Scientists are calling for greater scrutiny on UK’s use of opioid medication to combat overdoses. Illustration: Skinny Tang/REX
With 15 people dying from fentanyl overdose over the past two months, the UK has exceeded a record-high tally of fatal overdoses in 2018, compared with figures in 2017. Between Jan 1 and October, at least 44 people died from opioid overdoses, the highest number of deaths since 2012.
With the opioid epidemic spreading from West Virginia to the UK, scientists say that more needs to be done to monitor the drug’s use.
Deaths from carfentanil, a powerful synthetic opioid found in ketamine, opium and some synthetic drugs, have reached record levels in 2018, increasing by 36% to 451 across the UK since January, according to the latest figures from the Office for National Statistics (ONS).
Fentanyl, which is 100 times more potent than morphine, was first prescribed to terminally ill cancer patients as a painkiller in 2004, but has become much more popular in the past decade as a substitute for heroin or cocaine.
The Observer has revealed that at least two UK hospitals use a cutting agent that was originally designed to euthanise animals to cut the dosage of fentanyl prescribed to their own patients. Hospital services said that the specific substance they were using was approved by the Medicines and Healthcare products Regulatory Agency, the pharmaceutical regulator.
“There is an epidemic,” said Dr David Nutt, a former chairman of the Advisory Council on the Misuse of Drugs, the body that provides advice to the government on how to combat opioid abuse. “I have been alarmed by the increasing number of deaths.”
Gareth Morgan, a police officer in north London, lost his 25-year-old brother to an overdose of fentanyl, which killed him within 15 hours of first taking it. He said he felt the drug was helping to destigmatise opioids, allowing those using them to feel more normal.
“You can literally die before you even begin and that’s really concerning,” he said. “There’s quite a lot of people walking around with the drug taking themselves, so people should be aware and receive the correct care.”
The ONS did not release data for fatal overdoses from carfentanil in the first half of 2018. But a report published by Professor Simon Greene, of King’s College London, and colleagues, showed there had been 351 admissions to hospital for opioid-related carfentanil poisoning this year to September, up from just 69 a year earlier.
Across the UK, accidental overdose deaths have been rising since the middle of the last decade.
Between 2010 and 2015, the rise in accidental deaths caused by fentanyl was highest in the most deprived areas, but the first three quarters of 2018 showed a significant increase in the highest socioeconomic areas and a small decline in the most deprived areas.
James Gough, who resigned as the chief executive of the NHS national drugs strategy on Wednesday, warned that in some areas of the country, opioids were being sold without a prescription. “We really need better oversight,” he said.
Although the number of illicit overdoses can be harder to monitor, it appears heroin has been supplied in England and Wales through loopholes in drug licensing regulations and transport. The companies that supply the drugs are often based overseas, making monitoring impossible.
A spokesman for Home Office said it was “working to strengthen existing powers to tackle the supply of the drugs, improve information sharing to reduce the risk of misuse of these products”, and cautioned that users who fell ill from misuse should seek medical help.
However, Mark Davis, the principal secretary to the Treasury and lead on the criminal justice programme, said that there was “simply no evidence that stockpiling drug substitutes such as fentanyl is likely to reduce deaths from drug misuse”.
However, Nutt said: “I would argue that there is no way to do it without causing extreme harm. If the rush to access fentanyl is because they have an urge to do so or they are receiving some kind of drug-related trauma, there needs to be urgent steps to increase monitoring and reducing the use of fentanyl.”