An influx of lethally strong synthetic opioids could fuel a “second wave” of the UK’s drug deaths crisis, leading public health experts have warned.
Britain already suffers thousands of drug deaths every year, despite so far being spared a US-style opioid epidemic. But the esteemed Faculty of Public Health (FPH) warned on Friday that global drug markets are “rapidly evolving”, reflecting growing alarm that the UK may soon be awash with super-strength drugs.
Synthetic opioids – particularly nitazenes, which can be 500 times stronger than heroin – are now becoming increasingly prevalent in Europe, as the Taliban’s crackdown on opium production chokes heroin supplies, FPH experts wrote in commentary for The Lancet Public Health.
They warned that the 54 nitazene-related UK deaths reported in the past six months by the National Crime Agency are likely just “the tip of the iceberg”, as the emerging drugs are still not routinely tested for in post-mortem toxicologies.
Urging that governments must “find the political capital” to take the more radical steps “needed to prevent many more deaths”, the experts issued the stark verdict: “Actions taken now will not have been taken soon enough.”
These include expanding heroin-prescribing and drug-checking facilities and introducing overdose prevention centres. Widespread calls for the latter are opposed in England by both the Tories and Labour but are now being pursued in Scotland, where there is a political outcry over the scale of the crisis north of the border.
Drug-related deaths in England and Wales also hit a record high of nearly 5,000 fatalities in 2022, having risen for 11 years in a row amid an exodus of opiate users from treatment, as ministers prioritised abstinence over methadone, axed ring-fenced central funding, and shifted responsibility to councils.
“In the context of an existing drug-related deaths crisis, the increase in deaths associated with nitazenes is extremely concerning,” said co-author Dr Adam Holland.
Drug users use an unsanctioned safe consumption van set up by activist and recovering addict Peter Krykant in Glasgow in 2020— (Getty)
“While many colleagues are already doing brilliant work responding to the emergence of nitazenes, we are overdue a broader rethink of our approach to drugs. The evolving drug-related death crisis will not be solved with more stigma and criminalisation.”
The UK’s first nitazene-related death was recorded in 2019 and was followed by a spate of overdoses in the southeast of England in 2021. However, a “big influx” last summer saw nitazenes detected all over the country and increasingly sold in counterfeit tablets, co-author Dr Caroline Copeland told The Independent in December.
While many recent nitazene-related deaths have been linked to contaminated batches of heroin, the opioids are now being detected in a range of prescription products being traded illegally – including fake oxycodone (OxyContin), diazepam (Valium) and alprazolam (Xanax) – as well as in cannabis and illicit vapes.
“This means many consumers are using nitazenes inadvertently, unaware of the risks they face,” Dr Holland, Dr Copeland and four other experts from the FPH, Association of Directors of Public Health, and National Programme on Substance Abuse Deaths warned on Friday.
‘Actions taken now will not have been taken soon enough,’ the experts warn— (Getty/iStock)
“Without concerted action, nitazenes could devastate communities of people who use a range of drugs, including those who use drugs infrequently or source benzodiazepines and opioid painkillers from the internet,” they wrote.
Warning that European law enforcement attempts to crack down on the heroin trade may have exacerbated the growing problem of nitazenes, they lamented that proven public health interventions are often opposed by politicians fearful that the media and public might view them as “condoning drug use”.
“Similar arguments were used to oppose the introduction of other harm reduction interventions such as needle and syringe programmes that subsequently saved countless lives,” they wrote.
“Governments today must again find the political capital to facilitate the policies needed to prevent many more deaths. Actions taken now will not have been taken soon enough.”
A government spokesperson said: “We are highly alert to the threat from synthetic drugs and have already established a cross-government taskforce to coordinate our response to the risk from synthetic opioids, including nitazenes, to the UK.
“Our drug strategy is focused on tackling the supply of illicit drugs through relentless policing action as well as building a world-class system of treatment and recovery to turn people’s lives around and prevent crime.”
The government pledged a record £780m to make England’s drug services “world-leading” in December 2021, after a damning Home Office-commissioned review found the country’s treatment system was “not fit for purpose”, with services “left on their knees” by funding cuts.
