A new nitazenes alert has been issued by Public Health Scotland’s Rapid Action Drug Alerts and Response (RADAR) early warning system. Aimed at people working and volunteering in drug services, emergency services, healthcare settings and ‘high-risk’ environments like hostels and prisons, the alert urges people to follow the correct harm reduction advice for opioids and polydrug use, and to ‘promote and provide’ naloxone.
Nitazenes are now being widely detected in all parts of Scotland in both community and custodial settings, the alert stresses, posing a ‘substantial risk of overdose, hospitalisation and death’. They were present in 6 per cent of all post-mortem toxicology samples testing positive for a controlled drug in the first quarter of this year, it states, as well as 4 per cent of emergency department samples taken as part of the PHS ASSIST project between February and May.
The WEDINOS drug testing service has also detected nitazenes in more than 50 samples from ten Scottish NHS boards since 2022, it adds. While almost 60 per cent were in samples purchased as heroin, more than 20 per cent were purchased as oxycodone and 17 per cent were bought as benzodiazepines, usually diazepam. While the signs and response actions for nitazenes are the same as any other opioid overdose, their increased strength means the overdose ‘may be more sudden and severe’, the alert points out, adding that Scotland’s drug supply is ‘increasingly toxic and unpredictable’. PHS warned earlier this year of an increase in ‘sudden and rapid collapse overdoses’ requiring multiple doses of naloxone to reverse, with a ‘nitazene-type opioid’ linked to many (https://www.drinkanddrugsnews.com/public-health-scotland-issues-warning-after-increase-in-sudden-overdoses/).
NHS Ayrshire & Arran became the latest Scottish health board to issue its own nitazene warning earlier this month (https://www.drinkanddrugsnews.com/nhs-ayrshire-arran-issues-nitazene-warning/), while the most recent RADAR quarterly report warned that suspected Scottish drug deaths in the period March to May were up 15 per cent on the previous quarter and naloxone administration incidents had increased by 45 per cent (https://www.drinkanddrugsnews.com/drug-related-harms-on-the-increase-across-scotland-warns-phs/). The most recent Scottish drug death figures showed a total of 1,172 fatalities in 2023, four times the total in 2000 and by far the highest death rate in Europe.
Rapid Action Drug Alerts and Response (RADAR) alert: nitazenes at https://publichealthscotland.scot/publications/rapid-action-drug-alerts-and-response-radar-alert-nitazenes/rapid-action-drug-alerts-and-response-radar-alert-nitazenes-version-20/public-health-alert-for-action-nitazene-type-drugs-in-scotland/