Canberra's illicit drug users are increasingly ordering exotic products online, leaving doctors unsure how to treat suspected overdoses.
A Canberra emergency medicine specialist on Tuesday urged medical professionals and paramedics to be on alert for a potential spike in overdoses from a cheap synthetic drug linked to the death of a Sydney teenager.
Henry Kwan, 17, jumped off a third-floor balcony in June after taking an NBOMe-class drug which had LSD-type effects.
His death prompted bans to be imposed on a range of synthetic drugs.
In a letter to the Medical Journal of Australia, Calvary Hospital emergency physician David Caldicott and two other drug experts warned that publicity from the case could lead to more people taking the drugs.
Dr Caldicott said people suffering NBOMe overdoses could be mistakenly diagnosed as suffering from LSD intoxication.
But the NBOMe was longer-lasting and more toxic than LSD and overdose could lead to cardiovascular complications, agitation, seizures, hyperthermia, metabolic acidosis, organ failure and death.
''It has this serotonin toxicity, which is very dangerous and which is very scary to treat in its full form,'' Dr Caldicott told Fairfax Media.
''The tabs which are being sold can contain up to six times the effective dose required which only serves to increase the duration of effect and also the potential for overdose.''
While drug users were sometimes warned about potential impurities in drugs, NBOMe's purity could cause poisoning.
''We've argued in the past with, say methamphetamine, that it's a very impure drug and that it's nasty and you don't know what's in it,'' Dr Caldicott said.
''What you've got in the case of these synthetic novel psychoactive substances is a problem of over-supply and over-purity.''
Dr Caldicott's letter to the medical journal was co-authored by Melbourne psychologist Stephen Bright and Monica Barratt, of Curtin University's National Drug Research Institute.
The three experts warned that patients suffering from NBOMe overdoses might require a higher level of care than those who had LSD intoxication.
It was written in the wake of Henry Kwan's death, when it had been reported that NBOMe was available online for as little as $1.50 per tablet.
Dr Caldicott said an increasing number of Canberra drug users were turning to what he termed "novel products'' ordered online.
"They're things the general public would regard as research chemicals - things that don't really fall into any major classification,'' he said.
Dr Caldicott said the ability to order drugs using the internet was a nightmare for law enforcement officers used to targeting street-level dealing.
"We had ecstasy in the 1980s and that sort of merged into meth. This is the next generation. And the problem for us clinical folk is that it's coupled with this perfect storm of the internet,'' he said.
Despite the emergence of new types of illicit drugs, a new report shows that alcohol remained the most common principal substance of concern for people seeking treatment for drug addiction.
An Australian Institute of Health and Welfare report to be published on Wednesday showed that in 2011-12, alcohol was the main drug of concern in 48 per cent of treatment episodes in the ACT. There were more than 107,000 drug-related hospital admissions in Australia during 2011-12.