Synthetic opioids may have caused hundreds more UK deaths than thought | Opioids

Deaths caused by a synthetic opioid hundreds of times more potent than heroin may have been underestimated by up to a third in the UK, a study has found.

Nitazenes are a class of synthetic opioids that are extremely powerful and up to 500 times more potent than heroin. They were originally manufactured as a pain reliever in the 1950s, but their development was halted due to their extreme potency, leading to a high risk of addiction.

In 2024, the National Crime Agency (NCA) reported that 333 deaths in the UK were drug-related. However, researchers at King’s College London say the true number of deaths may have been underestimated, due to concerns that samples of the drug were likely to be missed during post-mortem toxicology tests.

The study involved researchers testing samples from rats anesthetized with the drug and found that on average, only 14% of the nitazene present at the time of the overdose was still present when tested under real-world pathology and toxicology sample handling conditions.

After this, the academics applied modeling to data from the UK’s National Program on Substance Use Mortality (NPSUM) to reveal that there was a one-third excess of drug deaths in Birmingham in 2023. The researchers concluded that the explanation for this discrepancy could be due to toxicologists not detecting nitazene in these cases.

“As a significant proportion of deaths are likely to be missed, this has serious implications for the accuracy of drug-related mortality data, which is used to inform the design and funding of harm reduction strategies,” said Dr Caroline Copeland, senior lecturer in pharmacology and toxicology at King’s and lead author of the study.

She added: “If nitazenes degrade in post-mortem blood samples, then we are almost certainly underestimating the true number of deaths they cause. This means we are trying to solve a crisis using incomplete data. When we don’t measure a problem correctly, we don’t design the right interventions – and the inevitable consequence is that preventable deaths will continue.”

“Behind this undercount are people dying suddenly from extremely powerful opioids, families left without answers, and communities facing a growing but largely hidden toll. »

Synthetic opioids have become a growing public health problem in recent years. In Scotland, health experts have warned the country faces a new death crisis from highly potent synthetic opioids, already linked to more than 100 deaths.

Mike Trace, chief executive of the Forward Trust and co-creator of the UK’s first national drugs strategy, said: “The extreme potency of nitazenes has clearly contributed to rising overdose and death rates among people who use drugs. This research shows that official figures are likely to be underestimated, supporting our calls for the Government to be more courageous in rolling out drug testing and overdose prevention measures to save lives. lives.”

“With more than 17,000 people each year in the UK dying from drug or alcohol-related causes, we cannot afford to shy away from providing vital health services to people who use illegal drugs.

A Government spokesperson said: “Every death from drug misuse is a tragedy. This Government is committed to reducing drug-related deaths and helping more people recover to live longer, healthier lives.

“We remain on high alert for emerging drug threats, working closely with health departments and law enforcement partners to stay ahead of criminals targeting our communities. Border Force also became the first agency in the world to use dogs specially trained to detect both fentanyl and deadly nitazenes.”