How an east London woman turned to the dark web for nitazene-laced painkillers after medical dismissal

As GPs face growing pressure to cut long-term opioid prescriptions, patients like Dalia – cut off without warning – are turning to the dark web, where counterfeit pills increasingly contain dangerous substances like nitazenes.

Ten days into a painful, unplanned withdrawal, Dalia bought her first batch of counterfeit painkillers. 

For three years, she’d relied on prescribed Tramadol to manage a chronic condition – until a GP cut her off without warning or discussion.

‘I was very unwell, going through withdrawal, and had experienced this before and didn’t want to experience it again,’ she told the Slice, ‘It hadn’t been a collaborative decision or up for discussion.’ 

Desperate for relief, Dalia purchased what appeared to be the prescription painkiller Oxycodone from the dark web. They later turned out to be counterfeits laced with nitazenes, an extremely potent synthetic opioid up to 500 times stronger than heroin. 

Dalia grew up on the outskirts of London and moved to the East End five years ago. She is in her mid-twenties and has a genetic health condition that affects her joints, causing her chronic pain and inflammation.

‘I started experiencing pain when I was around five or six, but wasn’t diagnosed until the age of 14 – before that, everything was put down to growing pains or attention,’ Dalia said. 

After her diagnosis, Dalia finally had a path to medical treatment. ‘I was freed of thinking that it was something I was making up, having been told a number of times over that 10 year span that it was all in my head,’ she said. 

She was gradually trialled on over 20 different medications, including Naproxen, Diazepam, Prednisolone and Baclofen to help with her pain. When she was around age 16, she was prescribed Tramadol, an opioid pain medication. 

‘The Tramadol was the first medication I’d been on that actually seemed to help – I was able to actually go to school some days, which is all I’d wanted, because my pain was at a semi-manageable level. Of course, it was still there, but it was a little bit quieter,’ Dalia said. 

In recent years, NHS doctors have been pushed to reduce long-term opioid use. In January 2021, there were over one million people in England who had been prescribed opiates for more than three months. Between January 2022 and March 2023, this number dropped to an average of 25,629 fewer people a month.

For Dalia, this reduction has been a source of ‘great anxiety […] as they allow me to function.’ Currently, she has a review of her medication every six months, and is worried that her prescription could be stopped again with no warning. 

‘I’ve never misused my prescriptions or had any significant side effects, but have had probably up to five different instances where a GP, not my consultant, decide that my opioid medications should be stopped,’ Dalia said. ‘I’ve not asked for an increase in my medications for at least three years.’

‘Doctors have always talked about the ‘risk of addiction’ when really they mean the risk of dependence,’ she said, ‘In my opinion. I’d rather take dependence on a medication and actually have a quality of life – after all, many people are dependent on other medications, like insulin, for example, to manage chronic conditions.’ 

Living in constant insecurity about her pain management and ability to function, Dalia felt her only option was to seek pain relief elsewhere. With the help of a friend, she took matters into her own hands and began ordering her own opioids on the dark web. 

‘I get what’s listed as Oxycodone as a ‘backup’ for when my pain is especially bad or unmanageable […] as well as to have something in case my pain medications face a shortage or my doctors decide to stop prescribing them,’ Dalia said. 

Dalia sends samples of the pills she buys to the Welsh Emerging Drugs & Identification of Novel Substances (WEDINOS) lab, the only lab in the UK which anonymously tests drug samples for free. Although safer, the system is slow, with results taking two to four weeks to come in.

Dalia’s current batch of painkillers was confirmed by WEDINOS to contain nitazenes. ‘I […] knew that there were lots of opioids contaminated with nitazenes, so I sent one to WEDINOS for testing. It came back as having nitazenes present,’ she said. 

Aside from heroin, counterfeit prescription pills like the kind Dalia purchased are the most likely choice drug for dealers to mix nitazenes into. They are appealing because they are so strong that they can be sold heavily diluted and at a low cost. 

The samples photographed on the WEDINOS website often appear indistinguishable from prescription pills (including foil-wrapped blister packs), and are sold by dealers as legitimate. 

These fake medicines laced with nitazenes have been responsible for several deaths in the UK already, including that of Guildhall student Alex Harpum, who had purchased what he thought was Xanax to help him sleep. 

The NHS is reducing its opioid prescriptions; however, long wait times for alternative medical treatment are barely improving. Presumably, this means finding helpful treatments for patients with chronic pain will be a long, slow process without guaranteed results. 

For some patients like Dalia, enduring this wait is unthinkable. She continues to take the nitazene-laced counterfeit OxyContin she was sold, although only once or twice a month in ‘emergency’ situations.

‘When I do take them, I take a tiny sliver of a pill at a time, and make sure that I’m with someone who has naloxone, just in case anything happens,’ she said. Naloxone is the antidote to an opiate overdose.

Dalia takes all the precautions she can, but taking nitazenes will always be a risk. They have never been officially approved for human consumption as pharmaceuticals because they are so strong and can easily cause an overdose.  

‘I’m definitely worried,’ she said, ‘I feel less at risk (though am not naive enough to assume I’m safe) as I’m fortunate enough to have access to information, and to have friends who know how to use naloxone.’

Dalia’s story exposes a dangerous consequence behind the NHS’s drive to reduce opioid prescriptions. While reductions in opioid prescriptions seem positive, they mask the growing number of patients who, unable to access consistent pain relief, are pushed towards illegal alternatives. 

For people like Dalia, the system’s failure to provide alternative treatment has created a deadly vacuum – one now filled by counterfeit pills laced with substances like nitazenes.

That Dalia now feels safer relying on dark web opioids than her own GP is a damning indictment of a system that too often dismisses and disbelieves those in chronic pain. Harm reduction measures, like WEDINOS and naloxone access, are patchy lifelines in a landscape of institutional neglect.

While policymakers focus on cutting prescriptions, the more difficult work—ensuring viable, humane alternatives for those who still need relief—is being neglected. Until that changes, stories like Dalia’s will only become more common. And the cost, for some, will be fatal.

‘Dalia’ is a pseudonym; her real name has been changed to preserve anonymity. 

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