Nitazenes - heralding a second wave for the UK drug-related death crisis?

Adam Holland, Caroline S. Copeland, Gillian Shorter, Dean J. Connolly, Alice Wiseman, John Mooney, Kevin Fenton, Magdalena Harris

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
18 Downloads (Pure)


The UK is in the midst of a drug-related crisis. Likely contributory factors include: disinvestment in drug treatment, harm reduction, and public services; changing patterns of socioeconomic deprivation; increasing poly-drug use; and an ageing cohort of people who use heroin. The UK crisis has not reached the scale of that in the US where 106 699 overdose deaths were reported in 2021. The latest wave of the crisis in the US has been driven primarily by fentanyl and other synthetic opioids, which were implicated in 88% of these deaths.

Highly potent synthetic opioids have not played such a prominent role in rising deaths among people who use drugs in the UK. Global drug markets are, however, rapidly evolving. Of particular concern is the emergence of nitazenes: a class of synthetic opioids developed by the pharmaceutical industry in the 1950s but never approved as medicines. Like other opioids, nitazenes can cause fatal respiratory depression, and some are hundreds of times more potent than heroin (table). In the UK, nitazenes have been detected in substances sold as other opioids, benzodiazepines, and cannabis products. This means many consumers are using nitazenes inadvertently, unaware of the risks they face.

Original languageEnglish
Pages (from-to)e71-e72
Number of pages2
JournalThe Lancet Public Health
Issue number2
Early online date12 Jan 2024
Publication statusPublished - Feb 2024


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