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January 2020 – United Kingdom: ACMD report on the misuse of fentanyl and fentanyl analogues as global number of opioid NPS rises

LONDON, United Kingdom – January 2020:  The Advisory Council on the Misuse of Drugs (ACMD) issued a report highlighting the pharmacology and toxic effects of fentanyl and related analogues, details of the misuse potential of both pharmaceutical and illicitly manufactured fentanyl compounds, and a summary of the associated harms as documented internationally and in the UK.  ACMD states that despite robust generic control on fentanyl analogues, the rates of registered deaths involving fentanyl and its analogues in the UK has increased over the past decade, with deaths likely to be under-represented. They conclude that there remains an ongoing risk of fentanyl and its analogues as well as other synthetic opioids infiltrating the UK heroin market and resulting in increasing rates of drug-related deaths. ACMD recommends research into and monitoring of trends (e.g. supply, demand, precursors, drug products etc.) and drug strategies relating to fentanyl and its analogues. ACMD also recommends training of health professionals in the appropriate therapeutic use of strong opioids and to include analysis of fentanyl and its analogues for all deaths related to drug poisoning.

At the global level, NPS with opioid effect including fentanyl analogues accounted for only 2% of the total NPS reported the UNODC Early Warning Advisory (EWA) while in 2019, their number has grown to more than 75 substances representing 8% of the total.  The WHO Expert Committee on Drug Dependence (ECDD) has recently reviewed two fentanyl analogues and recommended their inclusion in Schedule I of the Single Convention on Narcotic Drugs of 1961 as amended by the 1972 Protocol (see UNODC Early Warning Advisory news on NPS December 2019) – a decision the  Commission on Narcotic Drugs may take at their 63rd meeting in the first week of March 2020.

Figure 1: Annual number of unique synthetic NPS with opioid effects, 2009 – 2019*

Source: UNODC Early Warning Advisory on NPS (as of Dec. 2019).

*Note: 2019 data is not complete

For more information please see:

Misuse of fentanyl and fentanyl analogues

World Health Organization 2019 recommendation for 12 NPS for scheduling

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