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This scoping review aimed to map what is known about NSOs in Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach<\/jats:title>\n                    <jats:p>Scoping review of peer\u2010reviewed and grey literature on NSO detections and harms. Criteria: studies describing NSO market indicators and harms in Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Findings<\/jats:title>\n                    <jats:p>\n                      Overall, 912 peer\u2010reviewed studies were identified; 40 met criteria. Monitoring systems identified NSOs (e.g., \u03b2\u2010U10, nitazenes) for the first time in Australia. Nitazene toxicity appeared in emergency departments (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200911, 2021\u2010onwards), two involved intentional consumption. NSOs for sale to Australia on cryptomarkets comprised &lt;\u20091% of drug listings. Mortality studies identified fentanyl analogues (furanylfentanyl, acetylfentanyl) (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200922, 2013\u20132021), and other NSO U\u201047700; (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200912, 2016\u20132021) deaths. Thirty\u2010three nitazene deaths were reported; 24 in Victoria (2021\u2010onwards); 7 in SA (2022\u2010onwards); two in NSW (2024). Australian Federal Police reported 47 nitazene seizures since July 2023. Fifty\u2010one drug alerts were identified (2019\u20132024); 18 (34%) involved NSOs; 12 (24%) for nitazenes. Overall, 12 alerts were for NSO\u2010contaminated stimulants; at least two fatal overdoses were confirmed due to NSO\u2010contaminated stimulants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>Australia has strong monitoring capacity for NSOs post\u2010consumption. Harms occurring among opioid\u2010na\u00efve people unknowingly purchasing NSOs suggest a role for drug checking and cautious use of nitazene testing strips. Expanding take\u2010home naloxone availability in entertainment settings, and to all who use drugs, is warranted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This review demonstrated the recent and limited emergence of NSOs in Australia. Demand for NSOs is not yet clear; availability and harms are rapidly changing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dar.14079","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T13:00:09Z","timestamp":1748437209000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["A Scoping Review of the Emergence of Novel Synthetic Opioids in Australian Drug Markets: What Does This Mean\u00a0for Harm Reduction Responses?"],"prefix":"10.1111","volume":"45","author":[{"given":"Emmanuel","family":"Mammoliti","sequence":"first","affiliation":[{"name":"National Drug Research Institute Curtin University  Perth Australia"},{"name":"Disease Elimination Burnet Institute  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5341-1055","authenticated-orcid":false,"given":"Suzanne","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Disease Elimination Burnet Institute  Melbourne Australia"},{"name":"Monash\u00a0Addiction Research Centre Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8609-0075","authenticated-orcid":false,"given":"Amanda","family":"Roxburgh","sequence":"additional","affiliation":[{"name":"National Drug Research Institute Curtin University  Perth Australia"},{"name":"Disease Elimination Burnet Institute  Melbourne Australia"},{"name":"Monash\u00a0Addiction Research Centre Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108350"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/20451253221139616"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","unstructured":"B.Pardo J. 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