The arrival of an invisible killer: Is Tower Hamlets ready for Nitazenes?

Deadlier than heroin or fentanyl, nitazenes have arrived in Tower Hamlets. A new investigative series by the Slice asks, are we prepared?

It’s a quiet Monday afternoon, and I’m in Release’s harm reduction hub in Aldgate before doors open. The sunshine-filled room has a cosy couch, a shelf full of pamphlets on safe drug use, and tea and coffee brewing. 

From 2 pm, anyone can walk in to access their services; charge a phone, get clean needles and naloxone, access legal advice, and get test kits for drugs – all for free. Naloxone is an injectable medicine (similar to an EPI-PEN) which reverses an opioid overdose. 

This hub is an emergency measure. It was crowdfunded when Release cottoned on to a wave of deaths caused by synthetic opioids. 

The frantic fundraiser from January of 2024 reads: ‘Nitazenes are here and drug deaths continue to rise in England.’ 

We are not prepared: we do not have a structure to test drugs before consumption; drug services aren’t adapting to truly meet people where they are at – we know this because they are ringing our helpline instead.’ 

What’s a nitazene? To understand, we need to talk about heroin first. 

Heroin is an opiate, meaning it travels through the blood and blocks the pain receptors in your brain. This creates feelings of comfort and euphoria and is highly addictive. Withdrawal causes fever, chills, nausea and vomiting. An overdose can dangerously slow or completely stop the rate of breathing, causing death. 

Known as smack, dope, horse, or simply H, heroin is derived from opium poppy plants. It can be a white or brown powder and can be snorted, smoked and injected. It’s a Class A drug, meaning possession can land you up to 7 years in prison, whereas the sale or production of heroin can land you a life sentence. 

From the dark humour of Trainspotting to the ‘27 Club’ and the tragic death of stars like Kurt Cobain, heroin is infamous. Highly addictive and potentially deadly, the UK’s heroin epidemic swept the UK from the ‘70s to the early 2000s. 

But, in the past couple of years, a new kind of opiate has quietly been working its way into the UK’s drug supply. Even stronger than heroin, cheaper to manufacture and easier to overdose on, they are called nitazenes. They are so new to public understanding that my keyboard doesn’t recognise the word when I type it out. 

Nitazenes are a group of synthetic opioids up to 500 times more potent than fentanyl, the synthetic opioid which has killed over a quarter of a million Americans since 2018. They were first created by pharmaceutical researchers in the 1950s and intended for use as painkillers. However, their strength and high risk of addiction meant they were never released officially on the market. 

Nitazenes are most commonly mixed into heroin to bulk out the product. They are also found masquerading as everything from prescription painkillers to THC (tetrahydrocannabinol, the main active ingredient of cannabis) products. Like heroin, they cause respiratory depression that can be fatal. Some nitazenes are so potent that the amount needed to overdose is not visible to the human eye. 

The illegal mass–mass-manufacturing and distribution of nitazenes began in earnest in the early 2020s. Doctors, researchers and support workers have been quick to send out warnings, but the UK government has been slow to respond. 

Release, the UK’s centre of expertise on drugs and drug laws, administers a ‘Drugs Monitoring Network,’ in England and Wales. The network is comprised of a mixture of drug user activists, academics, frontline services and more who monitor the drug supply and report back on patterns. Release then summarise what they’ve learned across the sector, and feed the information back to professionals.

After a cluster of nitazene-related overdoses in 2021, Release realised it was time to raise the alarm. Shayla Schlossenberg, the Head of Drugs Services at Release, says that the UK was already in a drug-related death state of emergency before nitazenes contaminated the supply. ‘Lots of people in the sector were talking about contamination and about doing things differently, but on the ground people’s experiences were the same in terms of barriers to entering services.’ 

‘With this adulteration, it really felt like if we don’t take action very urgently, an absurd amount of life will be lost.’ 

Schlossenberg’s idea was simple: the harm reduction hub would be a completely open space where drug users could get information and tools to make drug use safer. After Release announced the fundraiser for the hub, the £7,500 needed was raised astoundingly quickly, in about a week. 

‘I’m not saying that that will be the be all end all for how we counter the crisis,’ Schlossenberg said, ‘But for now, if you don’t know about drug treatment services […] where do you go to get naloxone? Where do you go to learn about what’s happening in the drug supply? Where do you even get alerted to the fact that something is going on in England?’

Dr Caroline Copeland is a Senior Lecturer in Pharmacology & Toxicology at King’s College London, and the Director of the National Programme on Substance Use Mortality (NPSUM), which administers a database on national drug deaths. Copeland supervises a small team to track every drug-related death that happens in England, Wales and Northern Ireland. 

The database is currently lacking stable funding, and Copeland is on maternity leave. She has been working through her maternity leave to make sure drug deaths don’t go unrecorded and forgotten in what she describes as an urgent crisis. 

Using learnings from her database, Copeland co-authored Nitazenes—heralding a second wave for the UK drug-related death crisis? along with a group of other researchers in the medical journal The Lancet. The paper claims the 54 nitazene-linked deaths in the last six months of 2023 are likely ‘the tip of the iceberg,’ as the drug is not routinely tested for.

The paper further warns that ‘Without concerted action, nitazenes could devastate communities of people who use a range of drugs, including those who use drugs infrequently or source benzodiazepines and opioid painkillers from the internet,’ and concludes that ‘actions taken now will not have been taken soon enough.’  

In June of 2024, Dr Somen Banerjee told Tower Hamlets Council he was concerned about the use of nitazenes in the borough. In March of 2024, nitazenes became Class A drugs.

In October 2024, the Council launched a new Substance Misuse Strategy. warning that ‘New issues and challenges are constantly emerging. These include novel drugs like […] new synthetic opioids such as Nitazenes – which have higher risks for users – increasingly being seen on London’s streets.’

Tower Hamlets is one of the frontlines of a growing crisis. The Council claims to have the highest number of people in treatment for opiate use across London. In 2024-25, an estimated 1190 people were in treatment for opioid use in Tower Hamlets. However, most of the borough’s opioid users are not in treatment at all. 

Nitazenes are already here – and already claiming lives. Local services remain underfunded and unprepared. The grassroots response has been swift and compassionate, but without urgent, coordinated action, many more lives will be lost. This investigative series by the Tower Hamlets Slice asks: What would it take for us to truly be ready?

If you liked this, read Tower Hamlets Slice awarded bursary to fund crucial investigative reporting