By Hollie Bates and Dr. Mikael Khan
An insidious threat is taking hold across the globe – the rise of synthetic opioids. These manufactured drugs, often far more potent than their natural counterparts, are fuelling a surge in addiction and overdose deaths worldwide.
Opioids are a class of drugs derived from the opium poppy (Papaver somniferum). These can be sourced naturally or synthetically created to mimic their effects. They work by stimulating nerve cells in the brain called opioid receptors, relieving pain, and inducing feelings of euphoria. While some opioids, like codeine and morphine, play a vital role in pain management, their addictive potential is well-known. Heroin, an illegal opioid1, is a notorious example.
Synthetic opioids, however, are a different beast. Chemically engineered to mimic natural opioids, they are often far stronger – fentanyl, for example, can be up to 50 times more potent than heroin and a hundred times stronger than morphine2. This increased potency makes them incredibly addictive and significantly raises the risk of overdose and death. Effects of synthetic opioid use include euphoria, drowsiness, decreased gastrointestinal motility, nausea, decreased blood pressure, respiratory depression, and death.
The synthetic threat
Synthetic opioids pose a unique threat. While traditional opioids are produced in legal pharmaceutical laboratories for medicinal use and are highly regulated, synthetic opioids are produced in clandestine labs, allowing criminals and syndicates to bypass traditional drug trafficking routes and directly target local markets.
They can be disguised as legitimate pharmaceuticals and easily shipped through mail or courier services, which make them difficult to detect. They are often mixed with other drugs like cocaine or methamphetamine, creating a more dangerous and addictive cocktail.
A global problem
The UN, in its World Drug Report 2023, estimates that 60 million people worldwide misuse opioids. New synthetic opioid products available for illegal consumption worldwide has risen from 3% in 2015 to 14% in 20213.
In the UK, distribution of synthetic opioids in the illegal drug market is on the rise. In 2022, these substances were responsible for 2,261 opioids related deaths, or nearly half (46.1%) of all drug-related deaths in the country, according to the Office for National Statistics4. In recent weeks, news of synthetic opioids-related deaths5 in various parts of the country have again put the issue in the spotlight.
The synthetic opioid crisis extends beyond borders. Afghanistan, once the world’s main opium supplier, banned poppy cultivation in 2022, resulting in a 95% opium cultivation. In 2023, opium supply decreased from 6,200 tonnes to 333 tonnes. This disruption, with retail cost sharply rising by 248%, has forced European drug markets to turn to synthetic alternatives.
The US, meanwhile, is another epicentre of the crisis, with synthetic opioids use increasing since 2013. In 2019, 70,630 drug related deaths were reported with over half of these related to synthetic opioids. Between 2013 and 2019, synthetic opioids deaths increased by a staggering 1,040%6. In 2021, 107,622 people had succumbed to drug related deaths with 68% being linked to synthetic opioids. US authorities are tackling the issue by cracking down on production and distribution.
The UK’s challenges and response
The UK is also grappling with a rise in synthetic opioid deaths, particularly from fentanyl and nitazenes. Nitazenes were first created in the 1950s for medical purposes. Due to their extreme potency, these drugs were deemed too dangerous for human consumption and denied any use other than a select few compounds for academic research7. Since 2019, toxicology reports in Europe and the UK have identified the presence of nitazenes8.
To combat this, the UK government has reclassified them under the highest drug control category, imposing harsh penalties for production and possession. In March 2024, 15 synthetic opioids (14 nitazenes) were classified as Class A drugs under ‘The Misuse of Drugs Act 1971’. Possession carries the maximum sentence of seven years imprisonment and/or an unlimited fine, while production and supply a maximum sentence of life imprisonment and/or an unlimited fine.
Early warning systems and treatment
A key element of the UK’s strategy involves real-time drug detection via a state-of-the-art monitoring system that tests wastewater. This allows authorities to identify specific drugs, pinpointing locations where the drugs are present, and tailor responses accordingly. This surveillance system can measure the quantity of the drugs found in water and records spikes in high overdose areas.
It is crucial to stay ahead of this evolving threat. Companies like SUEZ recycling and recovery UK are at the forefront of water-based epidemiology, using advanced bespoke wastewater sampling and analysis techniques to detect not only illegal drugs but also substances used to synthesise them. This provides valuable insights into drug use trends, allowing authorities to target resources and interventions more effectively.
Furthermore, a 10-year plan is in place to expand the drug and alcohol treatment workforce in the UK, providing more support for those struggling with addiction. Additionally, expanding access to Naloxone, a lifesaving drug that reverses opioid overdoses, can be a crucial tool for preventing fatalities.
A step towards a safer future
The fight against synthetic opioids is a complex one. The measures outlined above demonstrates the UK’s commitment to tackling this crisis head-on. By implementing strict measures and penalties, the country has a fighting chance to curb this deadly trend. This crisis also presents an opportunity for the wastewater industry to develop further platforms to assist law enforcement and healthcare in combatting future drug threats. A global effort is needed to address the production and distribution of these synthetic killers, ensuring safer communities worldwide. Closer to home, SUEZ’s wastewater sampling and analysis is a key tool for deploying effective surveillance programmes in the UK.
SUEZ is committed to keeping the people and planet safe and thriving. It recognises the growing need for accurate and reliable environment data, which cater to both municipal and industrial clients. For more information about water-based epidemiology sampling and analysis services for a variety of industries, please send your queries to Project and Sales Manager Paul Pickard through aquaenquiries.uk@suez.com or call 01924 242255.
(Authors: Hollie Bates is Laboratory Technician and Dr. Mikael Khan is General Manager for sampling and analytical solutions for SUEZ recycling and recovery UK.)
References:
[1] https://hopkinsmedicine.org/health/treatment-tests-and-therapies/opioids
2 https://pubmed.ncbi.nlm.nih.gov/31643200/
3 https://www.unodc.org/res/WDR-2023/Special_Points_WDR2023_web_DP.pdf special points booklet page 4
5 https://www.bbc.co.uk/news/articles/c511ln20320o
6 https://www.who.int/news-room/fact-sheets/detail/opioid-overdose
7 https://www.drugsandalcohol.ie/39920/
8 https://www.unodc.org/LSS/Announcement/Details/cbec8f4c-73aa-49ee-9e2b-75620af8a910