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Speaker 1: You've heard on five Double A News this morning that

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Speaker 1: a man had to be resuscitated at the Royal Adelaide

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Speaker 1: Hospital after taking one pill, just one drug that he

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Speaker 1: bought off the street. He consumed an oxycodone pill and

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Speaker 1: testing of it showed large amounts of proton eltazine, which

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Speaker 1: can be toxic even in small amounts. So whoever's mixed

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Speaker 1: this in the tub out the back, you know, with

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Speaker 1: the engine oil in it and whatever else last week's washing,

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Speaker 1: has not mixed it correctly, or couldn't care, whatever it

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Speaker 1: might be, just sell the drug. And this bloke has

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Speaker 1: taken one of these pills, just one, and then has

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Speaker 1: had to be resuscitated in the Royal Adelaide Hospital. Obviously,

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Speaker 1: authorities are concerned because there is a music festival on

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Speaker 1: this weekend as well, and they fear more of these

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Speaker 1: drugs could be out there. Associate Professor Sam Alfred is

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Speaker 1: Judy Agency physician at the RA, Head of Toxicology at

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Speaker 1: the RA as well. It joins me now, Sam, good morning.

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Speaker 2: Good morning, Thanks thanks for having me.

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Speaker 1: On, Thank you for your time. It sounds extremely dangerous,

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Speaker 1: well it is.

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Speaker 2: It's a very very alarming scenario. The President Zine that

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Speaker 2: we've detected in this unfortunate patient is an extremely potent opiate,

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Speaker 2: is much stronger than morphine and pensyl and heroin, and alarmingly,

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Speaker 2: it works in a tablet form, which those other medications don't.

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Speaker 2: And then it appears to be a tablet in circulation

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Speaker 2: that's been deliberately designed to mimic a prescribed medication in

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Speaker 2: the form of oxycodone. And that little cluster of things

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Speaker 2: is an extremely worrying reality.

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Speaker 1: And I suppose this is something that a drug dealer

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Speaker 1: is cooked up in the back lab.

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Speaker 2: Well, I think it's probably possibly a little bit more

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Speaker 2: sophisticated than that. I think it's been very deliberately manufactured

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Speaker 2: to mimic a pharmaceutical drug. Probably is a cost saving exercise.

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Speaker 1: Yeah, So could these be at the music festival? I

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Speaker 1: know there is concern about that.

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Speaker 2: Well, yeah, I mean if there is circulating in the community,

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Speaker 2: then festivals are places where tablet use tends to tends

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Speaker 2: to occur, and it's a high risk in an environment,

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Speaker 2: and if this tablet is used, it extraordinarily high risk.

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Speaker 2: One tablet is definitely enough to kill somebody.

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Speaker 1: That's that's terrifying. So the police would be investigating this,

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Speaker 1: no doubt, I imagine.

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Speaker 2: Yeah. I mean my work is not in policing, My

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Speaker 2: work is in harm mitigation. But I imagine they will win.

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Speaker 1: Yeah. People that make this either don't know or don't care. Presumably,

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Speaker 1: well yes, again.

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Speaker 2: I can't speak to the motivate motivation of the average

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Speaker 2: drug dealer, but I suspect it. I expect it's a

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Speaker 2: low cost alternative to things like heroin and morphine to

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Speaker 2: make these drugs in a lab and to press them

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Speaker 2: in a pill press into whatever form you like, and

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Speaker 2: then to move them on. So I suspect must expect

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Speaker 2: there's money involved.

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Speaker 1: For someone who's taken the drug. What symptoms would would

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Speaker 1: somebody nearby notice all the person themselves.

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Speaker 2: Well, what they'll notice initially is the person becomes very

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Speaker 2: drowsy and goes to sleep. And then what they'll notice

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Speaker 2: is that they're a spiratuary rate starts to slow down,

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Speaker 2: and eventually they will stop breeding. And as they stop breeding,

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Speaker 2: they will change color, go blue and have a CARDI

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Speaker 2: carest and die.

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Speaker 1: So potential coma. I suppose if they're able to be resuscitated.

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Speaker 2: Yeah, yeah, and there is an antidote and we can

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Speaker 2: treat this, so people are keeping an eye out for

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Speaker 2: it and calling an ambulet's getting medical assistance. You know

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Speaker 2: we can reverse it. In fact, the lockstain is something

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Speaker 2: that's available free, that's the antidote to opiate poison, and

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Speaker 2: it's available free through community pharmacies in a spray form

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Speaker 2: that can be squirted up a patient's nose, or in

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Speaker 2: an intramuscular form that can be injected. So you know

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Speaker 2: people are going to be using these sorts of drugs,

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Speaker 2: or in environments where these sorts of drugs might be

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Speaker 2: used by others, it'd be very sensible to get hold

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Speaker 2: of some of the Lockstown and have it on you

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Speaker 2: so that you can help yourself and help your friends.

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Speaker 2: I'd strongly recommend that even if that has been done

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Speaker 2: and am and it should still be called because the

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Speaker 2: effects of the drug tend to last longer than the

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Speaker 2: reversal effects of the lockstown.

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Speaker 1: I don't know if you've got a view on this,

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Speaker 1: but I'd be interested to hear it. Your personal opinion

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Speaker 1: on people talking about pill testing at music festivals moving

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Speaker 1: forward and this, I mean my personal view is, why

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Speaker 1: would you take something you don't know it's origins? You

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Speaker 1: buy it from someone you've never met before. Just madness

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Speaker 1: to me. But the issue of pill testing, would that

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Speaker 1: solve this sort of problem?

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Speaker 2: Well, look, I don't think it'll solve this specific problem

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Speaker 2: because this drug is not likely to be picked up

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Speaker 2: by standard pill testing my opinion. But again, my opinion

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Speaker 2: is that there is a role for pill testing in

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Speaker 2: terms of picking up particularly high risk combination drugs. You know,

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Speaker 2: every now and then there's going to be a combination

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Speaker 2: of drugs which you know are going to cause a

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Speaker 2: pace significant problems, and you'd be inclined to tell them, look,

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Speaker 2: you really should not take that blue pill. So I

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Speaker 2: think there is a role for that, but I think

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Speaker 2: it's probably needs to be supplemented by other things, such

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Speaker 2: as the program that has detected the problem in this case,

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Speaker 2: where we're looking for the drugs that are present in

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Speaker 2: patients who have got into trouble, because what we're finding

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Speaker 2: actually is that most drug use doesn't happen at festivals

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Speaker 2: or in the nightclubs, where pill testing programs might actually

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Speaker 2: pick these things up. It tends to happen in patients'

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Speaker 2: homes or out in an urban environment before they head

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Speaker 2: into clubs and nightclubs and into festivals. So the opportunity

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Speaker 2: for pill testing to pick up these sorts of things,

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Speaker 2: you know, it's obviously limited to those patients that they

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Speaker 2: are using inside the location that the film testing set up.

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Speaker 1: Yeah. Indeed, for people who do take opioids and then

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Speaker 1: take this, would they have a higher tolerance against this

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Speaker 1: having well they.

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Speaker 2: Will, yeah, yeah, But then even in those patients there

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Speaker 2: are significant risk is the sorts of opioas that ENTERINGO

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Speaker 2: drug users for example, are using heroin and morphine or

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Speaker 2: or fentanyl, and those are really strong drugs, and they

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Speaker 2: do have risks, and in fact, you know, opius are

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Speaker 2: the leading cause of drug related death in the list

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Speaker 2: of drug using population, so they are at a higher risk.

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Speaker 2: But you're right, they have developed some tolerance and their

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Speaker 2: experienced users and aware of the risks. But even in

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Speaker 2: that patient population, this drug has the potential to kill.

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Speaker 2: Is just so exponentially stronger than the ones that they're

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Speaker 2: used to using, and that what they consider to be

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Speaker 2: a normal dose and may well kill them.

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Speaker 1: I don't know if you helped in the case of

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Speaker 1: this young man, but you're certainly across the obviously fact

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Speaker 1: he came to hospital and resuscitated. I imagine he's left

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Speaker 1: potentially with a different mindset about taking pills. You'd hope

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Speaker 1: so anyway, he'd hoped so.

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Speaker 2: Yeah, he's been a very lucky man.

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Speaker 1: Yeah, resuscitated and now discharged. Indeed, all right, Associate Professor

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Speaker 1: Sam Alfred, appreciate your time.

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Speaker 2: Thank you, oh, thank you very much for having Dudy

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Speaker 1: Emergency physician at the RAH, Head of Toxicology Services,