Victims of a nitazene overdose are likely to need more doses of naloxone to bring them back around. Since nitazenes require extensive testing to detect, frontline workers are often left guessing about the true cause of an overdose – such as one experienced by Gareth John, who manages a hostel in Cardiff.
“We found the gentleman laying on the floor with a needle. We put him in a position but we also put naloxone into him. We put four, five amounts of naloxone inside the person,” John told the Big Issue, adding it was not uncommon to use 10 or 12 doses of naloxone.
John, who works for homeless charity The Wallich and sits on local boards responding to drug deaths, said the Welsh capital saw a wave of deaths around Christmas 2023.
“It was just like another death, another death, another death, and every week it was information being shared from the area planning board with the hostels, to make sure everyone was up to date,” he said.
Nitazenes are here to stay, said Steve Brinksman, the medical director of Cranstoun, with the government’s decision to make them class A drugs not making a “blind bit of difference”.
“With the Taliban’s destruction of the opium crop in Afghanistan, then this year and next year the supply of heroin is going to become much more restricted,” Brinksman said. “It’s likely people will look to other things… to bulk out the bits of heroin that they get. It’s potentially a very significant change in the UK’s drugs scene.”
Recent samples submitted to Wedinos, a drug testing service, show nitazenes are present not just in street heroin, but in drugs often purchased online, such as valium, oxycodone and xanax. In one sample, nitazenes were found in a 2CB pill – a psychedelic typically used recreationally.
“Once it starts to get into drugs that are not opioids, then you’re dealing with people who don’t use opioids, who don’t have the tolerance, and potential for overdose and death is greater,” said Brinksman. “It’s high enough in people who’ve got a tolerance, but in opioid-naive people it’s a recipe for disaster.”
With information on the nitazenes crisis patchy and limited, the Big Issue went to ambulance services to try and understand the extent of overdoses not captured in official death data.
In May 2024, paramedics in England administered over 3,500 doses of naloxone – an increase from 2,385 in January 2023. Rather than a consistent supply, experts told the Big Issue, nitazenes often appear locally in bursts.
A lack of information and consistent testing makes it difficult for authorities and drug services to respond, said Katy Porter, CEO of The Loop.
“There is a lag in terms of information and therefore in terms of our understanding and response. If we are responding once there has been a large number of deaths, we are too late. Drug testing should enable us to get ahead of the curve here,” said Porter.
As shadow home secretary, Yvette Cooper accused Conservative ministers of “complacency” over the risks nitazenes pose. Now she is home secretary, and a government spokesperson told the Big Issue: “We are not complacent to the threat posed by new emerging drugs. It is vital we grip this problem and prevent them spreading more widely into communities and prevent tragic deaths from drug use.
“We will continue our engagement with partners across health, policing and wider public services to drive down drug misuse, and move forward with our mission to make streets safer.”
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