More people are dying from nitazenes – we risk repeating the US fentanyl crisis

On Friday, it was revealed that drug deaths in England and Wales have tragically risen for the eleventh consecutive year, with 5,565 people dying in 2024. 

The data also revealed that nitazenes – potent synthetic opioids, up to 500 times stronger than heroin – are surging with 195 deaths confirmed, up from 52 confirmed deaths the year prior. This comes a month after the figures for Scotland were released, which also revealed an enormous increase in nitazene deaths in 2024, and the first quarter of 2025.

A suspected delay in the recording of nitazene deaths – meaning we might be looking at deaths from over two years ago – gives further cause for alarm, as we do not know the true scale of the crisis, and what the reality on the ground is. 

Cranstoun, the organisation I work for, warned of an increase in nitazenes contaminating the drug supply in 2023, and set out a plan to respond, which was backed by dozens of Parliamentarians and leading experts.

While some of the recommendations have been adopted – including early warning systems, an overdose prevention centre, and the roll out of an additional drug checking facility – wholesale action has been too slow, as the crisis deepens.

On a local level, there are easy-wins which are proven to save lives but are not being adopted. For example, the Big Issue recently covered how two police forces in England are still not carrying anti-overdose medicine naloxone, despite it being highly effective in reversing overdose, and carries very minimal risk. 

Read more:

• My son died after taking deadly nitazenes, aged 33. Why did nobody save his life?
• Scotland faces growing nitazenes threat as it grapples with drugs deaths crisis
• The inside story of nitazenes and the drug deaths crisis rocking Britain: ‘No one is talking about it’

Furthermore, rough sleeping numbers are still also through the roof and people without a home are at a much higher risk of both encountering nitazenes, and using them in particularly unsafe conditions, which will disproportionately affect this group of people, with dire consequences. 

Where action – which should be lauded – has been adopted, the roll out of the measures has been on a very small scale, with just a few centres for drug checking, a single overdose prevention centre, and just a single centre offering diamorphine assisted treatment (often referred to as heroin assisted treatment). Additionally, the latter two interventions named currently only exist in Scotland, where the crisis is particularly bad.

The interventions outlined are all globally evidenced responses to drug harm and fatality which are proven to work, and we urge the government to move at pace to more widely roll out these schemes, before we sleepwalk into a public health emergency without any adequate level of preparedness. 

We have seen from North America, and the opioid crisis there, how quickly the situation can spiral, and how synthetic opioids can become ubiquitous in substances ranging from heroin, opioid pills and even cocaine. The situation there was worsened by both a lack of preparedness and a severe lack of accessible public services, which also demonstrates the need to support treatment providers and emergency responders, who will be tasked with keeping people alive.

It is not too late for the government to take act, but every day that passes without meaningful intervention, funding and bold action is a missed opportunity, and there is growing fear that the situation could deteriorate severely before the adequate level of response is given the go-ahead.

Ant Lehane is the policy lead at Cranstoun, an organisation delivering drug and alcohol treatment services.

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