Underreporting of fatalities linked to highly potent synthetic opioids, particularly nitazenes, could be as high as one-third across the United Kingdom. New research indicates that existing toxicology tests may fail to detect the presence of these drugs in postmortem samples, leading to an inaccurate assessment of drug-related deaths. This poses serious implications for public health interventions and harm reduction strategies.
The Rising Threat of Nitazenes
Nitazenes, a class of synthetic opioids, are up to 500 times stronger than heroin. Originally developed as painkillers in the 1950s, their production was halted due to extreme potency and addictive potential. However, they have resurfaced in illicit drug markets, contributing to a sharp increase in overdose deaths. The National Crime Agency (NCA) reported 333 fatalities linked to nitazenes in 2024, but researchers at King’s College London suggest this number is likely a substantial undercount.
Why Are Deaths Being Missed?
The study revealed that nitazenes degrade rapidly in postmortem blood samples, with only about 14% remaining detectable under standard toxicology testing conditions. This means that many overdose deaths caused by these drugs are being classified as other causes. The researchers applied modeling to data from the UK National Programme on Substance Use Mortality (NPSUM) and found evidence of a significant discrepancy in reported overdose deaths in Birmingham in 2023, suggesting that nitazenes were present but undetected in a considerable number of cases.
“If nitazenes are degrading in postmortem blood samples, then we are almost certainly undercounting the true number of deaths that they are causing. That means we’re trying to tackle a crisis using incomplete data.”
—Dr. Caroline Copeland, Senior Lecturer in Pharmacology and Toxicology at King’s College London
Implications for Public Health
The underreporting of synthetic opioid deaths has far-reaching consequences. Incomplete data hinder the effective design and funding of harm reduction programs, leaving communities vulnerable to preventable fatalities. The problem is particularly acute in Scotland, where health experts warn of a new drug deaths crisis linked to highly potent synthetic opioids already responsible for over 100 deaths.
Mike Trace, chief executive of the Forward Trust, emphasized the need for bolder government action: “We cannot afford to be hesitant in providing lifesaving health services to people taking illegal drugs.”
Government Response
The government maintains that it is committed to reducing drug-related deaths and supporting recovery. Border Force has deployed specially trained dogs to detect fentanyl and nitazenes, but experts argue that more proactive measures, such as expanded drug testing and overdose prevention initiatives, are crucial.
The inaccurate reporting of synthetic opioid deaths underscores a critical gap in the UK’s public health response. Addressing this undercount requires improved toxicology testing, comprehensive data collection, and a willingness to implement evidence-based harm reduction strategies.
