Public health warning: Opioid overdoses after using drugs thought to be cocaine

30 March 2026

​NSW Health is warning the community about the dangers of unexpected drugs in cocaine, following six recent opioid overdoses in Sydney and Western NSW.​​

Of the six people across NSW who presented to hospital in March with suspected opioid overdose after using substances they thought to be cocaine, one has required treatment in an intensive care unit.

Some of the people who presented to hospital were known to each other. Blood or urine testing of some of these people has shown that opioids such as heroin were present with cocaine.

Medical Director of the NSW Poisons Information Centre, Dr Darren Roberts, said it is important people recognise the signs of an opioid overdose early and know how to respond.

“Opioids such as heroin can cause pin-point pupils, drowsiness, loss of consciousness, slowed breathing/snoring and skin turning blue/grey and can be life-threatening," Dr Roberts said.

“One of the dangers of illicit drug supply is the contents and strength of the substance you are getting is uncertain and can be inconsistent.

“Opioids such as heroin can be sold as or found in cocaine, methamphetamine, and MDMA (ecstasy). You cannot always tell the difference between these drugs by appearance.

“People who use drugs such as cocaine, methamphetamine, MDMA or opioids should carry naloxone."

If you witness someone experiencing any unexpected symptoms after using drugs, you should call Triple Zero (000) immediately or seek urgent medical attention. Naloxone should be given immediately if available.

Naloxone is an important life-saving medication that reverses the effects of opioids. It does not require a prescription and is free for anyone at risk of opioid overdose in NSW.

It is available as an easy to use nasal spray or injection from some pharmacies and other health services. For more information on the take-home naloxone program visit: Your Room Ta​ke Home Naloxone​.

NUAA can mail you naloxone in a discreet package. Order via their online shop​​ (NUAA) or call (02) 9171 6650.

You won't get into trouble for seeking medical care. If you feel unwell, or if your friend feels unwell, do something about it.

Anyone who has concerns about adverse effects from drugs should contact the NSW Poisons Information Centre on 13 11 26, at any time 24/7.

For support and information on drug and alcohol problems, contact the Alcohol and Drug Information Service on 1800 250 015.  This is a 24/7 service offering confidential and anonymous telephone counselling and information. ​

NSW public drug warnings can be found at NSW Health Drug Alerts.​