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Fears of US-style opioid death surge as cocaine hits Australian streets laced with drug from China that's so deadly just FOUR GRAINS of it can kill you

Authorities fear a US-style opioid death surge after cocaine reached Australian streets laced with fentanyl - a drug so deadly it takes an amount equivalent to just four grains of salt to kill. 

The NSW Health Dep­artment issued a warning to the public, saying the opioids fentanyl and acetylfentanyl have 'recently been identified as likely adulterants in cocaine or ketamine'.

Fentanyl is used legally by doctors for pain relief, but dealers have started using the chemical to cut other drugs. 

Fentanyl is used legally by doctors for pain relief, but dealers have started using the chemical to cut other drugs

Fentanyl is used legally by doctors for pain relief, but dealers have started using the chemical to cut other drugs

The Department told Australians to look out for symptoms of drowsiness or skin going blue if people have taken cocaine.

The drug has killed tens of thousands of people in the United States, prompting President Donald Trump to call on China to declare fentanyl a 'controlled substance' and stop pumping it out.  

NSW Poisons Information Centre Professor Andrew Dawson said people in NSW who recently took what they believed to be cocaine or ketamine developed toxicity from acetylfentanyl and fentanyl in NSW.

'We've seen several people recently where acetylfentanyl was taken unknowingly and was associated with serious harm,' Prof Dawson told The Daily Telegraph. 

'It's important that people realise an overdose can occur with very small doses of fentanyl-related substances.'

The warning comes a week after a man died and two women were hospitalised after overdosing on cocaine in Lidcombe, in Sydney's south west. 

Health authorities haven't determined if fentanyl led to the incidents. 

Dr John Coyne from Australian Strategic Policy said it's 'incredibly difficult' for the Chinese government to be able to control and regulate the pharmaceutical industry. 

'We need to work with the Chinese government to better regulate their chemical and pharmaceutical industries in mainland China to prevent these sorts of drugs from being produced there and moved around the globe,' he said. 

The warning comes a week after a man died and two women were hospitalised after overdosing on cocaine in Lidcombe, in Sydney's south west

The warning comes a week after a man died and two women were hospitalised after overdosing on cocaine in Lidcombe, in Sydney's south west

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