Any headline containing the phrase “super-strength street drugs” is attention-grabbing, and not in a good way. In recent months, such news stories have all seemed to be about the same group of substances: nitazenes.
Nitazenes are often referred to as “synthetic opioids”, which makes them sound similar to fentanyl, oxycodone and tramadol, strong painkillers many are likely to have heard of. This familiarity might stem from one of them having been prescribed for post-surgical analgesia or as part of a cancer management plan, but possibly for a more negative reason such as accounts of addiction or even fatalities. While nitazenes have similar effects to opioids – causing a sense of relaxation and detachment, for example – they are much more potent, and therefore pose a high risk of overdose even in tiny quantities. It is for this reason that nitazenes, despite being around since the 1950s, are regarded as having no medical uses.
However, since 2019, nitazenes have been found in street drugs such as heroin, cocaine and pills in the UK. Not only does this highlight how an illicit – and therefore completely unregulated – drug is an unknown quantity (something we talk about in many of our workshops) but it is also a stark illustration of the harms that can result, with several deaths across the UK attributed to people unknowingly taking nitazenes.
The government is trying to act, last year moving 10 new nitazenes from the New Psychoactive Substances to the Misuse of Drugs Act as Class A substances – those regarded as being the most harmful. But clearly this is not going to have that much of an impact when it comes to street drugs, and particularly so when nitazenes are being used to “cut” other substances rather than being sold as a product in their own right: an NHS alert was issued last summer amid concerns about increasing number of overdose deaths, predominantly among pre-existing drug users.
In turn, this throws light on the need for broader awareness of the signs of an overdose: with nitazenes (and opioids more broadly), this includes unresponsiveness, slowed or impaired breathing, pinprick pupils, skin that is pale and cold, and a blue or greyish tinge to the extremities and lips. It also underlines the importance of naloxone, a medicine that can temporarily reverse the effects of opioid overdose, giving a longer window of time for emergency medics to try and save someone’s life, though the rules around who can carry naloxone differ across the UK.
We don’t get asked much about nitazenes, as at the moment they seem to be impacting a more mature and established group of drug users (rather than the young people who form the majority of our workshop audiences), but that doesn’t mean that they aren’t on our radar. Knowing the wider context is essential to our work as drugs education experts.
