Gus Birch, a 21-year-old aspiring journalist, died after unknowingly taking a tablet containing a potent synthetic opioid known as a nitazene, a coroner concluded. His death is among hundreds in the UK linked to the increasingly prevalent and dangerous drugs, which experts say are often disguised as more common medications.
Nicola Birch, Gus’s mother, described finding him after he had taken what he believed was oxycodone, a strong pain medication purchased illicitly. “I loved him very much and his loss is massive,” she said. “The awful thing is, I think he was at one of the best places in his life.” A post-mortem report later revealed the tablet contained a nitazene, a substance Nicola had never heard of.
Nitazenes are synthetic opioids that can be significantly more potent than heroin. Their emergence in the UK has prompted growing concern among health officials and law enforcement. According to data analysed by the BBC’s Shared Data Unit and the National Programme on Substance Use Mortality (NPSUM), 286 inquests in England, Wales and Northern Ireland linked deaths to nitazenes by the end of March 2025. Professor Michel Kazatchkine, a founding member of the Global Commission on Drugs Policy, stated the UK is “by far outpacing all other countries [in Europe] and it’s even outpacing Canada” in the number of deaths related to these drugs.
The NPSUM data reveals a pattern among those affected. More than one in five individuals in the analysed records lacked stable housing and lived in deprived areas with high unemployment and mental health challenges. Nine in ten of the inquest records were for men, with ages ranging from 17 to 66. Most were known to use drugs, and over half died in their homes. Crucially, almost every inquest concluded the death was accidental.
The availability of naloxone, an opioid antidote, remains a critical issue. The NPSUM data showed naloxone was only mentioned in one in seven inquest records. A coroner reviewing the death of Joe Black in January 2025 raised concerns that naloxone was not readily available to those who needed it, as some substance misuse services and mental health NHS Trusts were restricted from providing kits to patients or residents known to use drugs. Joe Black, 39, died from an overdose including heroin adulterated with nitazenes.
Joe’s mother, Jude, described her son as a “wonderful, sensitive, caring, intelligent, talented young man” and criticised the delay in addressing the issue. “I experience it diminishes the value of my son’s life and the tragedy of his death,” she said. “People like Joe are still hugely at risk and I’m sure they’re still dying.” The Department of Health and Social Care began a 10-week consultation in December 2025 on proposed legislative changes to expand naloxone access.
Efforts are underway to reach vulnerable individuals directly. In Sandwell, West Midlands, the charity Cranstoun is piloting a new outreach service led by nurse Sue McCutcheon. McCutcheon proactively seeks out people with substance dependence issues, providing treatments and naloxone. “If these people don’t come into our buildings to get naloxone, where are they going to get it from?” she asked.
The National Crime Agency (NCA) believes nitazenes are primarily being smuggled into the UK through the postal system, taking advantage of their potency and the minor volumes required for a potentially fatal dose. Adam Thompson, the NCA’s head of drugs threat, stated that even as heroin purity has decreased, Notice no signs of a heroin shortage. He emphasized that organised criminals are motivated by profit, buying cheap nitazenes to strengthen other drugs and increase their earnings.
Analysis of the inquest records similarly highlights the growing trend of polydrug use – the use of multiple substances simultaneously. Dr. Alex Lawson, a consultant clinical scientist in toxicology for University Hospitals Birmingham NHS Foundation Trust, noted that testing for nitazenes varies between laboratories and not all can keep up with the newest compounds. Research co-authored by Dr. Copeland suggests nitazene-related deaths may be underestimated by up to a third due to the rapid deterioration of the drugs in post-mortem samples.
The UK’s national drug-checking service, WEDINOS, found that more than a third of samples tested did not contain what the purchaser intended, with some containing unexpected additional substances. Dr. Copeland highlighted a shift in the way nitazenes are appearing in the drug supply, moving from being contaminants in heroin to being sold as complete substitutes for other drugs. “The complete mis-selling is something that is very concerning for nitazenes, as people don’t know what they’re taking, so they’re not going to be able to capture the necessary precautions,” she said.
In October 2025, the government launched a new awareness campaign targeting 16 to 24-year-olds and social media users to highlight the dangers of drugs, including nitazenes. The government has also guaranteed funding for council public health schemes, allocating £3.4bn for drug and alcohol prevention, treatment, and recovery. A spokesperson stated the government is enhancing surveillance and border security to prevent these substances from entering the country, and that naloxone is now carried by officers in 32 of the UK’s 45 police forces.
Nicola Birch expressed her desire to prevent others from experiencing her loss. “You don’t desire your child to be judged,” she said. “And I didn’t want Gus to be tarred with any of that… He wasn’t a great sleeper. I think he just thought he would take something, it would relax him and he would just have a nice sleep that night, and it put him to sleep and he never woke up.”