⚠️ Someone who is "snoring" heavily and cannot be woken is not asleep. That is an emergency.
Call 112 nowIn March 2025 the Trimbos Institute issued a Red Alert after someone in the Netherlands died with counterfeit oxycodone tablets in their possession. Analysis by the Netherlands Forensic Institute showed: no oxycodone, but a nitazene. This page sets out what was found, what the status is now, and what to do about it.
The acute Red Alert dates from March 2025, but this is not a closed incident. Since late 2024 the Netherlands Forensic Institute has investigated six deaths and four severe poisonings linked to a nitazene, in almost all cases via counterfeit oxycodone. On 8 April 2026 the Trimbos Institute confirmed the warning is still relevant.
The message has not changed in all that time: do not use oxycodone bought online.
Every step below can be traced to the Trimbos Institute, the Dutch Poisons Information Centre or the government. The links are at the bottom of this page.
Counterfeit 80 mg oxycodone tablets are found with the deceased. The pills had been bought online as pain medication, without a prescription. Trimbos refers in its 18 March report to "last Friday".
Analysis by the Netherlands Forensic Institute shows the pills contain the nitazene isotonitazepyne and no oxycodone. The DIMS monitoring system had earlier found protonitazene in another counterfeit oxycodone pill, also bought online.
Trimbos reports that counterfeit oxycodone tablets containing nitazenes are still being offered in the Netherlands, online and through dealers. The message remains: do not use oxycodone bought online.
This makes trade and possession punishable. It does not remove the substances from the market, but it gives investigation and enforcement a legal basis.
According to Drugsinfo, the public information site of the Trimbos Institute, several people ended up in hospital in 2025 after using medication bought online. The Health and Youth Care Inspectorate received reports of patients admitted to emergency departments with severe poisoning.
There are also reports of nitazene poisonings at DIMS, the Poisons Information Centre and the NFI. A complete overview is lacking, partly because nitazenes are hard to detect at the extremely low doses at which they are already dangerous.
Since late 2024 the Netherlands Forensic Institute has investigated six deaths and four severe poisonings linked to a nitazene. In the words of NFI toxicologist Kristof Maudens: "In almost all cases the nitazene was found in counterfeit oxycodone tablets." The NFI notes this is a lower bound: it has no view of toxicological testing done elsewhere, so the real numbers may be higher.
A survey by Dutch public broadcaster NOS along the Poisons Information Centre, Trimbos, the NFI and hospitals able to test for these substances found further suspected deaths. According to Erasmus MC these figures are most likely still an underestimate.
On the public information site Drugsinfo.nl the warning is explicitly reconfirmed. So this is not a closed incident from 2025: the risk of counterfeit oxycodone containing nitazenes still stands today.
These are not impurities or weaker variants. They are different substances, with a completely different risk profile from what the pill claims to be.
They are far more potent. A few milligrams can already cause serious breathing problems, which can be fatal.
They last longer than naloxone. Naloxone temporarily reverses the effect but wears off before the nitazene does. Someone who has come round can relapse afterwards. The Dutch Poisons Information Centre therefore advises doctors to use higher or repeated doses and longer observation.
According to the EU drugs agency, seven new nitazenes were reported in 2024; in total 25 are on the European monitoring list and they have been found in at least 21 EU countries.
Call 112, say it involves synthetic opioid painkillers and ask for naloxone. That is literally what Trimbos advises. Stay with the person, even if they seem to come round: nitazenes last longer than naloxone.
Recognising an overdose →There is no way to establish at home what is in them. Tell your GP you bought medication online; that is a medical question, not a confession. If you are afraid of withdrawal, say so.
About tapering off →The DIMS Red Alert app gives current warnings about dangerous batches. This page is updated periodically but does not replace those channels.
Go to Red Alert (DIMS) →Counterfeit is more profitable than the real thing. Real oxycodone has to leak from the legal supply chain and is therefore scarce. A pressed pill containing a cheap synthetic opioid costs a fraction and sells for the same price.
On top of that, oxycodone acts slowly. The buyer only notices hours later that something is wrong, and by then contact has been broken. Counterfeiting is rarely punished here, which makes it more attractive than with almost any other product.
A Red Alert is the most serious warning issued by the Drugs Information and Monitoring System (DIMS), part of the Trimbos Institute. It is issued when a batch in circulation carries an acute risk to life. It is a national warning to users, not a police notice.
Current. The acute Red Alert dates from March 2025, but the Trimbos Institute has repeatedly reconfirmed the warning since. The most recent confirmation on Drugsinfo.nl is dated 8 April 2026 and states literally that the warning is still relevant.
By late November 2025 the Netherlands Forensic Institute had investigated six deaths and four severe poisonings linked to a nitazene, in almost all cases via counterfeit oxycodone. The NFI states this is a lower bound, as it has no view of testing done elsewhere.
The pills found at the March 2025 death contained isotonitazepyne, a nitazene. There was no oxycodone in them. DIMS had earlier found protonitazene in another counterfeit oxycodone pill also bought online. So this is not contamination but an entirely different substance.
Through the DIMS Red Alert app and the news page of the Trimbos Institute. Those carry the current warnings about risky batches and new substances. This page is updated periodically but is not a replacement for the official channels.
Yes. In September 2025 the Dutch government decided to place all nitazenes under the Opium Act. That makes trade and possession punishable, but it does not remove the substances from the market.
The help page lists the organisations reachable today, including anonymous options, and what you can say if you don't know how to start.