Nitazenes
2-benzyl benzimidazole opioids · synthetic opioids
What is currently changing about this drug in the UK?
Nitazenes remain the leading UK synthetic-opioid preparedness threat. NRS recorded 247 Scottish drug use deaths involving nitazenes in 2025 versus 76 in 2024, including 215 involving etonitazene; expanded routine testing (etonitazene from May 2025) may explain part of the apparent increase. ONS mortality and Scottish RADAR also provide confirmed harm signals, while the geographic picture remains incomplete.
Overview
Identity, legal classification, form and pharmacological context
- Drug category
- Opioids · Synthetic drugs
- Common names
- 2-benzyl benzimidazole opioids, synthetic opioids
- Typical forms
- Detected in powders, counterfeit tablets and other products, often as undeclared ingredients
- Routes
- Exposure may occur through the route used for the product in which they are present and is frequently unintentional
- UK legal classification
- Class ANamed nitazenes and substances within the current generic nitazene definition are controlled as Class A.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, uneven mixing and uncertain identity create extreme overdose risk; injecting adds infection and tissue-damage risks.
Current intelligence status
Assessment, confidence and direction
Multiple credible sources support active preparedness while gaps in speed and geographic coverage remain.
Operational implications
Evidence-supported prompts for professional response
Maintain wide naloxone access, repeat-dose and airway protocols, fast testing, same-day treatment routes and cross-agency notification.
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
Drug-related deaths in Scotland, 2025
Published23 Sep 2026Reference period2025 registrations
NRS calls this series drug use deaths. Substance implication overlaps and does not prove sole causation. Nitazene testing expanded, including etonitazene in May 2025; 2025 versus 2024 rate difference is not statistically significant.Deaths related to drug poisoning in England and Wales
Published17 Oct 2025Reference period2024 registrations
Deaths are counted by registration year; substance mentions overlap and do not prove sole causation.RADAR quarterly report
Published28 Jul 2026Reference period05 Apr–04 Jul 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.