The pool of people at risk of overdose from a new type of super-strength synthetic opioid is widening.

Once linked to contaminated batches of heroin, nitazenes are increasingly being found in counterfeit medicines, including benzodiazepines and oxycodone. In December 2023, a report from the Advisory Council on the Misuse of Drugs (ACMD) noted that nitazene opioids can be sold as powders or in nasal spray form and can be given intravenously or by the sublingual or nasal routes, or even by vaping​[1]​.

The risk now is such that a national patient safety alert advised in July 2023 that NHS staff across primary and secondary care should be made aware of nitazenes’ high potency and toxicity to help avoid further overdoses​[2]​.