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‘Profound’ threat of lethal synthetic opioids is growing in Europe, officials warn

Drug users prepare heroin before injecting at an overdose prevention centre set up in Glasgow by activist Peter Krykant in 2020  (Jeff J Mitchell/Getty Images)
Drug users prepare heroin before injecting at an overdose prevention centre set up in Glasgow by activist Peter Krykant in 2020 (Jeff J Mitchell/Getty Images)

Super-strength synthetic opioids pose a growing threat to Europe and could have a “profound” impact on public health, officials at the European Union’s drugs monitoring agency have warned.

The Taliban crackdown on opium production in Afghanistan has raised fears that dwindling heroin supplies could see the gaps in Europe’s illicit drug markets instead flooded with lethally potent synthetic opioids, known as nitazenes, which can be 500 times stronger than heroin.

Experts and frontline drug services in the UK have been sounding the alarm for months over the increasing prevalence of nitazenes, which have been found in the past two years to have contaminated not just heroin, but also illicit vapes, diazepam and codeine.

Despite not all coroners yet testing for the drugs, the National Crime Agency was reported to have identified 65 nitazene deaths in the second half of 2023 alone – with detections in drug supplies soaring fivefold in two years. In November, police seized 150,000 nitazene tablets in London, in the UK’s largest-ever synthetic opioid haul.

In January, experts at the Faculty of Public Health warned that, with global drug markets “rapidly evolving”, a potential influx of nitazenes could fuel a “second wave” of the UK’s current drug deaths crisis. Britain already suffers thousands of fatal overdoses every year, despite so far being spared a US-style opioid epidemic.

Writing in the Lancet Public Health journal that those deaths confirmed by the NCA are likely just “the tip of the iceberg”, those experts urged governments to “find the political capital” to take the more radical steps “needed to prevent many more deaths”.

Their warning has now been highlighted by the EU’s drugs monitoring agency, which published a response in the same journal pointing to rapid increases in fatal overdoses in countries where nitazenes are already prevalent.

“Nitazenes pose a credible threat,” wrote five experts at the European Monitoring Centre for Drugs and Drug Addiction, adding: “Predicted changes in heroin availability in Europe could herald an increase in the use of synthetic opioids with possibly profound implications for public health.”

Lethal synthetic opioids have already been detected in the UK in heroin, and illicit vapes and diazepam (Getty Images)
Lethal synthetic opioids have already been detected in the UK in heroin, and illicit vapes and diazepam (Getty Images)

Noting that Baltic countries “have a long history of synthetic opioid problems dating back to an earlier Taliban ban on opioid production, and can serve as an early indicator of a more generalised future problem”, they pointed to Estonia and Latvia as examples showing how nitazenes can fuel a rapid rise in overdoses.

While nitazenes were first detected in Estonia in 2019, by 2022 they were implicated in 39 per cent of Estonia’s 82 drug deaths that year. The number of fatal overdoses in Estonia rose sharply to 117 the following year, with nitazenes implicated in just under half of these deaths.

Across the border in Latvia, nitazenes were detected in just two of the 63 fatal overdoses the country suffered in 2022. The following year, the total number of drug deaths more than doubled to hit 130, with nitazenes identified in 38 post-mortem toxicologies.

Noting that the “worrying” preliminary figures for 2023 could be underestimates, the researchers warned of signs that “problems associated with nitazenes might be growing in the EU”, with fatalities reported as far afield as the French island of Reunion, in the Indian Ocean, and non-fatal overdoses in Ireland.

Backing the call in January for governments to “find the political capital to facilitate the policies needed to prevent many more deaths”, the EU experts warned: “We cannot assume that existing approaches to responding to opioid problems will be sufficient without adapting to the challenges posed by the appearance of a range of highly potent but pharmacologically diverse substances.”

Warning that “actions taken now will not have been taken soon enough”, the experts in January called for the expansion of heroin-prescribing and drug-checking facilities, and the introduction overdose prevention centres – widespread calls for which are opposed in England by both the Tories and Labour.