The synthetic opioid nitazene is being mixed in with other street drugs, due to opium shortages.
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A looming gap in the opiate market is being filled by synthetic drugs such as nitazenes; a drug that experts and charities warn is causing unaccounted deaths in the capital.
Almost non-existent post-mortem testing for these drugs, alongside severely backlogged coroner services means that the number of nitazene-related deaths could be far more widespread than currently recognised.
Nitazenes are not typically tested for in post-mortem examinations.
Caroline Copeland, Director of the National Programme of Substance Abuse Deaths (NPSAD), said a “standard drug screen for a coroner costs between £200 to £400. If you have that report returned to you saying there’s fentanyl and heroin detected, you’re probably not going to go looking for anything else, as that itself is sufficient to cause death.”
Whilst more toxicology labs have started to add nitazene to their testing capabilities since a spike in drug-related deaths this summer, it doesn’t necessarily mean that these specific tests are requested.
Dr Copeland also warned that slow coronary services mean that statistics on current nitazene-related deaths are facing a backlog.
Whilst at the moment statistics show a spike in deaths in the West Midlands, Birmingham’s coronary service is “one of the quickest in the country in terms of releasing inquests and concluding inquests, they have an average of about three months. London’s delay is two years between death and conclusion of inquest”, meaning the number of nitazene deaths across London remains unaccounted for.
UK unprepared for ‘worrying’ rise in nitazene deaths
Jon Findley, the National Harm Reduction Lead at Humankind, a charity offering help for drugs and alcohol abuse, identified common concerns across grassroots organisations, for what an opium shortage could mean for the UK.
“I talk to other treatment providers and we’re really concerned about how ready we are in the UK for potent synthetic opioids. We’ve seen what’s happened in America – it’s really worrying…what’s coming – we just need to start getting ready for.”
Jon Findley warned that we are facing “a heroin drought in the next 12 months which we probably haven’t seen in two decades.”
He cautions that this will have a direct impact on street drug use in the UK, with sellers using nitazenes and other synthetic opioids to “bulk out heroin they’ve already purchased, instead of having to buy it at a much more inflated price.”
The impact so far
Production of opium, which is mainly exported from Afghanistan, declined dramatically after a ban by the Taliban de-facto authorities in April last year.
Whilst the total opium harvest in 2022 was 6,200 tonnes, in 2023, it fell to just 333 tonnes, according to the United Nations Office on Drugs and Crime (UNODC).
Since opium export takes roughly a year to hit UK streets, the consequences of this shortage can be expected in the coming months.
Since the Taliban banned opium production last year, Afghanistan’s agricultural landscape has changed significantly. CREDIT: COPYRIGHT ALCIS 2023, BASEMAP COPYRIGHT ESRI
Opium prices have soared since the announcement of the ban, meaning old batches of drugs are now often cut with synthetic opioids to make them go further.
Whilst heroin is most often contaminated with these synthetic opioids, they have also been traced in other illicit drugs, such as black market diazepam, percocet and even cannabis-infused vaping liquids.
The scale of the issue is reflected in the Government’s recent decision, following advice from the Advisory Council of the Misuse of Drugs (ACMD), to classify 14 new nitazenes as Class A drugs, after a rise in drug-related deaths.
Around 150,000 tablets of nitazene were found in a raid in Waltham Forest.
Detective Superintendent Helen Rance who led the investigation, said that:
“Synthetic opioids have been detected in batches of heroin found in London and across the UK; they substantially raise the risk of incredibly serious harm to the user and are believed to be linked to a number of deaths.”
Why can nitazenes be fatal?
The danger lies, according to Jon Findley, in the fact that people are unaware that they are taking nitazenes. Although naloxone, the drug administered to counteract opioid overdose can also be used to treat a nitazene overdose, the disparity in type and potency means the amount of naloxone required varies.
To understand nitazenes’ strength, if the potency of heroin (or its major constituent morphine) is 1, fentanyl is 50 to 100 times more potent.
Protonitazine is 200 times more potent.
Isotanitizine is 500 times more potent, and etonitazine is 1,000 times stronger.
Naloxone is only effective against less potent opioids.
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HeadlineBacklogged coroner services means number of synthetic opioid deaths in the UK is unknown
Short HeadlineExperts warn of potential opioid crisis
StandfirstThe exact number of nitazene-related deaths is currently unknown, due to lack of testing and backlogged coroner procedures.
A looming gap in the opiate market is being filled by synthetic drugs such as nitazenes; a drug that experts and charities warn is causing unaccounted deaths in the capital.
Almost non-existent post-mortem testing for these drugs, alongside severely backlogged coroner services means that the number of nitazene-related deaths could be far more widespread than currently recognised.
Nitazenes are not typically tested for in post-mortem examinations.
Caroline Copeland, Director of the National Programme of Substance Abuse Deaths (NPSAD), said a “standard drug screen for a coroner costs between £200 to £400. If you have that report returned to you saying there’s fentanyl and heroin detected, you’re probably not going to go looking for anything else, as that itself is sufficient to cause death.”
Whilst more toxicology labs have started to add nitazene to their testing capabilities since a spike in drug-related deaths this summer, it doesn’t necessarily mean that these specific tests are requested.
Dr Copeland also warned that slow coronary services mean that statistics on current nitazene-related deaths are facing a backlog.
Whilst at the moment statistics show a spike in deaths in the West Midlands, Birmingham’s coronary service is “one of the quickest in the country in terms of releasing inquests and concluding inquests, they have an average of about three months. London’s delay is two years between death and conclusion of inquest”, meaning the number of nitazene deaths across London remains unaccounted for.
UK unprepared for ‘worrying’ rise in nitazene deaths
Jon Findley, the National Harm Reduction Lead at Humankind, a charity offering help for drugs and alcohol abuse, identified common concerns across grassroots organisations, for what an opium shortage could mean for the UK.
“I talk to other treatment providers and we’re really concerned about how ready we are in the UK for potent synthetic opioids. We’ve seen what’s happened in America – it’s really worrying…what’s coming – we just need to start getting ready for.”
Jon Findley warned that we are facing “a heroin drought in the next 12 months which we probably haven’t seen in two decades.”
He cautions that this will have a direct impact on street drug use in the UK, with sellers using nitazenes and other synthetic opioids to “bulk out heroin they’ve already purchased, instead of having to buy it at a much more inflated price.”
The impact so far
Production of opium, which is mainly exported from Afghanistan, declined dramatically after a ban by the Taliban de-facto authorities in April last year.
Whilst the total opium harvest in 2022 was 6,200 tonnes, in 2023, it fell to just 333 tonnes, according to the United Nations Office on Drugs and Crime (UNODC).
Since opium export takes roughly a year to hit UK streets, the consequences of this shortage can be expected in the coming months.
Since the Taliban banned opium production last year, Afghanistan’s agricultural landscape has changed significantly. CREDIT: COPYRIGHT ALCIS 2023, BASEMAP COPYRIGHT ESRI
Opium prices have soared since the announcement of the ban, meaning old batches of drugs are now often cut with synthetic opioids to make them go further.
Whilst heroin is most often contaminated with these synthetic opioids, they have also been traced in other illicit drugs, such as black market diazepam, percocet and even cannabis-infused vaping liquids.
The scale of the issue is reflected in the Government’s recent decision, following advice from the Advisory Council of the Misuse of Drugs (ACMD), to classify 14 new nitazenes as Class A drugs, after a rise in drug-related deaths.
Around 150,000 tablets of nitazene were found in a raid in Waltham Forest.
Detective Superintendent Helen Rance who led the investigation, said that:
“Synthetic opioids have been detected in batches of heroin found in London and across the UK; they substantially raise the risk of incredibly serious harm to the user and are believed to be linked to a number of deaths.”
Why can nitazenes be fatal?
The danger lies, according to Jon Findley, in the fact that people are unaware that they are taking nitazenes. Although naloxone, the drug administered to counteract opioid overdose can also be used to treat a nitazene overdose, the disparity in type and potency means the amount of naloxone required varies.
To understand nitazenes’ strength, if the potency of heroin (or its major constituent morphine) is 1, fentanyl is 50 to 100 times more potent.
Protonitazine is 200 times more potent.
Isotanitizine is 500 times more potent, and etonitazine is 1,000 times stronger.
Naloxone is only effective against less potent opioids.
