As America continues to reel from a fentanyl crisis killing tens of thousands, Britain could face its own dangerous opioid crisis, former government advisors and drug experts have warned.

The deadly fentanyl family of opioids are 50 times more potent than heroin. But nitazenes, which are flooding into the UK, can reach up to 2,000 times heroin’s potency.

They were first created in the 1950s as opioid painkillers but were never approved for medical use. For 70 years, their existence was forgotten.

Then, after Britain and America’s withdrawal from Afghanistan – and the Taliban’s subsequent narcotics ban – they re-emerged as a way to strengthen low-purity heroin in case opium supplies dwindled.

Experts are united in their fear of the rising risk of nitazenes. Yet, while heroin users are still vulnerable, young people buying traditionally legal drugs such as Valium and Xanax as coping mechanisms are also at risk.

In fact, MailOnline analysis of data from the UK’s only drug testing facility Wedinos has revealed that two-thirds of ‘medication’ tested that was bought illegally online in the past year has been laced with nitazenes. Two-thirds of that total were bought by people intending to buy Valium (diazepam). 

Thankfully, the number of nitazene-related deaths are only at 458 in the last two years. However, there was a 166 per cent increase from 2023 (125 deaths) to 2024 (333 deaths) – more than double in a single year, and even that total is expected once toxicology and forensic testing improves and is finalised.

Steve Rolles, a senior policy analyst at the Transform Drug Policy Foundation, told MailOnline: ‘The number of deaths is rising at an alarming rate. It’s the tip of the iceberg. What has happened in the US should be a warning to policymakers in the UK. We could be heading to a US-style overdose crisis. We are talking thousands or tens of thousands dying.

Tens of thousands of Brits are at risk from extremely potent drugs called nitazenes. Synthetic drugs have already left many Brits incapacitated on the streets (pictured). Although there is no way to know immediately if a person has nitazenes in their systems, the effects of other synthetic drugs like fentanyl and cannabinoids are similar

Yet now fake pills sold online, such as this counterfeit diazepam (Valium) tablet, have been found to contain the super-strength drug

Yet now fake pills sold online, such as this counterfeit diazepam (Valium) tablet, have been found to contain the super-strength drug

One of the earliest British victims was Cerys Clark, 19, (pictured) from Middlesbrough, who died after ingesting counterfeit Xanax and OxyContin pills

One of the earliest British victims was Cerys Clark, 19, (pictured) from Middlesbrough, who died after ingesting counterfeit Xanax and OxyContin pills

‘All the indications are that is what is happening. I’m very wary of scaremongering about drugs but I’m deeply worried about the potential carnage opioids could do in the UK.

‘We already have the highest overdose rate in Europe. Nitazenes could make it way, way worse. 

‘This is a very serious public health emergency that’s not being taken seriously enough.’

He added: ‘I am scared. There’s almost one person dying every day from nitazenes and most people haven’t even heard of it.

‘If it was anything else, there would be national panic. The government hasn’t grasped the urgency of this.’

Rolles is starting to see heroin mixed with nitazenes on the streets of Britain.

He said: ‘It does seem it’s getting more [prevalent] as the heroin supply dries up.’

Nitazenes are appearing in a variety of forms. Some are bought, often by drug dealers, as pure pills. Others are found after being cut into illegal drugs such as heroin or traditionally legal medications like Valium and Xanax – or simply sold under those brand names without having any original product in them at all.

Pictured: A man in Manchester curls up on the floor, allegedly after taking drugs

Pictured: A man in Manchester curls up on the floor, allegedly after taking drugs

A man in Manchester clings to a public bench after seemingly having taken a synthetic drug

A man in Manchester clings to a public bench after seemingly having taken a synthetic drug

Pictured: A man who allegedly took the synthetic drug Spice in Doncaster

He was hunched over and motionless

Pictured: A man who allegedly took the synthetic drug Spice, a cannabinoid, in Doncaster

These pills purported to be traditionally legal drugs such as Valium (diazepam). Yet none of the typically legal drugs pictured in this story or tested by Wedinos in the last year actually contained any of the drugs they claimed to be

These pills purported to be traditionally legal drugs such as Valium (diazepam). Yet none of the typically legal drugs pictured in this story or tested by Wedinos in the last year actually contained any of the drugs they claimed to be

Mixing netazenes with other drugs can be difficult to do, meaning batches can vary in strength within a single bag. One area of illegally bought Xanax could have no netazenes. Another area could have enough to kill you. 

Dr Philip Berry is a consultant focusing on the international drug trade and a visiting research fellow at KCL.

He was previously a counter-narcotics official at the Home Office who worked for the Afghanistan Serious and Organised Crime team and was seconded to the Synthetic Opioids Taskforce Secretariat.

One of his specialities is Anglo–American counter-narcotics policies in Afghanistan in the post 9/11 era.

Unlike Rolles, Dr Berry thinks it is unlikely that the UK will have a US-style opioid crisis but emphasised how worrying the issue was.

He said as the UK’s wider population has never had the same levels of dependency on legal opioids for pain relief plus heroin users in the UK are more likely to be in drug treatment and harm reduction programmes than their US counterparts.

He said: ‘It’s uncertain how this problem will develop, but in the short term, it is likely criminal groups will continue to embed nitazenes into the UK market.

‘Ministers and officials from across government are prioritising tackling this issue.

Pictured: A nitazene powder sample at the Center for Forensic Science Research and Education in the US in 2023

Pictured: A nitazene powder sample at the Center for Forensic Science Research and Education in the US in 2023

Pictured: Yellow and green pure nitazene pills seized in Australia in 2023

Pictured: Yellow and green pure nitazene pills seized in Australia in 2023

Budding opera singer Alex Harpum, 23, (pictured) died in 2023 after swallowing what he thought was simply a Xanax pill that he bought online

Budding opera singer Alex Harpum, 23, (pictured) died in 2023 after swallowing what he thought was simply a Xanax pill that he bought online

Harry Dunrose, 21, (pictured) died after taking what he thought was a Valium for chronic pain

Harry Dunrose, 21, (pictured) died after taking what he thought was a Valium for chronic pain

Dylan Rocha, 21, (pictured) a promising musician, also died after overdosing on heroin that is believed to have been mixed with nitazenes

Dylan Rocha, 21, (pictured) a promising musician, also died after overdosing on heroin that is believed to have been mixed with nitazenes

‘This has the potential to get worse.’ 

More than 70 types of nitazenes have been identified worldwide. At least 14 specific types have been banned in the UK, although a new law in January banned all variants with a generic definition of nitazenes to stop gangs simply synthesising new unbanned ones to skirt the law.

Rolles said: ‘Fentanyl and nitazenes are very similar. They are both synthetic opioids. We are talking about a family of drugs. Nitazene is not a single drug, there is a whole group of them.

‘They are all extremely potent and dangerous but they are all quite different. It can be many thousands of times stronger than heroin. 

‘When the dosage is unknown or it’s used as an adulterant then less than a grain of sand can be enough to kill you.

‘Pharmacy drugs are incredibly regulated. Illegal drugs are not. You don’t know how much is in your heroin or [illegally purchased] Xanax.

‘The gap between the effective dose and overdose [in NSOs] is very small.’

Even people who regularly use drugs are getting worried. A 28-year-old former drug addict who spoke to MailOnline on the condition of anonymity said nitazenes are becoming well known on the street.

A young man in Manchester who appears to have taken drugs rolls onto his back

A young man in Manchester who appears to have taken drugs rolls onto his back

Pictured: A man believed to have taken a synthetic cannabinoid 'freezes' while standing up in Manchester

Pictured: A man believed to have taken a synthetic cannabinoid ‘freezes’ while standing up in Manchester 

‘Heavy addicts with nothing to live for are afraid of it,’ he said. ‘You don’t see that that often, so you know it’s bad.’

The former drug user said people taking drugs needed to keep aware about how nitazenes were developing in the UK market and warned against buying drugs from the dark web.

Now sober and employed, he started his path to recovery after suffering from a heart attack induced by his drug taking.

While he said he wasn’t sure whether he ever took a nitazene, he believes he tried fentanyl. 

He said: ‘Synthetics are coming through. It’s much cheaper. 

‘Heroin has been established for so long that people know how much to use. 

‘With synthetics you can take a normal quantity and you just stop breathing. 

‘It’s f***ing crazy. It’s way worse than heroin.’

In its 2025 National Strategic Assessment, the NCA said the ‘global synthetic drug markets are rapidly evolving and pose significant harm to users… and are a growing concern in the UK’.

It added: ‘The fortification of heroin with nitazenes and other synthetic opioids has increased the risks of harm to users. Drug-related deaths in the UK increased by 15% in 2023, with 4,936 drug misuse deaths in England, Wales, Scotland, and Northern Ireland.

‘They are increasingly detected mixed with heroin, but also a range of counterfeit pills (such as benzodiazepines and painkillers) to strengthen effects, often without the knowledge of the user. 

‘Fentanyl has re-emerged in some regions of the UK following a dip in recent years, but the threat remains low compared to nitazenes. 

‘Since June 2023, there have been 14 deaths related to the misuse of fentanyl, including 11 where nitazenes were also present. ‘

Videos posted online have shown how drugs including synthetic opioids and synthetic cannabinoids have turned Britons into shuffling, mummering ‘zombies’ just as happened with US fentanyl addicts who have taken tranq, also known as xylazine.

Yet far from just affecting those who want to get high, the growing nitazene problem in the UK is threatening youngsters buying pills online to cope with stress, anxiety and chronic pain.

Last year, 21-year-old Harry Dunrose died after taking what he thought was a Valium for chronic pain. 

He was previously prescribed the drug to deal with his chronic hypermobility, which caused pain and stiffness in his joints.

When his prescription ran out, he told friends he was going to buy the Valium drug diazepam on the black market.

After his death on March 3, 2024, drugs containing nitazenes were found at his supported accomodation in Hyde, near Manchester.  

In a tragically similar case, promising opera singer Alex Harpum, 23, died in 2023 after swallowing what he thought was simply a Xanax pill that he bought online.

His mother Anna Jaques, from north Wales, believed he may have bought the pill because he struggled to sleep while taking medication for his attention deficit hyperactivity disorder (ADHD). 

One of the earliest British victims was 19-year-old Cerys Clark, from Middlesbrough, who died in 2021, before nitazenes really started flooding into the UK.

She suffered from chronic back pain caused by scoliosis, a curvature of the spine, and Ehlers-Danlos Syndrome, a rare condition that causes pain in joints which can be dislocated easily.

In Philadelphia, America, four to five people die daily from overdosing. Pictured: People who use drugs standing in the street

In Philadelphia, America, four to five people die daily from overdosing. Pictured: People who use drugs standing in the street

Pictured: In New York, near Central Park, a man uses drugs. Fentanyl killed a record 75,000 Americans in 2021, the equivalent of 1,500 lives lost every week

Pictured: In New York, near Central Park, a man uses drugs. Fentanyl killed a record 75,000 Americans in 2021, the equivalent of 1,500 lives lost every week

In Philadelphia 'zombified' addicts sway on the street after taking drugs including fentanyl

In Philadelphia ‘zombified’ addicts sway on the street after taking drugs including fentanyl

She died after having two counterfeit drugs – a fake Xanax and a fake OxyContin, an American synthetic opioid and painkiller.

The fake Xanax contained a powerful synthetic benzodiazepine called flualprazolam, while the fake OxyContin was laced with N-pyrrolidino etonitazene. 

Her mother Lyndsey, a nurse, previously told the Mail: ‘There is no way Cerys would have taken something like that deliberately – she’d have had no tolerance to such powerful drugs. They would have been too much for her.

‘I remember once, Cerys even went into a panic when she realised that she had taken a pain med that was slightly out of date. That’s how sensible she was.’

Lyndsey suspected Cerys was given the drugs without her knowledge by a male acquaintance she was staying with.

The man, who she later learned had bought opioids that appear to have been adulterated online from the Czech Republic died of an overdose in the same flat four months later.

Greater Manchester police said: ‘A man was arrested in connection with [Cerys’s] death and was subsequently bailed while inquiries continued to determine if a criminal offence had been committed in relation to the death. The suspect died on December 23, 2021, and as a result, the investigation into the supply of drugs was stopped from a criminal perspective.’ 

What to do if someone overdoses on opioids 

Keep calm and follow these steps: 

  • Make sure that you’re not in any danger first
  • Keeping yourself safe is important. Call 999 and ask for an ambulance
  • Check to see if there is anything obstructing their airways
  • Place the person in the recovery position
  • You can find out how to do this here
  • If you have Prenoxad, inject it into their thigh or upper arm muscle
  • If you have Nyxoid, place the spray in their nose and press the plunger
  • Wait with the person until the ambulance arrives, and give the used naloxone kit to the paramedics 

Source: cgangegrowlive.org

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Professor Rick Lines, from the UK’s only drug testing centre Wedinos, said: ‘Perhaps people have found that they weren’t able to continue on a legitimate prescription and decided to go through what they think is an alternative legitimate route, but is in fact not.’ 

A month before Cerys died, Dylan Rocha, 21, a promising musician, also died after overdosing on heroin that is believed to have been mixed with nitazenes.

His mother previously told the Mail: ‘It’s clear to me that the presence of nitazene is what ended his life.’ 

How nitazenes are coming into the UK remains fairly unclear, although there have been reports they are available to buy online from China and receive in the post.

The cause of their re-emergence has been laid on the Taliban’s introduction of a ban on the production of narcotics in 2022, a year after the completion of British and American troops’ withdrawal from Afghanistan.

This spooked the heroin market, which relied on Afghanistan’s opium to create the dangerous drug.

Nitazenes, a drugs relic from the 1950s, were reintroduced as a way to boost low-purity heroin – and pave the way for synthetic drugs to take over the market.

Speaking about the Taliban’s narcotics ban, Dr Berry told MailOnline: ‘As the ban continues into its third year, there has not yet been a heroin supply shortage in the UK.

‘This is primarily due to substantial opium stockpiles in Afghanistan.

‘Even if there was a shortage of opium, Europe, including the UK, has high value heroin markets, so traders are likely to prioritise trafficking to the Continent.’

He added: ‘But the ban has caused market uncertainty in the UK. There’s been a drop in heroin purity at all levels and the wholesale price has increased.

‘Drug dealers have hedged against this uncertainty by reintroducing nitazenes into the UK market.

‘They re-emerged in the summer of 2023 and it seems likely nitazenes are here to stay.

‘Nitazenes offer several advantages. They can be produced anywhere in the world and they are relatively cheap to make and buy. They are widely available online making them accessible to dealers (and users) all over the world. And their high potency means you only need a small amount, therefore it’s easier to transport.

‘People are using nitazenes to fortify low-purity heroin.

‘So far, smaller-scale organised criminal groups are importing it and dealing at the county lines level as opposed to larger-scale Turkish or Pakistani groups.

‘The vast majority, if not all, are originating in China.’

He added that labs in India were also producing nitazenes and other synthetic opioids.

Charles Yates, the deputy director of the NCA, told MailOnline: ‘Poppy and opium production was very high in Afghanistan for decades prior to the Taliban ban and we judge that there remain significant reserves of heroin. This situation remains under constant review.

‘In most cases, organised criminals’ sole motivation for using nitazenes is greed. They buy potent nitazenes cheaply and mix them with bulking agents such as caffeine and paracetamol to strengthen the product being sold and make significant profits.

‘The UK is a destination for nitazenes manufactured in illicit labs in places like China but it is not always the final destination as well as into the UK using fast parcel, post and Royal Mail services. We have no evidence to indicate nitazenes are being manufactured in the UK.’

There is still debate in the UK, and worldwide, about the best way to combat drugs.

How to tell if someone has overdosed 

Keep an eye out for these signs that someone is having an overdose:

  • Deep snoring/gurgling noises 
  • You can’t wake the person up, and they don’t respond if you shake their shoulders or call their name 
  • A blue tinge to the lips, nail beds or other extremities 
  • They have stopped breathing

You should always call 999 if you think someone is having an overdose.

Don’t be scared that you’ll get in trouble. The ambulance will not bring the police with them except in very particular cases.

Source: changegrowlive.org 

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Some, such the UK and American governments, have long gone down the path of a ‘war on drugs’, focusing on smashing gangs, making narcotics illegal and discouraging drug making and taking.

Others, such as Rolles’s Transform Drug Policy Foundation believe regulation will make drugs safer for those set on using them regardless and decrease public spending on drug-related issues overall.

Rolles said: ‘The war on drugs gives crime groups more incentive to tilt the market with [more potent] drugs.

‘Very potent drugs are easy to transport. Why bring a ton of heroin when you can bring a kilogram of nitazene? A suitcase of heroin versus a matchbox of nitazene?

‘You can make the same amount of money. It’s more bang for your buck.

‘It’s a thousand times easier to smuggle than heroin, it’s relatively easy to make and you don’t need to get opium from Afghanistan or coca leaves from Colombia or grow cannabis in your basement. You just need a lab and scientists. 

‘Enforcement is doing the opposite of what it’s supposed to. It may make the importation of one drug more difficult.

‘The harder you enforce it, the harder the drugs become.’     

Earlier this year, the Home Office said measures were being stepped up across government to better equip police forces, the NHS and the Border Force to deal with synthetic drugs and the UK is contributing to international efforts to better protect communities. 

It highlighted that in a world first, Border Force dogs were being trained to detect a range of nitazenes and fentanyl, and police officers in many forces have been trained to carry and administer naloxone – a lifesaving medicine that reverses the effects of opioid overdose. 

The government said it was working with the National Police Chiefs’ Council to see the provision rolled out across most forces.

It added that the NCA was also working with police and the Border Force to stem any supply of nitazenes and fentanyl to and within the UK.

Policing Minister Dame Diana Johnson said: ‘Synthetic drugs cause devastation wherever they are found – to individuals, to families, to our town centres and our communities.

‘I have been concerned about the growing presence of these drugs on UK streets and I don’t think enough has been done in recent years to get a grip on it. 

The majority of substances tested by Wedinos, the only national drug-checking service in the UK, purported to be legal products, although they were all bought illegally

The majority of substances tested by Wedinos, the only national drug-checking service in the UK, purported to be legal products, although they were all bought illegally

Illegal drugs, such as this 'Iranian Gucci Heroin' also contained nitazenes. This sample had heroin mixed with protonitazene, which is 200 times more potent than heroin

Illegal drugs, such as this ‘Iranian Gucci Heroin’ also contained nitazenes. This sample had heroin mixed with protonitazene, which is 200 times more potent than heroin

‘Stepping up efforts to tackle this threat will form a key part of this government’s approach to drugs.

‘As part of our Plan for Change and mission to make our streets safer, we are dedicated to driving down drug misuse and harms through prevention and treatment while acting quickly to stop the criminals peddling these harmful substances.’ 

The government added it was spearheading a ‘workstream’ under the US-led Global Coalition to Address Synthetic Drug Threats that will focus on how governments across the world can control the availability of synthetic drugs through legislation intelligence sharing.

Rolles, at the forefront of the nitazene crisis on the ground For Rolles, believes the threat these synthetic drugs pose is still not being taken seriously enough. 

He said: ‘We need an emergency preparedness response and we need it now. 

‘There’s no meaningful enforcement solution. The idea that you can stop nitazenes coming into the country is just not credible. We know that because of 60 years of failure. 

‘We can’t even stop drugs getting into high security prisons. The idea we can have a secure border around the UK is ridiculous.

‘Even if you could, they would just make it in the UK. That’s not to say you don’t arrest people selling drugs. Just don’t be under any illusion that it will curtail anything.’

Like the government, he agreed that naloxone needed to be more widely available.

He also called for more supervised drug taking centres to ensure that people not ready to quit had medical professionals on hand to prevent deaths.

He said drug checking clinics could also help prevent overdose and reduce public money spent helping people affected by drugs.

Dr Caroline Copeland is a senior lecturer in pharmacology and toxicology at KCL and the director of the National Programme on Substance Use Mortality.

Like her KCL colleague Dr Berry, she agreed the UK’s opioid problem had ‘very different roots to the one in the US so I don’t think we’ll see the same scale’.

However, like Rolles she warned against relying measures on attacking drug use.

She told MailOnline: ‘People dying is of course not good.

‘I think punitive measures to stop drug use in the UK isn’t working. 

‘We need to be focussing on reducing drug demand as this is the only way we’ll be able to stem drug supply.  

‘This means more investment in health and social services for people who use drugs.’

NCA deputy director Charles Yates said: ‘Tackling Class A drugs, including synthetic opioids, is a priority for the NCA to stop the harm they cause to users, communities and the UK economy.

‘We and our partners, including public health and forensic services, are proactively monitoring for sudden rises in drug-related deaths and will act quickly to reduce threats.

‘We’re working closely with policing, Border Force and international partners to stem supply of nitazenes and other synthetic opioids to and within the UK.

‘We continue to monitor the availability of heroin throughout the supply chain and, whilst we have seen a reduction in purity at street-level, at this time there is no indication of a shortage in the UK.

‘With policing, Border Force, Home Office Intelligence and international partners, we do everything possible to ensure that all lines of enquiry are prioritised and vigorously pursued to stem any supply of nitazenes to and within the UK.

‘And we collaborate with police forces and regional organised crime units to arrest offenders responsible for the supply of these drugs.

‘The NCA and partners have worked together to prevent the threat rising as fast as independent estimates expected.

‘This has been through a combination of a wide rollout of the lifesaving antidote naloxone and public health measures to tackle demand, alongside strong enforcement.

‘Our officers are increasingly involved in tracking and seizing the substance. But we are not complacent and will be keeping up the pressure on those involved in supplying the drug.’

  • Do YOU have a story or tip? Email chris.matthews@mailonline.co.uk 

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