INSIDE THE NITAZENES CRISIS
Article: Agatha Scaggiante. Illustration: Rory Robertson-Shaw.
For the past two years, the UK has been in the midst of an invisible health crisis caused by nitazenes, a group of powerful synthetic opioids which can be up to 500 times stronger than heroin and ten times stronger than fentanyl.
These synthetic opioids were originally developed for medical use in the 1950s, but have never been made legal. After the Taliban banned poppy cultivation in 2022, herbal heroin became harder to make and sell, making nitazenes more appealing for dealers.
Nitazenes are mostly found in heroin and counterfeit painkillers, but have also been found in party drugs. What makes them so dangerous is that most people don't know they're taking them. They are often added to other drugs by dealers looking to make products stronger and more addictive. This can lead to accidental overdoses, even among experienced drug users.
Nitazenes have been linked to more than 400 deaths nationally since 2023, but experts believe this figure is likely just the tip of the iceberg.
The UK's only national drug death database, called the National Programme on Substance Use Mortality (NPSUM) is led by just one person and receives no consistent funding. As a result, for 2025, we currently do not know how many nitazene-linked deaths there have been.
Out of the UK's 93 coroners, four out of the eight who do not share their drug death data with the NPSUM database are in London, meaning the capital's data is especially patchy.
Nitazenes also 'break down' in the blood, and coroners don't always detect them in post-mortem testing. With all these factors considered, many nitazene-linked deaths are likely being undercounted.
We have been investigating the nitazenes crisis in London's East End, where opiate use is high, as a case study to share with councils across the country.
In Tower Hamlets, we found that rough sleepers are reporting higher rates of overdose and death, believed to be linked to nitazenes and other synthetic opioids. One rough sleeper named Keiran said, 'They're dropping like flies.'
A heroin user, named N, told us that every time he tests his heroin for nitazenes, it comes back positive. 'In the back of my mind, there's a concern especially with when I'm alone,' he said, "At the same time, it doesn't necessarily stop me. It's a concern but…it just makes it more dangerous."
And Dalia, a woman with chronic pain who buys prescription painkillers off the dark web, told us that her counterfeit pills are laced with nitazenes. Due to medical dismissal from her GP and the NHS's current pressure to reduce opioid prescriptions, Dalia feels she has no other choice but to rely on the nitazenes.
"When I do take them, I take a tiny sliver of a pill at a time, and make sure that I'm with someone who has naloxone, just in case anything happens," she said.
Naloxone is an antidote used to reverse an opioid overdose. It can be administered as a nasal spray or injection.
In the digital age of drug dealing, nitazenes are easy to smuggle. Most nitazenes are shipped via the postal system from China, where they are inexpensive and easily synthesised. They are sold on social media, chat apps like Telegram, and through the dark web.
Despite the danger, public awareness is still low. Across the country, many health professionals, pharmacists, and frontline workers haven't been briefed on nitazenes. The medicine naloxone quickly reverses an opioid overdose, but it's not as widely available across the country as it should be.
To fight this under-reported crisis, the UK urgently needs better drug data, more naloxone availability, and better public awareness.
Nitazenes: How to stay safe
Nitazenes pose serious risks, but there are steps you can take to be safer. If you consume heroin or counterfeit pain medication, you are at the highest risk of overdosing from nitazenes.
Where they are found
A couple of years ago, nitazenes were most commonly used to cut heroin. Today, they are still found in heroin but are most commonly found in pain medications, including counterfeit Oxycodone and counterfeit benzodiazepines, such as diazepam. In isolated cases, they have also been found in vapes.
Test your drugs with a DIY kit.
If you do use drugs, there are ways to make it safer. You can test substances for nitazenes using at-home test strips, available for free at many local rehabilitation and harm reduction services.
The test strips work similarly to COVID-19 tests and are easy to use yourself, although not as accurate as lab testing. When testing heroin, harm-reduction experts say that the results are most consistent if you test after you've already cooked up with an acidifier. So prepare it as you normally would in the cooker, then dip a test stick in before you draw up.
Test your drugs at a lab.
WEDINOS is a free and anonymous service in the UK that can tell you what's in your drugs. You can post a small sample to them without giving your name. The test results will be shared on their website: wedinos.org. You will need a postal address to send the sample, and results can take a few days to come back.
Check if you've taken them unintentionally.
If you think you've unknowingly used nitazenes, some drug support services offer urine screenings to detect exposure. It's important to find out because nitazenes may have an impact on your tolerance to methadone or other medication. To find a support service near you, visit talktofrank.com
Naloxone, the overdose antidote
Naloxone is a fast-acting medicine that can temporarily reverse an opioid overdose. It works to reverse overdoses caused by heroin, nitazenes, fentanyl, and any other opioids. It is safe to use even if you're unsure what someone took, and it could save a life.
Because nitazenes are so strong, a second or third dose of naloxone may be needed if there's no response after two or three minutes, or if the person becomes unconscious again after 30–90 minutes.
Always call 999 in an overdose situation, even after giving naloxone. Naloxone is a temporary fix, which keeps someone out of an overdose until they can get medical attention. You won't get in trouble for seeking help.
Naloxone comes as a nasal spray or injection pen and is available for free at many pharmacies and drug services. Your local Council should have a list of places where you can get naloxone for free on their website.
You don't need to be trained to use naloxone, but many places offer free training to make it more effective, which should only take ten minutes.
Safer use tips
While no drug use is completely safe, these tips can reduce the risks:
Start low, go slow. Take a small amount first and wait before taking more.
Avoid mixing drugs, especially with alcohol or other depressants.
Don't use alone. Let someone know what you're taking, so they can help in an emergency.
Carry naloxone and know how to use it.
Call 999 if someone becomes unconscious, has a seizure, or can't be woken.
For reliable and non-judgmental drug information, visit talktofrank.com.
Agatha Scaggiante is deputy editor at Tower Hamlets Slice. She has been investigating the rise of nitazenes as part of an inquiry into the drug in Tower Hamlets.
Each issue we print 40,000 copies, worth £120,000 to our vendors. Your £3/month subscription is used to print 30 copies per issue, worth £90 for our vendors. We went from 1000 copies per issue in 2018 to 40,000 per issue in 2025. The only thing stopping us from doing more is money. With your support, we can go even further. Help us print and distribute more copies for free to anyone who wants to sell it by becoming a monthly subscriber.