Mapping a crisis: As synthetic opioid deaths rise, UK drug data is full of blind spots
Nitazenes are evolving, but without reliable data on drug deaths, consumption or supply routes, how can local authorities respond?
The dangerous new synthetic opioids called nitazenes are a rising risk in the UK drug supply.
This new crisis has worrying echoes of the US’s fentanyl deaths crisis. Just like fentanyl, nitazenes were first spotted as an issue in the heroin supply. Now, they are being found in a wide range of fake pharmaceuticals and recreational drugs.
As governments catch on to the risk, there has been a scramble for better testing and new legislation. The challenge is that as soon as one type of synthetic opioid is legislated against, a cheaper, stronger version is waiting in the wings. After fentanyl, it was nitazenes. After nitazenes, who knows?
To fight the threat of new synthetic opioids, we need to spot patterns as they emerge. To do this, we need reliable data. Data can help set strategies, policies and developments in drug testing. Without it, we’re working in the dark.
Data on nitazene deaths
Dr. Caroline Copeland is a Senior Lecturer in Pharmacology & Toxicology at King’s College London. The day we met in March, Copeland was still on maternity leave. While her newborn napped, Copeland slipped away for a quick coffee to share her insights on the UK’s nitazenes crisis.
Copeland is the director of the National Programme on Substance Use Mortality (NPSUM), which administers the UK’s only drug death database. It is the only record we have of national drug deaths from 1997 to the present day.
What is staggering to learn is that Copeland runs the project on her own with no consistent funding. She is assisted only by her Phd students and relies on sporadic contributions from small grants to cover costs.
To ensure drug deaths in the last year didn’t go unrecorded among a rising synthetic opioid threat, Copeland has been working throughout her maternity leave.
‘It is kind of crazy that there’s not someone who will help fund it,’ Copeland said, ‘But a lot of the government schemes, charity schemes, they won’t fund data collection. They’ll fund research for a project, but not for routine data collection.’
To compile the data, Copeland relies on the voluntary cooperation of individual coroners across the country, who are under no legal obligation to share information. When they do, she receives the results of drug-related post-mortems, which must then be painstakingly translated into usable data.
Since June 2023, Copeland has identified at least 400 nitazene-related deaths, a figure she describes as ‘the tip of the iceberg’ for three key reasons.
Firstly, the available data only extends to May 2024, as further updates have been delayed during Copeland’s maternity leave due to a lack of funding to support interim staffing.
Secondly, although coroners have been recommended to test for synthetic opioids by the Chief Coroner since 2023, it’s not clear to what extent this advice has been followed. In addition, toxicology for nitazene testing remains inaccurate.
Thirdly, the data from coroners themselves is incomplete, as it is up to the discretion of each individual coroner whether or not to share data. We know that eight of the 93 coroners in the UK do not share their results with the NPSUM database.
Of those eight, four are based in London, one of the areas of highest concern for synthetic opioid deaths in the UK. This includes the coroner who oversees Tower Hamlets.
As a consequence of these failings, our most robust source of data on UK drug deaths is patchy, with nearly 10% of data missing outright, the rest potentially flawed, and the whole project struggling to sustain itself.
The entirety of the UK’s drug death data should not be dependent on the goodwill of one person. Data from NPSUM has been crucial in understanding the nitazenes crisis. If we want to respond to future drug threats quickly, the database will need robust support to keep going.
Data mishandling
Tower Hamlets has a Local Drug Information System (LDIS), which receives information from local stakeholders such as rehabilitation services, charities, medical professionals and police. This data is then used to assess local response.
According to Tower Hamlets Council, the borough has only seen two overdoses linked to nitazenes, both nonfatal. However, the LDIS is either missing crucial information, or information is being fed in too slowly for an effective response.
The Slice has found evidence of a death caused by nitazenes in Tower Hamlets on 19 September 2024. Frederick Ireland-Rose died as a result of ingesting nitazenes using a vape, according to an inquest report. According to his family, Ireland-Rose was born and died in Whitechapel’s Royal London Hospital.
A Slice investigation from January 2024 revealed a surge in reported deaths among the rough sleeper population in Tower Hamlets, believed to be linked to nitazenes.
A potential solution could be a system like Scotland’s Rapid Action Drug Alerts and Response (RADAR) system, which collects a broader range of data (sometimes unverified) in order to prioritise quicker responses.
Dr. Tara Shivaji, a consultant at Public Health Scotland (of which RADAR is part of), told the Slice, ‘One of the things that we realised was that the information that we were getting about what was causing these deaths was taking far too long to get to us. So by the time someone’s had a post-mortem and you know what drugs have been in their system, you’re often talking six months, sometimes a year after they’ve died.’
To improve speedy response, RADAR has set up what Shivaji calls ‘a pyramid of data.’ Well-verified information, such as an inquest report, is a the top of the ‘pyramid’ and has the highest priority. However, drug support groups, members of the public and various other local stakeholders can easily feed tips into the RADAR system, allowing them to spot emerging trends quickly.
‘The founding principles of RADAR are about how do we connect across the system to join up bits of information that sit in within different organisations […] So we’re able to, in a more timely way, assess these threats,’ Shivaji said.
To improve the response speed of local drug information systems such as the Tower Hamlets LDIS, an approach like RADAR’s is a promising potential solution.
Data on nitazene consumption
Consumption data allows us to learn which drugs are being laced with nitazenes and provides early warning signals of successors, helping to develop more effective public health responses.
However, as nitazenes are commonly used to cut other products, most people don’t know they’ve taken them. This means the only way to gather data on consumption is post-mortem, or by testing drugs before they are consumed.
In the UK, there’s only one initiative that offers the public accurate and anonymous drug analysis – WEDINOS, or more formally, the Welsh Emerging Drugs & Identification of Novel Substances Project.
The data it yields provides a timely – if incomplete – insight into emerging drug trends.
The first time nitazenes were detected in a drug sample was via a WEDINOS sample in April of 2021. WEDINOS issued an alert both nationally and internationally as a result, which allowed health workers to prepare for the new threat.
Professor Rick Lines, Head of Substance Misuse and Vulnerable Populations for Public Health Wales, of which WEDINOS is a part, said nitazenes have been detected at least once in ‘pretty much everything,’ including a vape which was supposed to contain concentrated THC.
‘One of the things we’ve learned from WEDINOS over the last 11 or 12 years is there’s just a huge amount of substitution within the illicit market,’ said Lines.
In 2025, WEDINOS processed 110 samples, which were found to contain nitazenes. Interestingly, in four cases, the sender said they’d intended to purchase nitazenes, suggesting that trends could be shifting to intentional use of nitazenes.
However, Lines stressed that WEDINOS samples don’t show an accurate picture of the UK drug market. The samples give insight into the drugs people want to test, not the proportion of drugs in the market.
‘We had this in Cardiff a couple of years ago where there were a number of fatal and non-fatal overdoses of nitazenes,’ Lines explained. ‘We saw a lot more submissions from Cardiff at that point in time. That just reflects the concern amongst consumers.’
WEDINOS’S data shows that nitazenes are increasingly appearing in drugs, but they are only able to test a tiny proportion of drugs in the UK – those handed in by health workers and drug users in Wales, or those mailed in via post from concerned users across the country.
A wider range of voluntary and local drug checking services like WEDINOS would make emerging risks easier to identify quickly.
Where are nitazenes coming from, and are they here to stay?
To respond to future synthetic opioid threats, it’s important that we quickly understand where they are being produced and how they are entering the country, so regulations can be put in place.
When nitazenes first became of concern in the UK drug market, they were not illegal. In the UK, nitazenes became Class A drugs in 2024, whereas China, the main producer of nitazenes, only strictly regulated them this month.
Pressure on China from the UK government eventually led to this change in legislation, but not after hundreds of nitazene-linked deaths.
Philip Berry is a Visiting Senior Lecturer at King’s College London, specialising in synthetic opioids and drug trade routes. Berry believes that India, which also manufactures nitazenes and synthetic opioids, could become more dominant in the market.
‘[China] doesn’t have an innate advantage over any other big producer of pharmaceuticals.’
Berry also explained that the quantity of nitazenes in the UK is a big unknown. ‘It’s very difficult to estimate the flow, the quantity of drugs coming into any particular country,’ he said.
Because nitazenes are easily purchased via post on the dark web or on normal social media sites, dealers don’t always need to rely on established trade routes to smuggle them in, meaning data on drug seizures is less reliable.
‘It is very challenging to really estimate the true size of the problem,’ Berry said, ‘And I think given the underestimation of [nitazene] deaths, there’s going to be a larger problem than is currently known.’
Will nitazenes become a bigger issue for the UK? Without knowing how much is in the drug supply, it’s hard to say.
‘The most recent outbreak of synthetic opioids started in the summer of 2023. So we are now two years on from this point. And the key question, which I don’t have an answer to and I’m not sure anybody else does, is what is the future?’ Berry said.
The Slice sent a Freedom of Information Request to the Tower Hamlets Metropolitan Police in March of 2025, asking for data on nitazene seizures locally. The police have yet to respond.
What’s next?
One of the main findings of this investigative series is just how little is known about the scale of the nitazenes crisis.
With global supply chains posing an enormous challenge to monitor, more robust data collection is needed to keep us ahead of this issue. Right now, the UK is playing catch-up in the dark.
Possibly the most shocking failure is a lack of steady funding for the NPSUM database, which is the only comprehensive source of information on national drug deaths.
How can the responsibility of compiling all of the UK’s drug deaths rest on the shoulders of one person? If the central government will not fund Dr Caroline Copeland’s research, charitable organisations or even local governments, such as the London General Authority, should step in to fill in the gaps.
Local Drug Information Systems also need improvement, as shown in Tower Hamlets, where no nitazene deaths have been recorded despite at least one confirmed case. A wider variety of stakeholders should be involved to ensure faster data collection.
As nitazene production begins shutting down in China, chemical manufacturers in India (where they have not yet been regulated) could step in to meet demand.
Alternatively, yet another synthetic opioid might emerge from China, requiring a completely new domestic response. The only way to keep ahead of these possibilities will be to stay informed.
Read our synthetic opioids series from the beginning: The arrival of an invisible killer: Is Tower Hamlets ready for Nitazenes?