DDN_May_2024 DDN May 2024 | Page 14



With the impact of synthetic drugs being realised across the UK , the APPG on Drugs , Alcohol and Justice dedicated its latest meeting to an escalating crisis . DDN reports

Steve Rolles , senior policy analyst at Transform , summarised the situation . The opioid market had been changing rapidly since the Taliban ’ s ban on opium production and destruction of Afghan poppy fields – which had previously accounted for 95 per cent of heroin in the UK . As opium could be stored for ten years , tons had been stockpiled , but prices had jumped up in the last six months and the stockpilers were cashing in . Alongside rising prices , purity had been falling and supply contraction was beginning to bite . Synthetic opioids were already filling the vacuum .

Fentanyls and nitazenes were of utmost concern as they were ‘ incredibly dangerous ’ – carfentanil was 10,000 times stronger than morphine and just a tiny amount of any of these drugs could be fatal . The ‘ cookie effect ’ increased the risk with such strong drugs – they were never mixed evenly so strength was not uniform across the batch . Furthermore , ‘ the market doesn ’ t just move to one drug – it mutates and
In New York City there are nine fentanyl deaths a day . ' What ’ s stopping this from happening in the UK ? Absolutely nothing .'
becomes very messy ,’ said Rolles . There were a ‘ whole bunch of variations ’ and the situation became confusing and chaotic . ‘ I ’ m genuinely scared ,’ he said . ‘ I ’ ve worked with colleagues in Canada and the US and have seen what has happened … there has been an absolutely terrifying level of death .’
MARKET TILT In Vancouver people weren ’ t able to get heroin that hadn ’ t been cut with fentanyl . An added complication was that people were actively seeking fentanyl – ‘ they like the rush and the euphoria and they don ’ t want to go back to heroin . They don ’ t want to put the cat back in the bag .’ In New York City there were nine fentanyl deaths a day . ‘ What ’ s stopping this from happening in the UK ? Absolutely nothing . Dealers are thinking “ why would we bother to ship from Afghanistan when we can manufacture a matchbox full ?” The legislation tilts the market towards drugs that are easier to manufacture .’
Rolles could see drug-related deaths in the UK doubling , trebling or quadrupling in a few years , ‘ or it could happen much faster ’. There were already about three nitazene deaths a week and we were ‘ looking down the barrel of a public health emergency ’. Current planning was ‘ woefully insufficient ’ and there needed to be new money and political commitment . ‘ I worry that we ’ ll have to have a big pile of dead bodies before anything happens ,’ he said . ‘ No one ’ s taking this as seriously as we should be .’
He recommended an emergency harm reduction plan that included drug-checking in every city and town , with test strips available for different drugs . Supervised drug consumption facilities should also be rolled out nationally and didn ’ t need to be multi-million pound units . Harm reduction advice needed to be realistic and relatable – and include housing environments for semi-supervised use , innovative prescribing options , and increased availability of naloxone .
In terms of political strategy , we had ‘ to speak with a collective voice ’ – experts together with people with lived experience – and avoid ‘ partisan polarisaton ’. We should lay out what was needed and how much it would cost , and act now . ‘ We also need to be absolutely clear that there is no enforcement solution ,’ he said . ‘ Banning drugs and increasing sentences and border seizures are all entirely ineffectual … organised crime doesn ’ t care if it ’ s illegal .’
ESCALATING SUPPLY ‘ The amount of drugs out there is escalating rapidly ,’ said Dr Adam Holland , co-chair of the Drugs Special Interest Group at the Faculty of Public Health . Not