United Kingdom›Drug Intelligence A–Z›Tramadol
Sources & methods↗
Operational substance intelligence

Drug Intelligence A–Z

UK drug profiles, emerging signals, harms and current intelligence

Editorial review: 4 November 2026
Evidence-led, not encyclopaedic

Profiles prioritise what is changing and what professionals need to watch. Evidence types are kept separate; a submitted sample or isolated detection is never treated as representative of the UK drug supply.

How evidence is assessed ›
Highest Current ConcernStrongest current emerging or escalating signals
Recently UpdatedNew evidence or revised assessment
Under SurveillanceDeveloping signals requiring continued monitoring
Category
Intelligence
SubstanceCategoryUK legal classificationCurrent UK intelligenceStatus / last reviewed
2C2C-B2CB · 2C B · NexusPsychedelicsSynthetic drugsClass AClass A, Schedule 1. Genuine 2C-B is a specific compound; tusi is a variable mixture.A synthetic psychedelic phenethylamine with stimulant-like effects. Genuine 2C-B is a specific chemical, distinct from the variable mixtures called tusi or pink cocaine.An established controlled drug with limited current UK trend evidence. Tusi or pink cocaine reports are not evidence of 2C-B exposure unless analysis identifies it.Established substance4 Nov 2026›ALAlcoholbooze · drinkDepressantsNot MDA-classifiedNot controlled under the Misuse of Drugs Act 1971; alcohol sale and supply are regulated separately.A widely used central nervous system depressant with substantial treatment, health and social harms.Alcohol remains a major component of treatment demand. Current platform evidence is strongest for English treatment contact rather than a single UK-wide trend measure.Established substance4 Nov 2026›ALAlkyl nitrites (poppers)poppers · alkyl nitrites · amyl nitriteInhalantsNot MDA-classifiedNot MDA-classified. PSA supply restrictions and product-safety controls remain relevant; an explicit exemption is only recommended.Volatile vasodilator liquids used for brief effects and smooth-muscle relaxation, with important blood-pressure, poisoning and eye risks.UK reports document poisoning and visual injury, but surveillance is incomplete. A proposed explicit Psychoactive Substances Act exemption has not been enacted.Established substance4 Nov 2026›AMAmphetaminespeed · whizz · baseStimulantsClass BClass A when in a preparation designed for administration by injection.A stimulant usually encountered as powder or paste in the UK illicit market.WAND estimated 55% lower consumption across comparable sampled sites between early 2021 and early 2026, including a 39% fall from early 2025, but this experimental signal does not establish a fall in every locality or population.Established substance4 Nov 2026›ANAnabolic-androgenic steroidsanabolic steroids · AAS · steroidsImage- and performance-enhancing drugsMedicinesClass CControlled AAS are Class C, generally Schedule 4 Part II. Personal-use possession exceptions do not authorise supply or postal import.Testosterone-related drugs used medically and non-medically for muscle growth, with endocrine, cardiovascular, psychological and injecting-related harms.UK clinical guidance recognises established service need. Available evidence does not establish a reliable current UK population total or a uniform national increase.Established substance4 Nov 2026›BEBenzodiazepinesbenzos · street benzos · downersDepressantsMedicinesCompound-specificMost named benzodiazepines are Class C; the exact control and medicines schedule depend on the compound.A medicine group whose illicit and counterfeit market includes rapidly changing compounds.ONS recorded 596 England and Wales drug-poisoning registrations mentioning benzodiazepines in 2025, down from 629 in 2024. Benzodiazepines were implicated in 433 Scottish drug use deaths in 2025, including 300 involving street benzodiazepines; both broad groups fell over the latest year. They remain prominent in polydrug deaths, while Scottish RADAR intelligence describes changes in the novel-benzodiazepine market. A tablet's appearance does not establish its contents.Established substance4 Nov 2026›BRBromazolambromos · street XanaxDepressantsSynthetic drugsClass CA Schedule 1 controlled drug with no recognised medicinal use in the UK.A novel benzodiazepine-type depressant not licensed as a medicine in the UK.England and Wales registrations mentioning bromazolam rose from 169 in 2024 to 177 in 2025. Scottish bromazolam-implicated deaths fell from a 2023 peak of 426 to 103 in 2025. RADAR indicates changing compounds in the street-benzodiazepine market; a decline in this one compound does not remove mixed-sedative risk.Under surveillance4 Nov 2026›BUBuprenorphinebupe · Subutex · SuboxoneOpioidsMedicinesClass CSchedule 3 medicine under the Misuse of Drugs Regulations 2001.A partial opioid agonist used in treatment and pain care, with diversion and combination risks.Current national sources support continued monitoring within the wider opioid and treatment picture; they do not indicate a distinct emerging UK market shift.Established substance4 Nov 2026›CACannabisweed · skunk · hash · resinCannabinoidsClass BCannabis, cannabis resin and cannabis oil are controlled; authorised cannabis-based medicines have separate schedules.The most commonly reported illicit drug in the Crime Survey for England and Wales.CSEW continues to show cannabis as the most prevalent illicit drug. Household-survey prevalence should not be used as a proxy for potency, dependence or severe harm.Established substance4 Nov 2026›COCocainepowder cocaine · coke · charlieStimulantsClass ACocaine is a Class A controlled drug.A short-acting stimulant with substantial mortality involvement and persistent UK market demand.ONS recorded 1,233 England and Wales registrations mentioning cocaine in 2025, down 3.6% from 1,279 in 2024. Cocaine nevertheless overtook heroin/morphine as the most frequently mentioned specific substance; opioids remained the largest group. Scotland separately recorded 589 cocaine-implicated drug use deaths in 2025 (52%, up 23%). Mortality data do not split powder from crack, and a mention does not establish sole causation.Increasing harm4 Nov 2026›COCodeinecody · co-codamol · lean ingredientOpioidsMedicinesClass BClass A if prepared for administration by injection. Codeine is generally Schedule 2, while qualifying low-strength preparations may be Schedule 5; medicine schedules are distinct from MDA class.An opioid medicine found in prescribed and over-the-counter combination products.Codeine contributes to the wider opioid mortality and dependence picture. Public sources do not currently establish a new UK-wide illicit-market shift.Established substance4 Nov 2026›CRCrack cocainecrack · rock · stonesStimulantsClass ACrack is a form of cocaine and is controlled as Class A.A smokeable form of cocaine associated with high-intensity use and distinct treatment and social harms.National mortality data record cocaine rather than a separate crack-specific total: 1,233 England and Wales registrations in 2025 and, separately, 589 Scottish drug use deaths in 2025. English treatment data therefore provide essential context for opiate-and-crack and crack-only need.Increasing harm4 Nov 2026›DIDiazepamValium · vallies · bluesDepressantsMedicinesClass CSchedule 4 Part 1 medicine under the Misuse of Drugs Regulations 2001.A long-acting benzodiazepine medicine also encountered through diversion and counterfeit markets.The current concern is strongly linked to combinations and uncertain tablet contents. Named-sale identity should be kept separate from analytical confirmation.Established substance4 Nov 2026›DMDMTN,N-dimethyltryptamine · dimethyltryptamine · DimitriPsychedelicsClass AClass A, Schedule 1. DMT-containing preparations are controlled; ceremonial or research labels do not provide a general exemption.N,N-dimethyltryptamine is a short-acting serotonergic psychedelic. Inhaled DMT, changa and ayahuasca differ in composition, duration and interaction risks.UK polydrug case reports and clinical research provide different evidence. Neither establishes a national increase in recreational use or sole DMT causation of deaths.Limited UK evidence4 Nov 2026›ETEtomidate and related compoundsetomidate · metomidate · propoxateDepressantsMedicinesSynthetic drugsCompound-specificEtomidate is prescription-only; Class C control is proposed, not commenced. Related compounds require separate assessment.Etomidate is an anaesthetic medicine detected in unregulated products. International vaping alerts support UK surveillance, while evidence of UK non-medical use remains limited.A small number of UK detections support surveillance. Overseas vaping alerts do not establish widespread UK use; proposed Class C etomidate control is not yet in force.Limited UK evidence4 Nov 2026›FEFentanylfent · fentanyl analoguesOpioidsSynthetic drugsMedicinesClass ASchedule 2 medicine under the Misuse of Drugs Regulations 2001.A highly potent synthetic opioid used medically and monitored in illicit drug markets.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.Under surveillance4 Nov 2026›GAGabapentinNeurontinDepressantsMedicinesClass CClass C and Schedule 3 since 1 April 2019; prescription-only medicine. GB and Northern Ireland regulations apply separately.A gabapentinoid prescribed for epilepsy and peripheral nerve pain, with dependence and overdose concerns that require assessment separately from pregabalin.The 2026 MHRA warning reinforces established dependence and withdrawal risks. Scotland’s 2025 gabapentin and/or pregabalin mortality category cannot isolate gabapentin or its trend.Established substance4 Nov 2026›GBGBLG · gamma-butyrolactoneDepressantsSynthetic drugsClass BControlled for human ingestion; legitimate industrial-use provisions apply.An industrial chemical rapidly converted to GHB in the body and used for similar effects.GBL is widely encountered in UK chemsex and sexualised drug-use settings and is rapidly converted to GHB in the body. GHB is also reported, and many UK datasets group GHB and GBL together, so the precise substance used or sold is not always distinguishable. A Home Office consultation published on 19 August 2026 proposes tighter controls; current law remains unchanged pending the outcome and any subsequent legislation.Established substance4 Nov 2026›GHGHBG · liquid ecstasyDepressantsClass BReclassified from Class C to Class B in April 2022.A short-acting depressant with a narrow margin between desired and severe effects.GBL is widely encountered in UK chemsex and sexualised drug-use settings and is rapidly converted to GHB in the body. GHB is also reported, and many UK datasets group GHB and GBL together, so the precise substance used or sold is not always distinguishable.Established substance4 Nov 2026›HEHeroinsmack · brown · gear · diamorphineOpioidsClass ADiamorphine is controlled as a Class A drug.The established illicit opioid market within which potent synthetic opioid adulteration is now a leading concern.England and Wales registrations mentioning heroin or morphine fell from 1,415 in 2024 to 1,210 in 2025; the official category combines the two substances. Heroin/morphine was implicated in 468 Scottish drug use deaths in 2025, the first annual increase since 2019. Heroin remains central to opioid deaths and treatment need. WAND suggested lower sampled consumption over time, but nitazene adulteration and incomplete rapid-harm data prevent a simple falling-risk conclusion.Established substance4 Nov 2026›KEKetamineket · K · special KDissociativesClass BSchedule 2 medicine under the Misuse of Drugs Regulations 2001.A dissociative anaesthetic associated with rising use, treatment demand and severe urinary harm.England and Wales registrations mentioning ketamine rose from 60 in 2024 to 115 in 2025. NRS recorded 33 Scottish drug use deaths implicating ketamine in 2025, an increase over the latest year; implication is not sole causation. ACMD, treatment and prevalence sources show increasing concern, particularly among younger people. WAND estimates fell 11% between early 2025 and early 2026 but remained 194% above 2021; wastewater cannot identify users’ ages or establish lower harm. Border Force seized 1,298 kg in January–March 2026, the highest quarterly total recorded in 15 years and 42% above the final quarter of 2025; this is an operational enforcement indicator, not an annual supply estimate.Increasing harm4 Nov 2026›LELean (Purple Drank)Lean · Purple Drank · Purple Stuff · Sizzurp · Dirty SpriteOpioidsDepressantsMedicinesContents-dependentDepends on ingredients and preparation; codeine linctus is prescription-only.A variable recreational drink associated with codeine and sedating medicines; contents determine its effects and legal status.MHRA documented UK codeine-linctus misuse and online promotion of Purple Drank in February 2024. This review did not identify a representative UK estimate of Lean use. Social-media visibility, local accounts and codeine-related deaths cannot establish Lean prevalence or a recent national increase.Established substance4 Nov 2026›LSLSDacid · tabs · blotterPsychedelicsClass ALSD is a Class A controlled drug.A potent psychedelic usually sold on blotter paper or as liquid drops.CSEW includes LSD within hallucinogen estimates, but current public data do not establish a distinct UK-wide escalation signal for LSD alone.Established substance4 Nov 2026›MDMDMAecstasy · E · Mandy · mollyStimulantsSynthetic drugsClass AMDMA, including products sold as ecstasy, is a Class A controlled drug.A stimulant and empathogen sold as tablets, powder or crystals, with variable strength and contents.England and Wales registrations mentioning MDMA/ecstasy rose from 78 in 2024 to 89 in 2025. WAND estimated 248% higher consumption at comparable sampled sites between early 2021 and early 2026, with a 5% latest annual increase and a large published 2026 standard error. Survey prevalence and analytical submissions measure different parts of the market. TEDI’s warning updated 20 October 2026 reports PMMA with MDMA in a UK tablet sold as MDMA (WEDINOS W105398); this selected detection does not estimate national contamination.Established substance4 Nov 2026›MEMedetomidineDepressantsSynthetic drugsNot MDA-classifiedThe September draft was withdrawn on 21 October 2026. A replacement laid on 27 October proposes Class C control; it remains draft and has not commenced.A potent non-opioid veterinary sedative detected in a small number of UK drug samples.ACMD reported limited UK detections in 2025 and recommended precautionary control. October 2026 RADAR confirms detections in selected Scottish drug-checking submissions and ASSIST hospital toxicology; these selected streams do not establish national prevalence. The PHS alert was issued in February 2026, rather than newly in October. North American evidence signals potential acute harm and severe withdrawal, but should not be presented as UK prevalence.Limited UK evidence4 Nov 2026›MEMephedrone4-MMC · meow meow · m-catStimulantsSynthetic drugsClass BMephedrone is covered by the Class B control of cathinone derivatives.A synthetic cathinone stimulant whose sold identity can be confused with newer cathinones.UK submitted-sample intelligence remains important because products sold as mephedrone may contain another cathinone. Individual detections cannot describe the wider market.Under surveillance4 Nov 2026›MEMethadonemeth · green · mixtureOpioidsMedicinesClass ASchedule 2 medicine under the Misuse of Drugs Regulations 2001.A long-acting opioid medicine central to treatment and also present in drug-related deaths.ONS recorded 584 England and Wales registrations mentioning methadone in 2025, down from 676 in 2024. Methadone was implicated in 338 Scottish drug use deaths in 2025, down over the latest year and from its 2020 peak. It remains prominent in opioid mortality data, but death-certificate mentions do not distinguish prescribed treatment from all other circumstances of exposure.Established substance4 Nov 2026›MEMethamphetaminecrystal meth · ice · TinaStimulantsSynthetic drugsClass AMethamphetamine was reclassified as Class A in 2007.A powerful long-acting stimulant with a smaller but monitored UK market.ONS recorded 48 England and Wales registrations mentioning methamphetamine in 2025, compared with 42 in 2024; the small numbers require caution. WAND estimated a 74% increase across 16 comparable English sites between January–April 2021 and January–April 2026 from a small baseline, including an 8% increase in the latest comparison; this does not establish uninterrupted growth or a UK-wide trend. Wide uncertainty and uneven geographic patterns require corroboration.Under surveillance4 Nov 2026›NINicotine, tobacco and vaping productsnicotine · tobacco · cigarettesStimulantsNicotine and tobaccoNot MDA-classifiedSeparate tobacco, vaping and medicines rules apply. Single-use vape sales are banned; initial age-of-sale and promotion measures took effect on 29 October 2026.Nicotine-containing products have different risks: tobacco combustion causes major disease, while regulated nicotine vaping is less harmful than smoking but is not risk-free.2025 UK adult smoking declined; adult GB vaping was broadly unchanged from 2024. The surveys have different ages, geography and definitions.Established substance4 Nov 2026›NINitazenes2-benzyl benzimidazole opioids · synthetic opioidsOpioidsSynthetic drugsClass ANamed nitazenes and substances within the current generic nitazene definition are controlled as Class A.A group of highly potent synthetic opioids detected in heroin and counterfeit medicines.England and Wales registrations mentioning nitazenes fell from 195 in 2024 to 150 in 2025. This does not establish lower current overdose risk. 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.Emerging threat4 Nov 2026›NINitrous oxidelaughing gas · NOS · balloonsDissociativesClass CControlled since November 2023; possession for legitimate purposes is exempt.An inhaled gas whose repeated heavy use can cause serious neurological injury.ONS recorded 15 England and Wales registrations mentioning nitrous oxide in 2025, compared with 10 in 2024; small counts do not establish a population trend. CSEW recorded a decrease in past-year use among people aged 16–24 in England and Wales, but prevalence does not capture dose, frequency or neurological harm.Established substance4 Nov 2026›OROrphinesorphine analogues · brorphine-like opioidsOpioidsSynthetic drugsTemporary class drugSeven named orphines have been temporarily controlled since 11 June 2026. Supply, production, import, export and possession with intent to supply are offences; permanent Class A control has been accepted in principle but is not yet in force.A distinct emerging group of high-potency synthetic opioids detected in the UK drug supply.WEDINOS reported orphine analogues in samples submitted as heroin, including alongside veterinary sedatives. UK authorities have also confirmed orphine-involved deaths and placed seven named compounds under temporary control.Emerging threat4 Nov 2026›OXOxycodoneoxy · OxyContinOpioidsMedicinesClass ASchedule 2 medicine under the Misuse of Drugs Regulations 2001.A strong opioid medicine with dependence, diversion and counterfeit-product risks.Oxycodone appears within the wider opioid mortality and prescribing context. Current public sources do not establish a distinct new UK illicit-market trend.Established substance4 Nov 2026›PRPregabalinpregabs · Lyrica · budsDepressantsMedicinesClass CSchedule 3 medicine under the Misuse of Drugs Regulations 2001.A gabapentinoid medicine prominent in polydrug mortality and dependence work.England and Wales registrations mentioning pregabalin fell from 617 in 2024 to 581 in 2025. Gabapentin and/or pregabalin were implicated in 330 Scottish drug use deaths in 2025, down over the latest year. Pregabalin remains prominent in mortality data across several UK nations, particularly in combinations; this combined Scottish category cannot isolate pregabalin. Death mentions overlap and do not show whether the medicine was prescribed.Established substance4 Nov 2026›PSPsilocybinmagic mushrooms · shroomsPsychedelicsClass APsilocin and fungi containing psilocin or an ester of psilocin are controlled as Class A.A psychedelic found in certain mushrooms and in some prepared products.CSEW measures magic-mushroom use within the household population, but current evidence does not support a distinct UK-wide alert status.Established substance4 Nov 2026›SESemi-synthetic cannabinoidsHHC · hexahydrocannabinol · HHCPCannabinoidsSynthetic drugsCompound-specificHHC and HHCP: Psychoactive Substances Act restrictions; Class B controls proposed, not yet commenced. THC and THCP are already Class B.HHC, HHCP and related THC-like products sold as vapes, edibles or treated plant material. This market grouping is distinct from both ordinary cannabis and the Spice-type SCRAs.HHC, HHCO and HHCP have been identified in selected UK samples. UK market reach remains uncertain; proposed Class B controls are not yet in force at this review.Limited UK evidence4 Nov 2026›SYSynthetic cannabinoidsSpice · Mamba · SCRAsCannabinoidsSynthetic drugsClass BControlled synthetic cannabinoid receptor agonists fall within named or generic Class B controls.Laboratory-made cannabinoid receptor agonists with highly variable compounds and potency.England and Wales registrations mentioning the synthetic-cannabinoid family rose from 44 in 2024 to 95 in 2025; the generic compound entry is a different measure. Persistent severe harms remain concentrated in settings including prisons and homelessness services. Submitted samples and incidents cannot estimate national prevalence.Established substance4 Nov 2026›SYSynthetic cathinones3-MMC · 3MMC · 3-methylmethcathinoneStimulantsSynthetic drugsClass B3-MMC, 4-CMC and MDPHP are Class B, Schedule 1. The wider family requires compound-specific assessment.A diverse stimulant family including 3-MMC, 4-CMC and MDPHP. Mephedrone is one member, while sold names such as monkey dust do not identify a single compound.UK evidence identifies 3-MMC, 4-CMC and MDPHP, with localised concerns and analytical uncertainty. Selected samples and seizures cannot establish national prevalence or a rise in every variant.Under surveillance4 Nov 2026›TRTramadoltrammies · tramsOpioidsMedicinesClass CSchedule 3 medicine under the Misuse of Drugs Regulations 2001.An opioid medicine with additional serotonergic effects and seizure risk.England and Wales registrations mentioning tramadol fell from 213 in 2024 to 176 in 2025. Tramadol remains part of the medicine-related opioid harm picture; current public sources do not establish a new UK-wide market escalation.Established substance4 Nov 2026›TUTusipink cocaine · tuci · tucibiSynthetic drugsStimulantsDissociativesContents-dependentTusi is not one substance; legal classification depends on the controlled drugs found in the mixture.Tusi, also known as pink cocaine or tuci or tucibi, is a variable polydrug mixture rather than a single drug or fixed recipe.Products analysed in the UK and Europe commonly contain ketamine combined with stimulant drugs, particularly MDMA and/or caffeine, although composition varies considerably. Despite the names ‘pink cocaine’ and ‘tucibi’, products may contain neither cocaine nor 2C-B.Limited UK evidence4 Nov 2026›XYXylazinetranq · veterinary sedativeDepressantsSynthetic drugsClass CControlled from January 2025 and placed in Schedule 4 Part 1 to preserve legitimate veterinary use.A non-opioid veterinary sedative detected within parts of the UK illicit drug supply.ONS recorded 21 England and Wales registrations mentioning xylazine in both 2024 and 2025. NRS recorded four Scottish drug use deaths implicating xylazine in 2025; routine testing began in 2024, limiting comparison. ACMD identified multifaceted evidence of UK detection, but coverage is incomplete and does not support a national prevalence estimate. Naloxone only treats any opioid component.Under surveillance4 Nov 2026›Z-Z-drugszopiclone · zolpidem · zaleplonDepressantsMedicinesClass CZopiclone, zolpidem and zaleplon are Class C, Schedule 4 Part 1. Controls must be checked for other hypnotics.Non-benzodiazepine hypnotic medicines, including zopiclone, zolpidem and zaleplon, used for insomnia and associated with dependence, withdrawal and sedative interactions.MHRA strengthened dependence and withdrawal warnings in January 2026. Current sources do not establish a UK-wide increase in non-medical use.Established substance4 Nov 2026›
Directory reviewed4 November 2026

Individual evidence review dates are shown on each profile. Status reflects the strength and direction of current UK evidence, not a universal severity score. Profiles are updated when new official statistics, analytical evidence or corroborated rapid intelligence change the assessment.