Fentanyl
fent · fentanyl analogues
What does current UK evidence show?
ONS recorded 55 England and Wales registrations mentioning fentanyl in 2025, compared with 60 in 2024; these counts do not distinguish medical exposure from illicit supply. Fentanyl remains a preparedness concern, but current UK synthetic-opioid intelligence is more strongly centred on nitazenes. Detection should not be assumed without analytical confirmation.
Overview
Identity, legal classification, form and pharmacological context
- Drug category
- Opioids · Synthetic drugs · Medicines
- Common names
- fent, fentanyl analogues
- Typical forms
- Medical formulations include patches, injections and lozenges; illicit fentanyl may occur in powders or counterfeit tablets and may be an undeclared adulterant
- Routes
- Medical route depends on the formulation. Illicit exposure may be intentional or unintentional through another product
- UK legal classification
- Class ASchedule 2 medicine under the Misuse of Drugs Regulations 2001.Check government source ↗
- Concise pharmacology
- Acts primarily at opioid receptors, producing analgesia, sedation and respiratory depression.
Main harms
Concise clinical and polydrug picture
Reduced consciousness and slowed or stopped breathing are the principal overdose risks.
Dependence, constipation, endocrine effects and repeated overdose risk can develop.
Withdrawal can include agitation, pain, diarrhoea, vomiting, insomnia and intense craving.
Benzodiazepines, alcohol, gabapentinoids and other sedatives increase respiratory-depression risk.
Very high potency, uncertain concentration and unintentional exposure create severe overdose risk; injecting adds infection and tissue-damage risks.
Current intelligence status
Assessment, confidence and direction
ONS recorded 55 England and Wales registrations mentioning fentanyl in 2025, compared with 60 in 2024; these counts do not distinguish medical exposure from illicit supply. Fentanyl remains a preparedness concern, but current UK synthetic-opioid intelligence is more strongly centred on nitazenes. Detection should not be assumed without analytical confirmation.
Reason: Credible but partial sources support a constrained assessment; the direction or reach cannot be generalised across the UK.
Principal source limits: Deaths are counted by registration year; 62.7% of the 2025 registrations concern earlier deaths. Substance mentions overlap and do not prove sole causation. Rapid Scottish intelligence combines several systems; figures may be revised and are not directly comparable with UK-wide statistics.
Geography and reference periods are given in each linked source card below. The rating is an editorial evidence judgement, not a probability, clinical risk score or TD priority.Signals justify continued monitoring, but current evidence does not support a formal escalation assessment.
Operational implications
Evidence-supported prompts for professional response
Keep naloxone and overdose protocols ready while distinguishing fentanyl from other synthetic opioids in alerts and toxicology.
Record substance, sold identity, route, frequency and combinations; review overdose and withdrawal needs.
Prioritise airway and breathing, give naloxone for suspected opioid overdose and continue supportive care.
Send unexpected products or incidents through agreed testing and alert routes; distinguish confirmed results from preliminary reports.
Related intelligence
Continue into connected platform evidence
Sources & limitations
Direct evidence links, reference periods and status
Deaths related to drug poisoning in England and Wales: 2025 registrations
Published4 Nov 2026Reference period2025 registrations; 2024 occurrences
Deaths are counted by registration year; 62.7% of the 2025 registrations concern earlier deaths. Substance mentions overlap and do not prove sole causation.RADAR quarterly report
Published27 Oct 2026Reference periodScottish streams differ: suspected deaths June–August; forensic toxicology April–June 2026
Rapid Scottish intelligence combines several systems; figures may be revised and are not directly comparable with UK-wide statistics.Welsh Emerging Drugs and Identification of Novel Substances
PublishedContinuousReference periodSubmitted samples
Submitted samples confirm their own contents but cannot estimate prevalence or represent the wider drug supply.Fentanyl drug profile
PublishedSource page undatedReference periodPharmacology and formulations
Profile does not establish the frequency of illicit fentanyl in the current UK supply.