In 2023, our Stayin’ Alive campaign stated that drugs are changing, and this is even more true in 2024.
A range of drugs across the UK continues to be contaminated with nitazenes, synthetic cannabinoids, novel benzodiazepines and occasionally xylazine. The risk of overdose leading to death or other adverse consequences remains very high.
Nitazenes can be up to 500 times more potent than heroin and there have been at least 65 deaths involving nitazenes across the UK, with many more yet to be confirmed via the coronial process. Nitazenes are not universally tested for when someone dies from drug-related causes – this means there are likely to be many more deaths than we are aware of where nitazenes have been involved. It’s also likely that deaths involving nitazenes will continue to rise as heroin supplies in the UK dwindle as a result of the Taliban’s ban on growing the opium poppy in Afghanistan.
WEDINOS
We are very grateful to WEDINOS and other drug checking facilities such as The Loop and MANDRAKE for their work identifying these contaminants. We’ve encouraged people to test their drugs via WEDINOS, a free service available across the UK. To meet the needs of people using illicit drugs in the face of changing drug markets, however, changes in process and allocation of resources are urgently required.
With the high potency of nitazenes, it’s essential that we can get drugs checked before they’re used. Currently, there is a delay of at least several days or sometimes weeks. It’s highly unlikely that people who use drugs will wait this long for results before consuming them and an unrealistic expectation for people who may be dependent on the drugs they use.
Positive Developments
One recent positive development is the wider availability of self-test lateral flow immunoassay tests for nitazenes and xylazine. While these are welcome, they are only part of what’s needed. Technology exists to make mobile, hand-held testing devices that give instant results and, importantly, an indication of purity levels – something self-tests are unable to provide. Armed with these devices, our dedicated teams and outreach workers could make a much bigger difference to the safety of people at such severe risk of overdose.
We must get upstream of the use of these drugs if we are to prevent more needless deaths. A range of unnecessary obstacles prevent us from achieving more effective drug checking and saving lives. Difficulties obtaining Home Office licences and restrictive legislation leaves our workforce with their hands tied. Supporting people to get their drugs tested opens them up to the risk of prosecution for possession and supply (when handing over for testing) of illicit drugs.
Barriers to effective checking
We are deeply frustrated by the barriers preventing more effective drug checking and are devastated by the continued deaths from contaminated drugs. Worse still, we know that we can prevent more deaths with proactive service or outreach-led drug checking – we’re frequently told by people who use drugs that they are worried they will die, that they want to have their drugs checked, and would adapt their drug use according to the results. We must change this. And we can.
We urge the Home Office to work with our sector to allow for more easily obtainable drug testing licenses. We would also welcome the chance to work with local authority commissioners to discuss how the current supplementary treatment grant could be used to fund this vital work. This funding would cover the cost of making handheld testing devices and lab testing more readily available. Furthermore, we believe OHID should underline drug testing as a national priority in our collective effort to save lives.
Working together
Together, we can remove the unnecessary barriers to drug testing, capitalise on the unique access and contact our services have with people who use drugs, and ensure people are equipped to be kept safer from the increased risks posed by contaminated drug supplies.
We’ve come a long way in some respects – widespread naloxone availability is a great example of progress, as is some police forces enabling their officers to carry naloxone. We work every day to attract, engage and retain people in treatment, a system well known to also reduce the risk of death. But we’re all too aware of the reality that some people will continue to use illicit drugs. There must be swifter, more radical progress on drug checking if we want to reduce drug overdose deaths in the UK.
Peter Furlong is national harm reduction lead at Change Grow Live; Chris Rintoul is innovation and harm reduction lead at Cranstoun; Iain ‘Buff’ Cameron is project manager, harm reduction services at Extern; Maddie O’Hare is deputy director of HIT; Jon Findlay is national harm reduction lead at Humankind, and Deb Hussey is national safer lives lead at Turning Point.
Related articles:
(Features, November 2023): Stayin’ Alive – A new family of synthetic opioids, known as nitazenes, have adulterated a number of illicit drugs in the UK.
(News, December 2023): Nitazenes detected in 25 Scottish drug deaths
(News, August 2023): Better utilisation of data and data sharing, including early warning systems, is needed to address the escalating drug crisis in the UK
(Partner Updates, September 2023): Release, alongside EuroNPUD and other drug treatment service colleagues in the UK, have produced harm reduction advice on nitazenes.
(News, January 2023): Fentanyl behind 80% increase in New York’s overdose deaths
(Features, June 2017): Meet the Fentanyls, a guide to the fentanyl family by Kevin Flemen.
Search the DDN archive for more on nitazenes, fentanyl and synthetic opioids.