Synthetic opioids are human synthesised substances made in a laboratory that target opioid receptors in the body. These chemicals affect the body in a similar manner to natural opioids, such as heroin.
Synthetic opioids are prescribed by medical professionals due to their effective pain-relieving properties, however, when misused can be highly addictive and are associated with a number of adverse risks.
Across the United Kingdom, there is a growing rate of opiate use disorders, a condition which requires medical intervention to be successfully treated.
More About Synthetic Opioids
Opioids can be naturally found in the seed pods of particular opium poppy plants. These drugs have been extremely useful for pain management for humankind for hundreds of years and are prescribed by doctors worldwide daily.
Synthetic opioids are manufactured in a laboratory and were invented as alternatives to their naturally occurring predecessors due to their faster production time and higher potency. The increased strength means pain is able to be treated at higher efficiency with a lower dosage.
Some kinds of synthetic opioids are legal for pain management purposes: some of these include tramadol, methadone, oxycodone, and fentanyl. Though due to the potent nature of these drugs, they have a high potential for abuse and for some people, even taking them as prescribed results in an opioid use disorder.
People also take illegal synthetic opioids for recreational purposes. The most frequently encountered types of these drugs are fentanyl analogues, which are linked internationally to a number of drug-related deaths. Two kinds of this drug include 2-benzyl benzimidazole (nitazene) and the piperidine benzimidazolone (brorphine-like) opioids.
Opioid Use Disorder
Both natural and synthetic opioids bind to opioid receptors that are stationed around the brain and body. This binding blocks pain signals from being able to be communicated throughout the body and numbs the sensation. This mechanism also produces powerful euphoric and relaxing effects, causing people to become addicted to this high.
If someone uses these drugs multiple times, their body can become dependent on the substance and experience withdrawal if it isn’t taken regularly. From this, an opioid use disorder can form. Other symptoms of this condition include:
- Continuing to take the drug despite the negative effects on someone’s health, relationships, and career
- Uncontrollable cravings
- Changes in sleeping habits
- Weight loss
- Flu-like symptoms
- Lack of hygiene
- New financial difficulties
- Isolation from family and friends
- Hiding the drug-taking behaviour
Once a person develops an opioid use disorder, it can be very difficult to stop taking the drug. Alongside fighting the uncomfortable and dangerous withdrawal symptoms – including intense drug cravings, insomnia, hallucinations, and more – through drug taking, the brain has undergone physical and chemical changes in its reward and decision-making centres. These changes make it incredibly difficult to stop drug-taking behaviour, even when the person may want to.
Due to the high potency of these synthetic drugs, the risk of overdose is also higher compared to naturally occurring opioids, because substantially lower amounts are needed to reach the point of overdose.
Overdosing on synthetic opioids poses a serious threat to life. If you suspect someone may be experiencing an overdose, contact the emergency services immediately. Symptoms of an overdose on synthetic opioids include:
- Loss of consciousness
- Cardiorespiratory arrest
Synthetic Opioids in the UK
As it is relatively easy to modify the chemical structure of drugs, new synthetic opioids (NSOs) are always being generated. This creates challenges in trying to control the legal status of synthetic drugs, with laws always changing and trying to control the newly created chemical structures.
One of the NSOs currently under a careful watch in the UK is nitazene due to international reports documenting severe toxicity of this drug. This substance is commonly sold as powders or nasal spray and is taken via intravenous injection, under the tongue, the nasal passageways, or inhalation.
There have also been reports of nitazene being used to fortify street heroin (to make it more potent) and in counterfeit medications. This is extremely dangerous as people may not realise this powerful drug is included in what they have taken, and this substantially increases the risk of a fatal overdose.
The piperidine benzimidazolone opioid brorphine – or “purple heroin” – is another NSO that is growing in popularity. This chemical can trigger life-threatening respiratory depression and arrest, with at least sixty overdoses being put to the use of this drug globally.
Brorphine has been increasingly detected in seized powders and medications, again posing an increased chance of a fatal overdose. This drug is usually taken orally or via inhalation, though can also be intravenously injected.
Currently, both nitazene and brorphine are not controlled under the Misuse of Drugs Act 1971, which aims to prevent the misuse of controlled drugs. As they are both psychoactive, they are covered under the Psychoactive Substances Act 2016, which makes the import, supply, and possession with the intent to supply (of these substances) punishable offences.
The Public Health Impact of Opioids
Over the past thirteen years in the UK, new psychoactive substances have posed a substantial public health risk, with NSOs increasingly contributing to this challenge. The misuse of prescription opioids also poses a large threat to public health, with a study finding the UK consumes the highest rate of prescription opioids for pain management per capita in the world.
Between 2020 and 2021 in England, the Office for Health Improvement and Disparity reported over half of the adults in treatment for a substance use disorder were there for problems with opioids.
The Office for National Statistics also found that nearly half of the drug poisoning deaths in 2020 involved an opiate (49.6%), which is 4.8% higher than in 2019, and shockingly 48.2% higher than in 2010.
Although opioid use is on the rise, the UK government has a whole-system approach strategy to tackle illegal drug use and supply. One of these measures is investing a record £780 million into the drug treatment system, allowing more people to access substance abuse treatment and help them stay clean.
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