Emergency advice released for Tower Hamlets to battle the nitazene and synthetic opioid crisis

New guidance from the Government for local authorities to fight synthetic drug deaths says Tower Hamlets must expand harm reduction, review its strategy and improve information gathering

Nitazenes are a potent class of synthetic opioids that have linked to at least 400 drug-related deaths since June 2023. After years of warnings from grassroots groups, scientists, and charities raising the alarm on synthetic opioids, the government has finally acknowledged the growing crisis.

Last week, the Central government released its Local Preparedness for Synthetic Opioids report, which outlines urgent recommendations for local authorities nationwide. Every borough has been asked to submit a synthetic opioid awareness plan, including Tower Hamlets. 

The timing is critical. Experts warn that due to significant gaps in drug testing, the 400 reported deaths are likely only the tip of the iceberg, with the true number of nitazene-related fatalities expected to be far higher.

In Tower Hamlets, the number of deaths linked to nitazenes is currently unknown – it is one of the few boroughs where the coroner is not releasing data. However, the borough claims to have the highest number of opiate users in drug treatment in London, and local rough sleepers have reported a spike in unusual deaths and overdoses due to synthetic opioids.  

Although the report is a welcome step in addressing this health crisis, some have critiqued it for shifting responsibility to a local level. Will Haydock of Collective Voice, a national charity working to improve England’s drug and alcohol treatment and recovery system says, ‘Athough the report’s recommendations are sensible, they focus on what can be done at a local level, begging the question: what is the Government itself planning to do to address this potential crisis?’

The Government’s Local Preparedness for Synthetic Opioids report contains 12 recommendations; we consider three of the most relevant for Tower Hamlets.

Recommendation #1: Combatting Drugs Partnerships (CDPs) should review their preparedness plans 

The Tower Hamlets CDP is reviewed yearly, however, currently, a dedicated synthetic opioid strategy has not been put in place. Councillor Abu Talha Chowdhury is the lead cabinet member for Safer Communities, which helps deliver the CDP. He told the Slice that a synthetic opioid preparedness strategy is ‘in development.’ 

Chowdhury confirmed that nitazenes are of concern locally, saying, ‘I’ve seen it sort of ramp up in the last year or so, but I’ve been sighted on it for over two years.’

The Tower Hamlets CDP is currently being restructured, with plans to award contracts to service providers based on how well they perform on specific outcomes. 

In theory, this will mean that a more diverse offering of drug support services, including the opening of a new culturally sensitive treatment centre, which will have staff from a variety of backgrounds. 

‘Currently, the treatment service is in front of a mosque, probably one of the biggest mosques in Europe,’ Chowdhury said, ‘So for Muslims to walk in there, there is this issue of stigma.’ The CDP has earmarked £500k a year for the new culturally sensitive treatment centre, and if approved by the Council, it will open this year. The centre has been advocated for repeatedly by grassroots organisations like Coffee Afrik. 

In addition, a new dedicated group of Tower Hamlets Enforcement Officers (THEOs) will specifically target drug crime and anti-social behaviour in the borough.

For the moment, assessment of the CDP or the Council’s preparedness for synthetic opioid treatment is speculative. 

The Council still needs to submit a synthetic opioid preparedness plan to the central government, and the overhaul to its drug support services doesn’t go into effect until September. 

Recommendation #2: We need to make sure that naloxone (the antidote to opioid overdose) is sufficiently available across the borough. 

Through the course of our investigation, we’ve heard repeatedly from experts that harm reduction materials like naloxone and clean needles are one of the most cost-effective and successful ways to fight the opioid death crisis. 

Katherine Watkinson from Turning Point, a drug recovery and social care charity, recently explained to the BBC that there is little to no risk associated with administering naloxone, even to someone who has another health condition or doesn’t need it. 

‘That’s why we’re really supportive of it being out in communities, be that through police officers, we’ve trained taxi divers, ubers drivers…’ Watkinson explained, ‘We had a case recently where we had a group of overdoses that happened near an ice cream kiosk, so we’ve trained the staff in the ice cream kiosk, because it’s identified that they’re likely to be the first people on the scene.

It’s making sure that it is available to be administered as quickly as possible when there is somebody who needs it.’

The new CDP claims it will expand harm reduction supplies like naloxone ‘into wider settings that people who misuse substances access routinely.’ In practice, this could mean an expansion of services like Release’s harm reduction hub, which gives out free nitazene test kits, legal and medical advice, clean needles, naloxone and more. 

Release’s open-door hub currently receives only £10k from the Council, and the CDP is not clear if the service will receive further funding this year. 

THEOs, criminal enforcement officers who patrol the streets, have also now received naloxone training. This means they can safely administer the life-saving antidote if needed to reverse an opioid overdose. 

Chowdhury explained that the decision to provide naloxone training to THEOs was based on the perception that many drug users in the borough were already carrying it. ‘It got to the point where so many users had naloxone already that we weren’t giving away all of the naloxone we had, which I think is a testament to the borough being well prepared,’ he said.

However, pharmacists in Tower Hamlets, who help distribute naloxone and clean needles for free, paint a different picture. While they report high use of the clean needle programme, several said that naloxone isn’t as widely taken up and that uptake could be significantly improved.

Dani Singer from Safe CIC, a local charity which distributes harm reduction supplies, was sceptical that there was an excess of naloxone, and said that many drug users in Tower Hamlets don’t have access to it. ‘If they’ve got too much, then they aren’t distributing it enough,’ Singer said, ‘You can’t get it that easily at all.’ 

When asked for further comment, the Councillor said, ‘Our understanding from ongoing and regular conversation with a wide range of support services is that there is enough naloxone in circulation. We work closely with a wide range of organisations who are best positioned to support opiate users, and ensure all these organisations have naloxone.’ 

So, is the borough well stocked with naloxone because it’s well prepared, as the Councillor suggests, or because too few people are taking it due to a lack of awareness or education?

Recommendation #3: Local Drug Information Systems need support and better data. 

The Council’s Local Drug Information System (LDIS) is a network of information from local stakeholders like rehabilitation services, charities, medical professionals and police. The LDIS helps us understand if the drug supply is infected with synthetic opioids, and sends out alerts and warnings.

Isaac Hoeschen, Cllr. Chowdhury’s cabinet support officer explained that ‘In the last three months of 2024 was the first time we received a formal alert [about nitazenes] and since then we’ve received one other formal alert, both of which were triggered by non-lethal overdoses.’

He added that ‘[Nitazenes are] not the sort of thing that is moving around nightlife venues or constantly pressing in the borough yet.’

The accuracy of an LDIS depends on which stakeholders are involved and how well they communicate. For example, the Aldgate-based charity Release put out a warning about nitazenes nationally in 2021. However, Release only became part of the LDIS last year, so any earlier warnings would not have been passed on in the LDIS. 

The new central government advice says, ‘It is best practice for local coroners and LDIS to collaborate when potent synthetic opioids are confirmed to be present in post-mortem toxicology.’ 

In Tower Hamlets, it is currently not possible to assess whether bodies are being tested for synthetic opioids like nitazenes, or what testing methods are being used, if any. 

Shayla Schlossenberg from Release is sceptical that the risk of synthetic opioids is being accurately assessed. ‘I think they’re giving an answer based off of something they don’t know,’ they said. 

Singer, from Safe CIC, feels that the number in Tower Hamlets (just two non-fatal overdoses and no fatal overdoses linked to synthetic opioids) is unlikely to be accurate. ‘I just think that can’t be true,’ Singer said, ‘There’s so much that’s unreported,’ 

The local coroner is not releasing data to public health groups and/or scientists on nitazene-related deaths, leaving it unclear whether testing is taking place at all or how long it takes for a post-mortem to be conducted. The coroner does produce an internal report for the CDP whenever there is a drug death. 

Recent studies have also shown that toxicology testing for nitazenes is not as reliable as previously thought. Coroners will need to change the way they test for nitazenes in order to accurately record deaths. 

When asked how non-fatal overdoses (NFO) are being tested for, the Councillor said, ‘We have nitazene testing strips in all our services and hostels/supported housing. In case of an NFO, service users (or service staff) can use testing strips to test the substance involved. Even without strips, in many cases the users and their peers, are able to self-report what they understand to be involved.’

To understand if we are tracking synthetic opioids well locally, we can look at other boroughs with similar numbers of opioid users. In Camden, for example, which had the same number of drug deaths as Tower Hamlets in 2023 (14), there were 32 non-fatal overdoses believed to be caused by nitazenes in March 2025.

What’s next?

Tower Hamlets finds itself at a critical juncture in the fight against synthetic opioids like nitazenes. While the borough has taken some steps – from naloxone training for enforcement officers to developing a culturally sensitive treatment centre – serious gaps remain. 

Mixed messages from officials and frontline workers highlight a disconnect between perceived preparedness and the on-the-ground reality.

In addition, it’s not yet clear if the LDIS is effective at assessing local risk. With no clear data from the coroner, it’s also impossible to track the true impact of nitazenes locally. 

Without accurate testing, better public education, and properly resourced harm reduction services, the borough risks flying blind in the face of a growing national crisis.

Whether Tower Hamlets will lead on this issue, or be left reacting too late, depends on how quickly it can turn plans into action, and whether it listens to the people on the front lines of the opioid epidemic.

Read our synthetic opioids series from the beginning: The arrival of an invisible killer: Is Tower Hamlets ready for Nitazenes?