TitFentanyl is now the most commonly used illicit opioid in countries like the United States and Canada. In the past 10 years, fentanyl has caused over half a million deaths. And fentanyl is now in the United Kingdom, as numbers of deaths from fentanyl show a steady upward trend.

In this blog, we explore why it is possible that fentanyl will also flood into the UK, why it has not already done so, and also look at other synthetic opioids which have made their way to the streets of the UK.

If you or your loved one needs help for fentanyl addiction and you don’t know where to turn, contact us on +44 20 4530 5225.

A Brief History of Fentanyl

Fentanyl is a powerful synthetic opioid first synthesized by Dr. Paul Janssen, a Belgian chemist, in 1959. It was originally developed for use as an intravenous anesthetic, and was found to be incredibly potent—about 50 to 100 times stronger than morphine. Health professionals began to  use it to manage severe pain in patients, especially those undergoing surgery or dealing with chronic pain, in the form of patches, lozenges, or injectable solutions.

In the 1990s, fentanyl began to be increasingly prescribed for pain management, particularly in patients with cancer or those experiencing intense post-surgical pain. However, its misuse potential started to surface as well, especially in the form of illicit fentanyl, which was often mixed with other drugs to increase potency.

Black market fentanyl was being sent over from China and being sent to Mexico, where cartels would combine it with heroin, producing a stronger and more deadly form of the drug. It is easy to see why cartels have a preference for fentanyl – the potency of fentanyl means it is far easier to transport, and low costs ensure that cartel profits are maximized.

By the 2000s, fentanyl-related overdoses began rising sharply in the U.S., and concerns about illicit production and distribution spread globally. Fentanyl became widely available on the black market, often mixed with other illicit substances like heroin or counterfeit prescription pills, leading to an alarming increase in overdose deaths.

Today, fentanyl use is rife across the United States, Canada and Mexico. In 2023, there were around 74,000 deaths caused by fentanyl in the US alone.

The Growing Presence of Fentanyl in the UK

Heroin has been a problem in the UK since the 1960s, though the impact of heroin only became pronounced in the country in the 1980s, as parts of the UK saw a decline. Major cities like London, Liverpool and Glasgow saw a significant rise in heroin users, as many people turned to the drug in desperation to escape difficult living environments.

There are now around 50,000 to 60,000 people who are dependent on heroin in the UK. But until now, fentanyl has rarely been seen. That may be beginning to change. In 2023, the UK saw 41 deaths from fentanyl, and while this figure is very low compared with the US, it shows that fentanyl is making its way into the country.

With 41 deaths in a year, it means that it is possible that already 1000s of drug users in the UK are consuming fentanyl, either wittingly or unwittingly. Should fentanyl become popular in the UK, it will be hard to eradicate.

Profits are far greater with fentanyl, and the costs to end users are much lower. Should disruption happen to the importation of heroin, it is likely that fentanyl will become far more common, as distributors seek to meet the demand for powerful opioids.

This disruption has happened before. In 2010 and 2011, poor poppy harvests in Afghanistan (where many of the poppies for UK heroin are grown), interdiction efforts, and logistical challenges in the drug trade meant international drug gangs were not able to supply the United Kingdom, resulting in a heroin “drought”.

The result then was that many heroin users switched over to substitute opioids available on the NHS, such as methadone and Subutex, while others began using non-opioid drugs, such as crack cocaine.

Should a similar drought happen again, the results could be disastrous, as it would allow fentanyl to imbed itself in the UK drug scene.

Why Has Fentanyl Not Taken Off in the UK Already?

With such vast sums to be made for those who import fentanyl, why has fentanyl not taken over in the UK, as it has done in the US and Canada? The main reason for this is likely to be the people behind importation into these areas.

The Mexican drug cartels who control the majority of the drug market in the United States have shown themselves to be incredibly ruthless, willing to assassinate politicians in Mexico, murder Mexican citizens in wholesale fashion, and supply drugs which they know will kill great swathes of people each year.

They are effectively able to control large areas of Mexico, and claim numbers which rival those of the Mexican army. They also possess military-grade weapons which allow them to take on the military effectively.

And while some transnational drug organizations are well-organised and have large numbers of active participants, it is likely that as law enforcement agencies are aware of how destructive fentanyl could be if it enters the UK, any signs of fentanyl use are being heavily monitored. 

Gangs importing into the UK lack the overwhelming strength which cartel forces have, meaning they could never protect themselves from armed forces anywhere they do business within the UK and Europe. As fentanyl deaths in the UK trigger intense scrutiny by drug agencies in the UK, fentanyl importation then becomes a far more dangerous proposal for gangs than “only” importing heroin.

Nitazenes in the UK: Novel Synthetic Opioids

Fentanyl is not the only powerful synthetic opioid which has recently appeared within the black market in the UK. Nitazenes, a family of opioids which are similar in action to fentanyl but even more powerful, have also been causing deaths in the United Kingdom.

Isotonitazene, Nitazene, Cyalonitazene, Metonitazene, like fentanyl, are manufactured within China and shipped overseas, often mixed with traditional street opioids such as heroin.

Between June 1, 2023, and May 31, 2024, nitazenes were associated with 179 deaths in England, far more than deaths caused by fentanyl in the same period. Should heroin supplies to the UK be interrupted, it is also highly likely that these nitazenes also become more widely available. 

The Need for Support Before It’s Too Late

As fentanyl and nitazenes continue to make their way into the UK’s drug scene, there is an urgent need for increased public awareness, better detection methods, and more resources dedicated to tackling the synthetic opioid crisis. Without comprehensive intervention, it’s likely that the number of fatalities linked to fentanyl and similar substances will continue to rise.

Should there be disruption in the flow of heroin into the UK again, it is likely that fentanyl and other powerful synthetic opioids will have the opportunity to take hold.

To help combat this growing problem, it’s essential for individuals and communities to stay informed about the dangers of these powerful opioids. If you or someone you know is struggling with addiction, seeking professional help is a crucial step toward recovery. Contact us on +44 20 4530 5225 to find out more about how we can help.