Effects to look out for

  • Unexpected drowsiness
  • Pinpoint pupils
  • Loss of consciousness
  • Slow breathing/snoring
  • Skin turning blue/grey

Getting help

If you or your friends see the warning signs of overdose:

  • Seek help immediately from your nearest emergency department or call Triple Zero (000). You won’t get into trouble for seeking medical care.
  • Start CPR if someone is not responsive.
  • Use naloxone if you have it. Call ‘000’ even if naloxone has been given.

Take Home Naloxone program

  • Naloxone is a life-saving medicine that can temporarily reverse an opioid overdose. Naloxone is available in a very easy to use nasal spray, and as a pre-filled injection.
  • You should carry naloxone if:
    • you are using drugs in the form of a pill, powder, crystal or liquid
    • you are going somewhere where drugs will be present
  • If you are at risk of experiencing or witnessing an opioid overdose you can get naloxone for free without a prescription in NSW from some community pharmacies, needle and syringe programs, opioid treatment services and NUAA.
  • Visit Your Room - Naloxone for participating sites and more information on take-home naloxone.
  • NUAA can mail you naloxone in a discreet package. Order via their online shop or call (02) 9171 6650.

Support and advice

For free and confidential advice:

  • Call Alcohol and Drug Information Service (ADIS) on 1800 250 015 at any time 24/7. Start a Web Chat with an ADIS counsellor Mon-Fri, 8.30am-5pm.
  • Call NUAA and DanceWize NSW's PeerLine on 1800 644 413 (Mon-Fri 9am-5pm) to speak to a peer or visit NUAA for a range of resources on opioids and naloxone.
  • Call the NSW Poisons Information Centre on 13 11 26 for information on adverse effects from drugs.
  • Visit Your Room for fact sheets and other resources.​​


 

Current as at: Monday 30 March 2026