Health

Inquests Reveal Widespread Impact of Synthetic Drugs

An investigation by the BBC has found that fatalities linked to nitazene have increased, amid a shift in the illicit drug trade.

Synthetic opioid drugs known as nitazenes have been associated with numerous fatalities in the UK, with experts warning that they can be significantly more potent than heroin.

Gus in Mexico, standing on a hill with his arms crossed in a chequered overshirt, sunglasses and a wide-brimmed sun hat with a lake and low sun in the background — Gus had recently returned home after travelling around Mexico for six months

It has been discovered that some individuals are unknowingly consuming these substances, as they are often mixed with other drugs and sold as cheaper alternatives.

The question remains as to how nitazenes are entering the UK's drug supply chain and whether authorities are taking sufficient measures to combat their spread.

After completing his A-levels, Gus explored various career paths and traveled abroad, eventually deciding to pursue a degree in journalism at a university.

His experiences documenting the effects of climate change while hiking volcanoes in Mexico solidified his decision to apply for the journalism course.

Tragedy struck when Gus's mother, Nicola, found him unresponsive at their home, having accidentally overdosed at the age of 21.

Nicola expressed her profound grief, stating, "I loved him dearly, and his loss is immense. The tragic part is that he seemed to be in a good place in his life."

On the evening of his death, Gus had taken what he believed to be an oxycodone tablet, which he had purchased illicitly, while watching a film and eating a takeaway meal.

However, a post-mortem report received by Nicola three months later revealed that the tablet was actually a type of nitazene.

Despite her background in medicine as a radiographer, Nicola was unfamiliar with these synthetic opioid drugs.

A coroner's investigation later concluded that Gus's death was caused by the substitution of a nitazene for the oxycodone he had intended to take.

Nicola recounted the distressing experience of receiving the post-mortem report, saying, "It was devastating to suddenly learn the cause of my child's death."

Nicola looks down the barrel of the camera with an alleyway in the background, looking sullen with her mouth closed. She has white hair, wears glasses and has a blue scarf underneath her khaki-coloured overcoat — Nicola's loved her son Gus's courage and "little Mona Lisa smile"

Upon reading the report, Nicola was shocked to discover that the substance responsible for Gus's death was a nitazene, a drug she had never heard of.

Gus is one of hundreds of individuals whose deaths have been linked to nitazenes in the UK since their emergence in 2021.

According to Professor Michel Kazatchkine, a founding member of the Global Commission on Drugs Policy, the UK's nitazene-related death toll surpasses that of other European countries and even Canada.

An analysis of exclusive data from The National Programme on Substance Use Mortality (NPSUM) by the BBC Shared Data Unit has provided insight into the scope of the issue.

The data, comprising voluntary reports from coroners in England, Wales, and Northern Ireland, is not exhaustive due to the time it takes for drug-related deaths to be registered and the fact that not all coroners participate.

By the end of March 2025, the data included 286 inquests involving deaths forensically linked to nitazenes.

Dr. Caroline Copeland, director of NPSUM, noted that the affected individuals often come from marginalized backgrounds.

A portrait photo of Dr Caroline Copeland sitting at a table in a blue-knitted jumper. Behind her curly blond hair you can see shelves lined with jars from an old pharmacy with ornate lettering explaining the contents such as "opium" as well as research books — Dr Copeland has an advisory role to the government about drug-related deaths

The analysis revealed that over one-fifth of the individuals in the records lacked stable housing, lived in deprived areas with high unemployment and mental health issues.

Further findings include:

Naloxone, a crucial opioid antidote, was found in only one in seven inquest records, highlighting a potential gap in prevention efforts.

The picture shows only the right hand of Dr Caroline Copeland who holds between her index finger and thumb, a vial the size of the tip of her finger, containing nitazene with a laboratory label wrapped around it — The amount of nitazene – ordered legitimately for research purposes – in this vial was enough for a potentially fatal dose for ten people, Copeland said

In January 2025, a coroner raised concerns about the limited availability of naloxone, citing the case of Joe Black, who died from a nitazene-adulterated heroin overdose.

Joe, a 39-year-old with schizophrenia and substance misuse disorder, was found dead at a hostel in Camden, London.

Neither the hostel nor the mental health NHS Trust treating Joe were permitted to provide naloxone kits to residents or patients who used drugs.

In response, the Department of Health and Social Care initiated a 10-week consultation on proposed legislative changes to expand naloxone access in the UK.

Joe's mother, Jude, remembered her son as a "wonderful, sensitive, caring, intelligent, and talented young man" who deserved to live.

She emphasized that Joe's struggles with illness and addiction made him vulnerable to exploitation and accidental overdose.

Jude criticized the delay in initiating the consultation, stating that it diminished the value of her son's life and the tragedy of his death.

She expressed concern that individuals like Joe remain at risk and continue to die due to the lack of action.

In the West Midlands, the charity Cranstoun is piloting an outreach service to proactively engage with individuals struggling with substance dependence.

Sue McCutcheon, a nurse with over 30 years of experience, is part of the outreach team, providing naloxone and prescribing treatments to those in need.

Joe Black sits, strumming his guitar. The picture is taken from a perspective looking down on Joe from above so you can see his dark, dreadlocked hair, highlighted blond at the tips. His eyes are partially closed and his lips together as he plays. You can see a short black stubble goatee. Joe identified as mixed white and black Caribbean/Jewish, according to his family, and he also had Irish heritage. — Joe Black released electro music under the artist name Nexus 23

She emphasized the importance of making naloxone available to those who may not be able to access traditional services.

McCutcheon views providing naloxone as a moral obligation, stating, "If these individuals don't come to our facilities to receive naloxone, where will they obtain it?"

The National Crime Agency (NCA) believes that nitazenes are being smuggled into the UK through postal services, exploiting their potency and small volume.

Although the ban on opium poppy harvesting in Afghanistan has been suggested as a factor, the NCA's Adam Thompson noted that heroin purity has decreased, but there is no evidence of a shortage in the UK.

Sue McCutcheon smiles at the camera with her mouth closed. Her red hair is swept into a rough parting on her left. She is wearing a woolen jumper with a black/white/grey pattern and a black mountaineering coat over the top. She is sitting askew on a low wall with another adjacent red brick wall in the background — Sue McCutcheon's project is called DEMO: Dynamic Evolving Model of Outreach

Thompson attributed the use of nitazenes by organized criminals to greed, as they can purchase potent nitazenes cheaply and mix them with other drugs to increase profits.

The government has pledged to enhance its surveillance and early warning systems to alert the public to emerging drug threats.

According to Thompson, the primary motivation for using nitazenes is financial gain, as they can be used to strengthen the potency of other drugs and generate significant profits.

The government has committed to continuing its efforts to improve surveillance and early warning systems to address the evolving drug landscape.

An examination of inquest records revealed a rising trend of multiple drug use, also known as polydrug use, being implicated in an increasing number of deaths.

Dr Alex Lawson serves as a consultant clinical scientist in toxicology at University Hospitals Birmingham NHS Foundation Trust, bringing expertise to the field.

Dr Alex Lawson in his lab coat with an office in the toxicology lab in the background — Dr Alex Lawson says the nitazenes that people are testing for will vary from lab to lab

Following a surge in nitazene-related deaths in the city during summer 2023, local agencies shared key lessons to inform contingency plans for potential future outbreaks in other areas.

An analysis of NPSUM records showed that approximately one in seven cases originated from the coroner's area covered by Dr Lawson's team.

The team conducts thorough tests on blood, urine, and other tissues to detect up to 2,500 different types of drugs, although this level of investigation is not uniformly applied across all coroner areas.

According to Dr Lawson, "Progress is being made, but the specific nitazenes being tested for can vary between labs, and not all laboratories can keep pace with the latest nitazenes emerging on the market."

Research co-authored by Copeland, published recently, suggests that nitazene-related deaths may have been underreported by as much as a third.

The study found that these drugs degrade more quickly in post-mortem blood samples than the typical processing time for forensic samples, which may lead to their detection being missed.

The most recent annual report from WEDINOS, the UK's sole national drug-checking service, revealed that over a third of the samples tested contained unexpected substances, while some did not match the intended purchase.

Copeland noted that at the beginning of 2023, nitazenes were primarily found contaminating heroin, but now they are often being used as a complete substitute for other drugs.

Copeland expressed concern about the mis-selling of nitazenes, stating, "The fact that people are unaware of what they're taking means they cannot take necessary precautions, which is a significant concern."

In October 2025, the government launched a new awareness campaign targeting 16 to 24-year-olds and social media users to educate them about the risks associated with drugs, including nitazenes.

Gus sits on a beach in swimming shorts and his bare legs and a long sleeve t-shirt and looks over his left shoulder and smiles at the camera — Gus bought what he thought was oxycodone online, but the tablets contained nitazenes

The government announced guaranteed funding for council public health schemes over the next three years, allocating £3.4bn for drug and alcohol prevention, treatment, and recovery initiatives.

A government spokesperson declined an interview request but stated that their strategy involves strengthening border security to prevent the entry of "these lethal substances" into the country.

The spokesperson also mentioned that naloxone is now being carried by officers in 32 out of 45 police forces across the UK.

Nicola shared her experience, saying, "You don't want your child to be judged, and there's often a stigma surrounding certain types of deaths, including those related to substances."

Nicola continued, "Initially, I didn't want to disclose anything, but I realized I had to inform my son's friends and others about what happened."

She recalled, "My son had trouble sleeping, and I think he took something to relax, expecting a good night's sleep, but unfortunately, it resulted in his death."

Additional data journalism was provided by Paul Bradshaw.

For more information on this story, please refer to the provided links.

The Shared Data Unit collaborates with news organizations across the media industry, as part of a partnership between the BBC and the News Media Association, to make data journalism accessible.

Further details about the Local News Partnerships can be found on the relevant webpage.

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Health

Study Explores if Brain Stimulation Can Reduce Selfish Behavior

Researchers have found a way to temporarily and marginally decrease self-centered behavior in individuals by activating two specific regions of the brain.

Researchers have made a groundbreaking discovery, finding that temporary reductions in selfish behavior can be achieved by stimulating specific areas of the brain.

The image shows a brain scan seen from the dront of the head. The lobes of the brain are artifically coloured in bright red and you can see the pink outline of a person's skull around the brain.

A recent study conducted at the University of Zurich involved 44 participants who were tasked with dividing a sum of money between themselves and an anonymous partner, allowing scientists to observe their decision-making processes.

The experiment utilized electrical current to stimulate the frontal and parietal regions of the brain, located at the front and rear of the skull, respectively. When these areas were stimulated simultaneously, participants exhibited a greater willingness to share their funds.

According to Prof Christian Ruff, a lead author of the study, the observed effects were consistent, albeit modest in scale.

Statistical analysis revealed a notable increase in participants' willingness to allocate funds to others, indicating a shift in their behavior.

The findings not only provide insight into the neural mechanisms underlying fundamental human behavior but may also have implications for the treatment of certain brain disorders characterized by impaired social behavior.

Prof Ruff noted that some individuals struggle with profound social difficulties due to an inability to consider others' perspectives, leading to consistently selfish behavior, and suggested that this discovery could potentially be used to address such issues.

However, the effects of the brain stimulation were found to be short-lived, suggesting that repeated application may be necessary to achieve lasting changes.

Prof Ruff likened the potential effects of repeated stimulation to the benefits of regular exercise, stating that consistent application over a prolonged period could lead to significant changes in behavior, much like the physical adaptations that occur with regular gym attendance.

This latest discovery builds upon a previous study in which researchers monitored brain activity while participants engaged in a similar money-sharing game, providing a foundation for the current findings.

A participant receiving non-invasive brain stimulation during an experiment in a laboratory setting. The volunteer sits in the foreground with another person, whose hands can be seen, holding a scanning device over the person's head. A scan of their brain is visible on a screen behind.

The earlier study identified two brain regions that appeared to be synchronized, with neural activity occurring at the same frequency, when participants made more generous decisions.

These brain areas are known to play a crucial role in decision-making and empathy, enabling individuals to distinguish between their own feelings and those of others.

When participants made selfless decisions, the regions responsible for empathy and decision-making were found to be communicating with each other.

The researchers sought to investigate whether electrical stimulation could be used to influence this communication and promote more selfless decision-making.

One participant who underwent the brain stimulation test described the experience as a gentle, soothing sensation, comparable to a warm shower or light rain on the scalp.

The participant reported making decisions while receiving the stimulation without feeling any external influence on their choices.

The discovery of a consistent neural pattern associated with selfless decision-making across multiple individuals suggests that altruism may be an innate, evolutionarily conserved trait that enables humans to care for one another.

Prof Ruff emphasized the clinical significance of this finding, highlighting the potential to modify and influence this neural mechanism.

Dr Jie Hu, a co-author of the study, noted that the research provides evidence of a causal relationship between brain activity and decision-making, demonstrating that targeted stimulation can alter an individual's sharing behavior.

By manipulating communication within a specific brain network using non-invasive stimulation, the researchers observed a shift in participants' decisions, influencing the balance between self-interest and altruism.

Addressing concerns about the potential implications of this research, Prof Ruff assured that the experiment was conducted with strict adherence to medical regulations and ethical guidelines, ensuring the well-being and informed consent of all participants.

The neuroscientist drew a distinction between the controlled, medically regulated nature of the experiment and the often-subliminal influences of social media and advertising, which can affect behavior without explicit consent.

Prof Ruff suggested that, in contrast to the experiment, the impacts of social media and advertising on brain function and behavior are often unforeseen and uncontrolled, highlighting the importance of careful consideration and regulation in such contexts.

Health

NHS Workers to Receive 3.3% Pay Increase

Labor unions have expressed displeasure, yet the government maintains that its actions showcase a dedication to its workforce.

The government has confirmed that NHS staff in England will receive a 3.3% pay increase in the upcoming financial year.

Nurses on a ward, checking patient notes

This pay award applies to approximately 1.4 million health workers, including nurses, midwives, physiotherapists, and porters, but excludes doctors, dentists, and senior management.

Although the Department of Health and Social Care initially proposed a lower figure, it has accepted the recommendation of the independent pay review body to demonstrate its commitment to NHS staff, resulting in a higher pay rise than initially suggested.

However, several health unions have expressed disappointment with the announced pay award.

Prof Nicola Ranger, general secretary of the Royal College of Nursing (RCN), noted that the 3.3% increase falls short of the current consumer price index (CPI) inflation rate of 3.4%, which measures the rise in prices over the past year.

Prof Ranger stated, "A pay award that is lower than the current inflation rate is unacceptable, and unless inflation decreases, the government will be imposing a real pay cut on NHS workers."

She criticized the government's approach, saying, "This strategy of making last-minute decisions is not an appropriate way to treat individuals who are essential to a system in crisis."

Prof Ranger indicated that she would wait to see the pay awards for the rest of the public sector and doctors before deciding on a course of action.

The RCN had previously reacted strongly to the 5.4% pay increase received by resident doctors last year, compared to the 3.6% increase received by nurses, which they described as "grotesque".

Prof Ranger emphasized, "Nursing staff will not accept being treated with disrespect, as has happened in the past when they were given lower pay awards than other groups."

Helga Pile, head of health at Unison, the largest health union, commented, "NHS staff who are already under financial pressure will be outraged by another pay award that fails to keep up with inflation."

"Once again, they are expected to deliver more while their pay effectively decreases, as it falls behind the rising cost of living," she added.

In response, the government argued that the pay award is actually above the forecasted inflation rate for the coming year, which is around 2%.

A spokesperson for the Department of Health and Social Care stated, "This government greatly values the outstanding work of NHS staff and is committed to supporting them."

The pay increase is expected to be implemented by the start of April.

However, the government did not provide a timeline for the announcement on doctors' pay, as the pay review body responsible for making recommendations on their pay has yet to submit its report to ministers.

The government is currently engaged in negotiations with the British Medical Association regarding the pay of resident doctors, previously known as junior doctors.

Members of the BMA recently voted in favor of strike action, granting them a six-month mandate for walkouts, and there have been 14 strikes so far in the ongoing dispute.

Health

NHS Waiting List Hits Three-Year Low

In England, the backlog has fallen below 7.3 million for the first time since 2023, yet worries persist regarding prolonged waiting times in accident and emergency departments.

England's hospital waiting list has reached its lowest point in almost three years, marking a significant milestone in the country's healthcare system.

A group of surgeons operating on a patient in theatre

As of December 2025, the number of patients awaiting treatment, including knee and hip operations, stood at 7.29 million, the lowest figure recorded since February 2023.

However, the latest monthly update from NHS England reveals that long wait times persist in Accident and Emergency departments, with a record number of patients experiencing 12-hour trolley waits.

In January 2026, over 71,500 patients spent more than 12 hours waiting for a hospital bed after being assessed by A&E staff, the highest number tracked since 2010.

This translates to nearly one in five patients admitted after visiting A&E waiting for an extended period.

According to Health Secretary Wes Streeting, while progress has been made, significant challenges still need to be addressed.

Streeting acknowledged that "there is much more to do" and emphasized the need to accelerate progress, but expressed optimism that the NHS is on the path to recovery.

Dr. Vicky Price, representing the Society for Acute Medicine, noted that hospitals are operating beyond safe capacity in terms of emergency care.

Dr. Price highlighted the vulnerability of patients who require admission, often elderly and frail individuals with complex needs, who are at greater risk of harm when care is delivered in corridors and hospitals exceed safe limits.

Duncan Burton, Chief Nursing Officer for England, commended the progress made in reducing wait times, achieved despite the challenges posed by strikes by resident doctors.

Burton attributed this progress to the hard work and dedication of NHS staff, describing it as a "triumph".

Although the waiting list decreased, performance against the 18-week target slightly declined, with 61.5% of patients waiting less than 18 weeks, compared to 61.8% in November, and still short of the 92% target set to be met by 2029.

Rory Deighton of the NHS Confederation, which represents hospitals, welcomed the progress but cautioned that it obscures significant regional variations.

A recent BBC report revealed that nearly a quarter of hospital trusts experienced worsening wait times over the past year.

Deighton emphasized that the NHS is composed of numerous separate organizations, each with unique financial and operational challenges, making it more difficult to address care backlogs in some areas.

According to Deighton, this means that tackling care backlogs will be more challenging in certain parts of the country due to these distinct regional challenges.