Misuse of fentanyl and fentanyl analogues

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In July 2017, the then-Home Secretary commissioned the Advisory Council on the Misuse of Drugs (ACMD) to consider fentanyl and fentanyl analogues following the publication of the Drug Strategy 2017.

Prompted by concerns over increased rates of drug-related deaths and growing evidence from law enforcement agencies of fentanyl entering European drug markets, the Home Secretary commissioned the ACMD to write a report on the number and nature of known fentanyl analogues – and their known and likely risk factors.

The ACMD’s Novel Psychoactive Substances (NPS) Committee set out to address this area, and drafted a report which included:

  • a literature review on the pharmacology and toxic effects of fentanyl and related analogues
  • details of the misuse potential of both pharmaceutical and illicitly manufactured fentanyl compounds
  • a summary of the associated harms as documented internationally and in the UK

The ACMD NPS Committee reports that while the UK fentanyl generic has proved to be robust in controlling the majority of fentanyl-related analogues, rates of registered deaths involving fentanyl variants in the UK has steadily increased over the past decade. The rates of fentanyl-implicated drug-related deaths are likely to be under-represented, since sufficiently detailed forensic analyses are not always carried out.

It can be concluded that fentanyl and fentanyl analogues present a significant risk to UK public health. Current monitoring and surveillance systems should be adapted to help identify the true scale of this threat.

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