Drugs cut with dangerous substances

Drugs are increasingly cut with dangerous synthetic opioids like nitazenes, which are killing 100s of people each year in the UK. This is happening in a wide range of drugs, not just heroin, and you can never really know what is in any street or counterfeit drug, whether purchased online or on the street.

Fake oxycodone tablets, which are made to look like real medicines, like Oxycontin or Percocet, are especially something to avoid. These pills are killing people because they are increasingly cut with these dangerous opioids.

Synthetic opioids have also been reported in other counterfeit pills, like fake diazepam (brand name Valium) and fake alprazolam (brand name Xanax). Don’t be fooled by legit looking packaging – just because a drug looks like a real medicine, doesn't mean it really is.

It's very easy to overdose on synthetic opioids, because there's only a small difference between a dose that will get you high, and one that can kill you. Synthetic opioids are man-made drugs that mimic the effects of natural opioids (such as opium or heroin) but can be much more deadly. Most synthetic opioids, including nitazenes and fentanyl, are class A drugs which means they're illegal to have for yourself, give away or sell. Some synthetic opioids are used in healthcare as pain relievers or anaesthetics but fakes are also made and sold illegally. Others have no legitimate uses and are only produced and sold illegally.

Reduce your risk by avoiding drugs altogether. Or, if you must use them, you might be able to reduce the risks if you:

• Have naloxone at hand. The opioid overdose antidote, naloxone, works on synthetic opioids so have it to hand if you’re going to put yourself at risk. You can get it from your nearest drug service.

• Don’t use alone

• Start with just a small amount and wait to see what the effect is before considering taking any more

• If you’re in a group, don’t all use at the same time so there is no-one available to help and get help if people go over