The New Killer Drugs

“For every drug overdose that results in death, there are many more nonfatal overdoses, each one with its own emotional and economic toll.” 

― Centres for Disease Control and Prevention

Fourth wave of fentanyl overdoses persists in America

Cast your mind back to the US Presidential debates in 2016 and you’ll likely remember politicians debating/arguing about how to control and manage the opioid epidemic destroying the lives of many in middle-class suburban America. Since then, legacy media attention on the opioid crisis has been left to print and written publications rather than News TV programmes, thus diverting the public gaze from the subject. Tragically, the opioid crisis is still ravaging communities, with health professionals reporting a fourth wave of the fentanyl epidemic in the autumn of 2023. The opioid epidemic still has a grip on large swathes of America with no signs of the end in sight.

In January 2024, politicians in Portland, US, declared a 90-day state of emergency to tackle fentanyl abuse. BBC writes: “Senior state and city officials said Portland was being damaged by open use of the drug. The city has been struggling with homelessness and drug use in recent years, causing several major businesses and some residents to move out of the city. According to Multnomah County―where Portland is located―the number of overdose deaths involving fentanyl increased by 533% between 2018 and 2022.”

Fentanyl is a potent synthetic opioid drug prescribed by health professionals to treat acute physical pain, such as the after-effects of surgery or to alleviate the symptoms for those with terminal cancer. Here are some facts regarding fentanyl:

  • Fentanyl is 50 times stronger than heroin
  • It’s 100 times stronger than morphine
  • Such is the demand from drug addicts that there’s a black market for the synthetic opioid. Illicit drug dealers sell the opioid in both powder and liquid form, in person and online via the dark web
  • Fentanyl is the most common drug associated with overdose deaths in America
  • As of September 2023, 150 lives are taken by fentanyl overdose daily

Over-prescribed medication and illicit sales have deepened the fentanyl crisis, with a very real black market for the drug. Individuals addicted to the substance are mixing the drug with potent stimulants such as cocaine, increasing the probability of short and long-term injury. Science Direct reports: “Use of methamphetamine and cocaine are major elements to the public health crisis caused by illicit drug use in 2023. While there is extensive evidence that fentanyl is a primary driver of overdose and overdose deaths, psychostimulants are also involved in many of these deaths (and non-fatal overdoses) in ways that we may not fully understand. One thing is clear, efforts to effectively address the current illicit drug crisis need to go beyond simply addressing the risk of opioid/fentanyl use.”

Similarly, Wiley Library writes: “The rise of illicitly manufactured fentanyl has ushered in an overdose crisis in the United States of unprecedented magnitude. This has created conditions that have promoted a number of other shifts in the illicit drug supply, leading to rising polysubstance overdose deaths—the so-called ‘fourth wave’ of the crisis, especially involving stimulants and fentanyl co-use starting in 2015. Mixtures of fentanyl analogues and drugs of various drug classes, such as stimulants, benzodiazepines, tranquilizers, and other opioids have been noted in distinct geographies.”

Is there an opioid crisis in the UK?

Although fentanyl hasn’t yet wreaked havoc in the UK to the same extent, Kings College reported that the first case of a British person to overdose and die using fentanyl, heroin, cocaine, and xylazine was in May 2022. This has raised concerns about future potential trends among health professionals and the police. Health professionals are increasingly worried about the number of people using opioids and showing signs of a dependency. Opioids are commonly prescribed to treat cancer patients in the UK, however they can be highly addictive.

In an article published in 2023 by National Library of Medicine (National Centre for Biotechnology Information, USA) which focuses on opioid use and dependency in England, it states: “The opioid crisis in the United States (US) is one of the most high-profile public health scandals of the 21st century with millions of people unknowingly becoming dependent on opioids. The United Kingdom (UK) had the world’s highest rate of opioid consumption in 2019, and opiate-related drug poisoning deaths have increased by 388% since 1993 in England and Wales. This article explores the epidemiological definitions of public health emergencies and epidemics in the context of opioid use, misuse, and mortality in England, to establish whether England is facing an opioid crisis.”

The paper concludes: “England has experienced a dramatic increase in the prescribing of opioids concurrent with a rise in opioid-related deaths and the number of people seeking treatment for prescription opioid misuse. Whilst opioid mortality rates in England have not reached the levels of the US, the harms of opioid use and mortality have continued to increase. Therefore, the situation in England can be defined as an opioid epidemic but not a public health emergency like the US, as opioid addiction, overdose, and deaths have not yet threatened to overwhelm routine health services. However, it appears that England is facing a chronic pain emergency where investment and access to pain services for people with chronic pain and addiction are urgently needed.”

Let’s look at the opioids prescribed to individuals with chronic pain in the UK.

  • Oxycodone
  • Buprenorphine
  • Fentanyl
  • Alfentanil
  • Morphine
  • Hydromorphone
  • Methadone
  • Diamorphine
  • Tramadol
  • Codeine
  • Co-codamol


The opioid is often prescribed after painkillers like paracetamol and ibuprofen have proved ineffective in the management of acute or chronic pain. It’s a prescription-only drug and usually comes in the form of tablets or capsules, but can also be injected. Oxycodone can be highly addictive and side effects such as constipation, sickness and drowsiness are common.


Commonly known as Subutex, this powerful opioid is often prescribed and used to act as a substitute for individuals experiencing a withdrawal from heroin, morphine, codeine, and oxycodone. Buprenorphine is often prescribed to treat moderate to acute physical pain. It’s possible to become dependent on Buprenorphine and so a good medical doctor will monitor the patient carefully.


As we have already explored, fentanyl is a powerful opioid with highly addictive properties, and is causing major concern among health professionals in the West. Common side effects include stomach pain, vomiting, confusion, constipation, tiredness, itching, skin rash, dizziness, urinary retention, and headaches.


It’s a synthetic, short-acting opioid, and is widely used as an analgesic supplement during surgical procedures. It’s five to ten times less potent than fentanyl and has a rapid onset of one to two minutes (it’s rapidly distributed to the brain and organs meaning its effects can be feltwithin two minutes). Alfentanil side effects include dizziness, chest pain, fainting, blurred vision, and irregular heartbeat.


It acts on the central nervous system to relieve pain. Its brand names are Sevredol, MST, Zomorph, Morphgesic, MXL, Oramorph. Morphine can be highly addictive, with drug addicts commonly using it when heroin isn’t available to them. The most common symptoms associated with morphine use are drowsiness, constipation, nausea, stomach pain, itchy skin, and vomiting.


Is used to treat both moderate and acute physical pain via oral liquid and tablets. Hydromorphone belongs to the group of medicines known as narcotic analgesics (pain medications), and therefore can be addictive. Unless carefully monitored, a dependency can easily occur. Side effects may include dry mouth, headache, muscle pain, joint and back pain, and stomach pain.


It’s a synthetic opiate mostly used in the treatment of drug addiction. Methadone is often included during the detoxification and maintenance stages of a patient’s treatment plan. Methadone helps to mitigate symptoms of a withdrawal from strong pain killers and opioids such as heroin. Its symptoms usually include mild headache, drowsiness, dizziness, dry eyes and mouth, and constipation.


Another strong painkiller used to alleviate moderate to severe pain. It’s often prescribed to cancer patients to treat chronic pain. It can also be used to treat breathlessness caused by a build-up of fluid in the lungs during parturition. A small number of people have a severe rection to diamorphine, however the side effects usually consist of drowsiness, feeling sick and vomiting, and a foggy brain (mental clouding).


As with all the opioids listed here, Tramadol is used to treat chronic physical pain and will dramatically reduce its effects. Its brand names are Marol, Maxitram, Tramulief, Zydol, Zamadol and Tramquel. Tramadol has addictive properties and can lead to a dependency, especially with long-term use. One in ten users report experiencing dizziness and sickness.


It’s an opioid pain relief usually prescribed for mild to moderate physical pain, but also available over the counter. It comes in tablet or liquid form and can also be injected. Common side effects are a foggy brain, drowsiness, tiredness, sickness, dry mouth, and constipation.


Co-codamol is codeine and paracetamol combined. It’s usually prescribed to treat aches and pains ranging from migraines, toothaches, headaches, and muscle pain (it’s also available over the counter). It usually takes one hour to feel its effect and can last up to four to five hours. As with other strong painkillers already listed, co-codamol works by blocking the pain signals to the brain. It can be addictive, and a dependency can occur, especially with long-term use.

Addcounsel’s treatment for drug addiction

At Addcounsel, we’re experts in overseeing a progressive, managed recovery from drug addiction, with our focus firmly on your health and comfort. Instead of merely addressing the symptoms, we look deeper, analysing the causes of your dependency. Addressing the deeper psychological core of your condition is crucial in allowing you to embark upon a healthy, confident life, free from dependence.

Drug dependence can assume many forms. At its worst, extreme dependence will render an individual unable to function without constant access to the substance they’re addicted to. But it can also hide in plain sight, providing a crutch or coping mechanism that gives the illusion of control. In either case, a life without the substance can be difficult to imagine.

You don’t have to go through this alone. Our seasoned experts have developed a “whole person” approach to private drug addiction treatment, addressing not just the symptoms but the underlying causes that led to addiction in the first place. We help you develop effective, lifelong strategies for coping and self-management, to ensure a sustained recovery and rehabilitation.  We provide expert treatment for a wide range of substance and behavioural dependencies and mental health conditions, including cocaine, heroin, cannabis, amphetamine, ecstasy (MDMA) and prescription drug dependency.

Our dedicated team will help and guide you through the entire process from start to finish, in the comfort and anonymity of our luxury, private mental health and addiction treatment accommodation in Mayfair, Chelsea, Knightsbridge or Notting Hill, London.

Contact us today to start your recovery journey.


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