Quiet destruction: Everything our investigation has uncovered about the nitazenes crisis
Beneath the surface of east London, a new synthetic opioid crisis is emerging – our six-month investigation has traced the shadowy rise of nitazenes and the tireless work of those striving to save lives before the wave breaks.
When we began investigating nitazenes in early 2025, we’d heard worrying reports from the Council’s health board about the arrival of new synthetic opioids in Tower Hamlets called nitazenes. Nitazenes are even more potent and deadly than fentanyl, which has killed over a quarter of a million Americans since 2018.
Could a new wave of the drug-death crisis be hitting our shores? We wanted to find out how serious the problem was, what the borough was doing to avoid the opioid crisis that America has endured, and what we could do to create better outcomes for the most vulnerable communities, not just in Tower Hamlets but across the UK.
During our six-month investigation, we’ve spoken to medical professionals, academics, politicians, and impacted drug users to establish the scale of the crisis and what they think needs to be done to avoid more deaths. We discovered that the problem is far worse than is being reported, but there are potential solutions that bring some hope.
We’ve asked, why are nitazenes in our local drug supply? Who are they impacting, and why is this crisis so uniquely misunderstood? Most importantly, what should we be doing next?
The arrival of an invisible killer
The first official warning received in Tower Hamlets was in June 2024, when the Council’s health board lead, Dr. Somen Banerjee, warned of the potential impact of a new type of synthetic opioids called nitazenes. Given that Tower Hamlets has 3,613 opioid users, among the highest number in London, this puts our borough at the front line of the crisis.
Nitazenes are following the same pattern as the four waves of the U.S. opioid crisis, but spreading much faster. The first wave began in the U.S. nearly 30 years ago with the misuse of prescription drugs, the second when opioids found their way into heroin, the third was the rise of fentanyl, and the fourth wave in 2015 when fentanyl analogues began to be used in a wider range of drugs, including party drugs.
Nitazenes first started appearing in the UK’s heroin supplies in 2021. Since then, there has been a surge of reported deaths and overdoses in Tower Hamlets’ rough sleeper community. And already, nitazenes are now turning up in other substances, including those sold as counterfeit prescription pills, vapes, and party drugs.
At the time of Tower Hamlets’ first official warning a year ago, nitazenes had already been linked to 400 known drug-related deaths in the UK since June 2023, but a lack of data means this is the tip of the iceberg.
On 15 September 2024, a young man was found unresponsive in his home with a nitazene-laced vape in his hand. After being briefly resuscitated, he died on 19 September 2024 at the Royal London Hospital in Whitechapel.
On 26 May 2025, the first nightlife-related deaths were reported in London; two young people were found dead in their apartment after taking post-party downers, Oxycodone, which, unknown to them, had been laced with nitazenes.
One of the highest risk groups is now people buying counterfeit medications on the dark web, such as east London resident Dalia, who sources counterfeit Oxycodone to control pain caused by a joint condition, which causes her chronic pain.
As GPs face growing pressure to cut long-term opioid prescriptions, patients like Dalia are increasingly turning to illegal methods of sourcing opioids.
A new generation of opioids
Drug dealers typically mix nitazenes into other drugs to make them stronger, cheaper to produce, and more addictive. Critically, this means people can consume them without realising it, leading to unintentional addiction and overdose.
Nitazenes are 500 times stronger than natural heroin made from poppies, and fifty times stronger than fentanyl.
They are so potent that a fatal amount can be invisible to the human eye. Given their potency, if nitazenes are mixed badly with other drugs, a user can inadvertently have a deadly overdose even with a small amount of drugs.
Due to the small volumes needed, nitazenes are also easier to transport and therefore harder to intercept. Once, massive shipments of drugs had to be smuggled across county lines and distributed to UK dealers to be sold locally. Now, Telegram channels, WhatsApp groups and dark web marketplaces are the new, easier way to buy drugs.
Today, the majority of synthetic opioids, including nitazenes, arrive in small packages in the post, sent directly from manufacturers in China, posing a policing challenge. Lots of tiny shipments slipping through are much harder to track or monitor than big drug seizures.
Like heroin and other synthetic opioids, an overdose from nitazenes can be reversed using the antidote naloxone. However, a much higher dose of naloxone might be needed to reverse a nitazene overdose.
Working in the dark
Despite the well-documented rise of opioid abuse around the world and early warnings issued by frontline services in the UK, awareness of nitazenes in Tower Hamlets is dangerously low.
Interviews with medics, GPs, pharmacies, and clubbers in the borough reveal that few have heard about nitazenes.
Awareness locally is also low about naloxone, the life-saving antidote to an opiate overdose. In Tower Hamlets, organisations responsible for distributing naloxone, such as community pharmacies, were not clearly informed that it could be used for overdoses caused by nitazenes. Drug users were also reportedly wary about using or accepting naloxone.
At the date of publishing, the Council has not issued a public service announcement for fear that promoting the presence of nitazenes in the drug supplies could encourage users to seek it out. However, one Council health official admitted this should be reviewed.
As our investigation continued, it became clear that national data on nitazenes is severely flawed. We found that the UK’s only comprehensive drug death database is incomplete, lacks consistent funding, and relies entirely on one woman. After returning from maternity leave, she is now working through a backlog of cases, further delaying her research.
In May, we reported on new studies showing that nitazenes are often missing from post-mortem tests. This is because the drugs are highly unstable and can break down before toxicology testing is done, meaning even more drug-related deaths may be going uncounted in already incomplete datasets.
In Tower Hamlets, the Local Drug Information System was aware of only two non-fatal overdoses due to nitazenes in the borough, despite at least one confirmed nitazenes-related death in Whitechapel, and more reported informally by rough sleepers.
Testing drug samples for nitazenes before consumption is more reliable, but testing strips are also flawed and free drug-checking laboratory services such as The Loop and WEDINOS don’t have the funding or permission to expand their national services.
Conflicted government responses
Modern policy on dealing with drug use is haunted by the opium dens that proliferated in our very own borough. In the Victorian East End, the British understanding of addiction shifted from a medical condition to a moral failing.
Today, the same stigma is reflected in the sluggish and often contradictory response to the nitazene and synthetic opioid crisis in the UK, including a lack of political will to acknowledge the crisis and take action towards it.
There is only one politician, Hackney councillor and London Assembly member Zoë Garbett, who has been brave enough to speak up consistently about the health crisis being caused by nitazenes.
On 9 May 2025, in a scramble to keep up, the central government issued emergency advice on synthetic opioid preparedness, requiring all councils to submit a plan of action.
Tower Hamlets, with its high number of opioid users, has the opportunity to be a ‘best practice’ case study for the rest of the country. Its response so far is positive but leaves room for improvement.
As part of its response, the Council has assigned six Tower Hamlets Enforcement Officers (THEOs) to drug outreach. The THEOs, who look similar to police and can issue fines, have received basic training on how to signpost users to treatment centres.
The THEO’s confused role as both crime enforcers and drug outreach officers could be doing more harm than good, with only an estimated 25 successful referrals to rehabilitation services, despite the £1 million investment.
Our investigation also found that the council’s Local Drug Information System is missing key data, including at least one nitazene death not logged in the system. And the council has admitted that naloxone distribution is low, with only 824 kits distributed in 2023/2024.
Despite data gaps and evolving policy, promising local solutions to the synthetic opioid crisis are being trialled here in Tower Hamlets.
A culturally sensitive rehabilitation centre, designed to support women, Muslims and ethnic minority residents, is set to open later this year in Bow. The centre aims to close the gap in demographics accessing rehabilitation services in Tower Hamlets – women are especially in need of better access.
Additionally, drug treatment charity Release now runs a harm reduction hub in Aldgate, which was crowdfunded as an emergency response to nitazenes in the drug supply. You can donate here to keep the hub stocked.
And at the end of June, the London Harm Reduction Collective ran a non-functioning demo of an Overdose Prevention Site (OPS) near Brick Lane.
Overdose prevention sites allow safe supervised drug injection, preventing potential overdoses and connecting drug users with rehabilitation services and harm reduction. If approved, the site would be the first of its kind in England.
Initial community feedback on the demo OPS has been positive. However, the new culturally sensitive rehabilitation centre has caused controversy due to its proximity to a school.
Although promising, these solutions will need community support to move forward.
Positively, since the Slice began highlighting this issue, naloxone availability has improved. Being cheap, easy to use, and able to reverse an opiate overdose 95% of the time, naloxone is considered one of the best tools for saving lives.
Release has been commissioned to distribute more naloxone in areas with high drug use, and hostels across the borough have been stocked with naloxone. The Council is also working with the Royal London Hospital’s A&E service to make naloxone available 24/7, which previously was not the case.
This could still be improved. San Francisco achieved a 23% drop in drug deaths and attributes this to their aggressive rollout of naloxone availability. They developed a citywide policy, tripled the number of their dedicated street care workers, increased distribution from 47,000 doses to more than 158,000 doses, made it available in 50% of supportive housing with a target of 100%, and trained 4,126 people in overdose recognition and naloxone use.
Another key solution is drug testing. UK drug testing service The Loop allows users to quickly and anonymously check what their drugs contain using mobile labs in busy public places, making drug deaths like these avoidable.
The Loop plans to expand its drug checking services in London, pending licensing from the Home Office. Currently, they are running a fundraising campaign called Test & Know. You can donate here towards a new life-saving mobile laboratory.
To test illegal substances anonymously (through mail-in samples), there is only one option in the UK, the Welsh Emerging Drugs & Identification of Novel Substances Project (WEDINOS). Currently, WEDINOS is only funded by the Welsh government despite testing drugs from across the UK. A similar lab in England would contribute towards better outcomes locally.
What’s next for the nitazenes crisis?
The nitazenes and synthetic opioids crisis in the UK has shifted significantly throughout this investigation. When we began, it was mostly heroin users being impacted. Now, a wider demographic is at risk, ranging from users of prescription pain medication to clubbers on a night out.
At the start of our investigation, nitazenes were also almost always consumed by accident, slipped secretly into other drugs by dealers as a cheap way to fortify them.
Now, drug experts believe we are seeing a worrying trend towards intentional use of nitazenes, with opioid users seeking out stronger and cheaper alternatives to heroin or prescription medication.
Another major shift has been in the perceived size of the crisis. Gaps in our national drug death data have shown that nitazenes-linked deaths are most likely being largely undercounted.
As the crisis continues to develop, manufacturing and supply routes are also shifting. Just this month, China began regulating nitazene-linked chemical materials. India, which has a similarly robust chemical manufacturing system but hasn’t yet regulated nitazenes, could take China’s place as their lead exporter.
If the most popular nitazenes become difficult to manufacture, new variations may take their place. In the past six weeks, two new nitazene variations have been detected for the first time in the UK by the WEDINOS lab.
Another possible option is a completely new kind of synthetic opioid emerging to replace nitazenes, posing entirely new challenges for testing, legislation, and harm reduction.
In conclusion
Since the Slice has begun raising awareness of the under-reported synthetic opioid crisis, solutions have begun to be implemented. But is it enough, and without greater effort, will it keep pace with the speed of new variants?
It is welcome news that naloxone and nitazene testing strips are now available in all drug-related services across Tower Hamlets. However, it needs to be more widely available across the borough and the country.
Funding and support are urgently needed to improve both our national drug data and our Local Drug Information System. The Slice is currently exploring a research partnership to improve local data on nitazenes.
Our reporting has revealed a shameful gap in UK drug-death data, as well as challenges for testing drug samples, drug supplies, and toxicology. If we don’t fully understand this crisis, we will not be able to fight it.
We also need better public awareness. Most people on the street have heard of fentanyl, but very few people have heard of nitazenes. Yet it is nitazenes, not fentanyl, that are now being mixed into heroin, pain medications and party drugs in the UK, causing overdoses and deaths.
Perhaps most fundamentally, the moral judgment towards drug users needs to be set aside. Otherwise, we risk willful negligence similar to the one that worsened the AIDs crisis.
When we started this series, the word nitazenes was so new that my keyboard flagged it as a misspelling when I typed it out. Today, the word is finally recognised, with no squiggly red line underneath. But to truly understand and address this crisis, we still have a long way to go.
Read our synthetic opioids series from the beginning: The arrival of an invisible killer: Is Tower Hamlets ready for Nitazenes?