Class A

Synthetic opioids

Also called: Fentanyl, acetylfentanyl, carfentanyl, fentanyls, methadone, nitazenes, oxycodone, tramadol

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, while others have no legitimate uses and are produced and sold illicitly. Synthetic opioids are often mixed with other drugs, especially heroin, which can increase the risk of overdose.

Important

Drugs are increasingly cut with dangerous synthetic opioids like nitazenes, which have killed 100s of people in the UK in the past year. 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. Find out more about the risks and what to do below.

Quick info

How the drug works varies from person to person

How you might feel

Euphoric, relaxed and/or confused, sleepy.

Effects on your body

Effects are similar to natural opioids but can be much stronger, especially when mixed with other drugs, with a higher risk of overdose. Side effects can include respiratory depression, nausea and confusion.

How long it takes to work

This depends on how it is taken but the effects can be very quick – quicker than heroin.

How long the effects last

How long the effects last and the drug stays in your system depends on how much you’ve taken, your size and what other drugs you may have also taken.

Overdose and death.
Injecting synthetic opioids can damage your veins and arteries.

If you or someone else needs urgent help after taking drugs or drinking, call 999 for an ambulance. Tell the crew everything you know. It could save their life.

Call 999 What else to do in an emergency

Is it dangerous to mix with other drugs?

Yes. There is a greater risk of overdose and death if you mix synthetic opioids with other drugs that suppress breathing such as alcohol, benzodiazepines (like diazepam or Xanax/Valium), and/or other opiate drugs (like heroin).

Dangerous combinations:

+ Cannabinoids
+ Heroin
+ Synthetic and semi-synthetic cannabinoids
+ Nitrous oxide
+ New psychoactive substances
+ Image and performance enhancing drug (IPEDs)
+ Hallucinogens
+ Stimulants
+ Cannabis
+ Depressants

How does it make you feel?

As with natural opiates, the effects of synthetic opioids include:

pain relief
euphoria or well-being
relaxation
sleepiness, with high doses you might lose consciousness
People also report sweating, itching, dizziness and confusion, itching, and feeling, or being, sick.

Physical health risks

Suppression of normal breathing, including respiratory arrest (when you stop breathing altogether) which is often fatal. If you think someone may be having an opioid overdose, call 999 immediately and start first aid. If naloxone is available, use it.

There is an antidote for these drugs called naloxone, so if you use opioids or know someone who uses them, you should be able to get naloxone for free in your area. Ask your local drug treatment service where.

Other risks include:

Loss of consciousness and coma
Dizziness or fainting
Withdrawal symptoms, including nausea and retching
Itching
Lethargy
Constipation

If you inject synthetic opioids you can do nasty damage to your veins and arteries, and this can lead to gangrene (death of body tissue, usually a finger, toe or a limb), blood clots/thromboses and to infections.

There are also risks from sharing needles, syringes and other equipment used for injecting – with the danger of developing serious tissue infections or spreading viral infections like hepatitis B, hepatitis C or HIV.

Other risks

There are also social harms that can develop with repeated use of synthetic opioids, especially if you become addicted. These social harms can include committing crime to afford to buy more synthetic opioids, disruption to your family life and other relationships, general poor health and social functioning including through loss of employment.

What is synthetic opioids cut with?

Potent synthetic opioids like fentanyls and nitazenes are most often found added to heroin, making those who use them more vulnerable to overdose.

It is possible that a synthetic opioid may be contaminated during its production and shipment or it may be mixed with another substance(s), such as sugar, starch or powdered milk, to increase its bulk and the seller’s profits.

More harmful adulterants that may be added (as they are to heroin) include paracetamol and benzodiazepines.

Xylazine, an animal tranquilliser, is also increasingly being added to opioids and can make the suppression of normal breathing much worse.

What does it look like?

Synthetic opioids used in medicine mainly come as pills and capsules, patches, lozenges and solutions for injection.

Illegally produced synthetic opioids can also be in a range of forms including pills, or powder, often mixed with or replacing heroin. Illicit synthetic opioids are sometimes sold to look like medical opioids or, less commonly, benzodiazepines. They have also been found mixed with synthetic cannabinoids. They are often much more dangerous than what they are sold as or mixed with.

Class: A

Most synthetic opioids are Class A, which means it's illegal to have for yourself, give away or sell.
Possession can get you up to 7 years in prison, an unlimited fine or both.
Supplying someone else, even your friends, can get you life in prison, an unlimited fine or both.

Like drink-driving, driving when high is dangerous and illegal. If you’re caught driving under the influence, you may receive a heavy fine, driving ban, or prison sentence.

If the police catch people supplying illegal drugs in a home, club, bar or hostel, they can potentially prosecute the landlord, club owner or any other person concerned in the management of the premises.

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Synthetic opioids

Important