Use of Nitazen, a synthetic opioid that can in some cases be more powerful than fentanyl, is on the rise in Western Europe, linked to a rise in overdose deaths and posing a “significant” risk to public health, according to the United Nations World Drug Report released on Wednesday.
The United Nations Office on Drugs and Crime (UNODC) reports that the number of people using drugs worldwide has soared, increasing by 20 percent over the past decade to 292 million.
While cannabis remains the most widely used drug in the world, opioid users are the second most common with 60 million, followed by amphetamine users with 30 million, cocaine users with 23 million and ecstasy users with 20 million.
UNODC Executive Director Ghada Wali said the emergence of Nitazen and record supply and growing demand for other substances have led to increased drug disorders and environmental damage.
“Drug production, trafficking and use continue to exacerbate insecurity and inequality, causing immeasurable harm to people’s health, safety and well-being,” she said.
The rise in Nitazen is of particular concern to authorities because the synthetic drug is extremely potent and can be mixed with other substances, meaning users can ingest it without knowing it.
That, combined with the Taliban’s crackdown on opium production in Afghanistan in 2022, which saw the harvest fall by 95 percent, has raised concerns that synthetic opioids could fill a heroin gap in European markets.
“Some nitazenes are more potent than fentanyl and are causing fatal outcomes in Western and Central Europe and North America. A total of 78 new unregulated opioids have been identified on the European market since 2009, including 13 highly potent benzimidazole (nitazene) opioids,” the report said.
“In parallel, the number of new Nitazen reports has increased in recent years. At a global level, the number of new Nitazen uniques is now approaching the number of fentanyl analogues, while the number of new Nitazen uniques reported in Europe has exceeded the number of fentanyl analogues since 2021.”
While synthetic opioid use remains lower in Europe than in North America, it is on the rise, with recent drug-related deaths in the Baltic states of Latvia and Estonia, France, Ireland and the UK.
In Ireland, Nitazen, sold as heroin, caused 77 overdoses in Dublin and Cork in late 2023, according to local media. Nitazen was found in 48% of drug-related deaths in Estonia and 29% of drug-related deaths in Latvia in 2023.
The report also noted that cocaine use in Europe is at a record high. Pictured, a Portuguese judicial police officer removes cocaine from an open peach juice can (Photo: Horacio Villalobos Corbis/Corbis via Getty)
The EU’s European Medicines Agency (EUDA), which is due to expand its powers next week to respond to the changing drug threat, but has not yet done so, said there were “concerns that in future shortages of heroin, the market void could be filled by more powerful synthetic opioids and synthetic stimulants.”
“This could have potentially significant adverse effects on public health and safety,” the department said in a report earlier this month.
According to the UK National Crime Agency (NCA), Nitazen has been linked to 176 deaths in the UK, 47 of which occurred in Scotland. The drug is manufactured in China and sent to the UK via parcels and post, but the UK is not always its final destination – it is sometimes exported to other countries.
“Since June 2023, there has been an increasing prevalence of synthetic opioid/nitazene in the UK,” a spokesperson for the agency said, “However, forensic analysis shows that the majority of heroin seized is not fortified with nitazene and remains contaminated with typical impurities.”
Robin Pollard, head of policy and influence at UK drug and alcohol support charity WithYou, said: “It is becoming increasingly common for cheaper, more dangerous drugs like Nitazen to be found in the UK’s illegal drug supply.”
He said they have similar effects to other opioids such as morphine and heroin, but carry an increased risk of harm, overdose and death.
“In the case of Nitazen, the lethal dose can be as small as two grains of sand,” he said.
The group is calling for practical measures to tackle synthetic opioids on the UK market, such as expanding drug testing services and treatment programmes.
“Additional funding is also needed to introduce harm reduction services, which are not widely used,” he said.
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In May, the UK government announced that six more synthetic opioids would be placed under the highest level of regulation, in addition to the 15 already classified as Class A drugs.
At the time, Crime and Police Minister Chris Philp said: “We cannot allow the same devastating toll that synthetic opioids have taken in other countries to happen in the UK.”
“This is another step in our response – not only does it send a clear message that there are serious consequences for trafficking these drugs, but we are also updating the law to ensure we can respond swiftly as new threats emerge.”
The World Drug Report states that cocaine use worldwide has hit an all-time high, with production reaching 2,757 tonnes, a 20% increase since 2022.
Elsewhere, there has been a “renaissance” of psychedelic drugs, with them being used for “quasi-therapeutic” purposes.
“The populist movement has contributed to creating an environment that encourages growing commercial interest and widespread access to unsupervised, ‘quasi-therapeutic’ and non-medical use of psychedelics,” the report said.
“Such a move could preempt the development of scientific therapeutic evidence and guidelines for the medical use of psychedelics, potentially jeopardizing public health goals and increasing the health risks associated with unsupervised use of psychedelics,” the report said.
