Department of Health and Social Care
Central Government
Action Taken
The DHSC has a surveillance system in place to track changing drug markets and harms, including toxicology results from coroner post-mortem toxicology labs and implemented a structured process for assessing the threat posed by synthetic opioids and other drugs. DHSC has published guidance that sets out essential practical information such as who can supply naloxone, the products available, how to use naloxone and other basic lifesaving tools, and the training required. FRANK website has a page providing detailed information on when and how to use naloxone. (AI summary)
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Dear Ms Bourke,
Thank you for the Regulation 28 report of 6 June 2025 sent to Professor , Chief Medical Officer at the Department of Health and Social Care (DHSC) about the death of Frederick Ireland-Rose. I am replying as the Minister with responsibility for Public Health and Prevention.
Firstly, I would like to say how saddened I was to read of the circumstances of Mr Ireland- Rose’s death, and I offer my sincere condolences to their family and loved ones. The circumstances your report describes are deeply concerning and I am grateful to you for bringing these important matters to my attention.
The Government is taking the threat from potent synthetic drugs, including synthetic opioids such as fentanyl and nitazenes, very seriously. Drug-related deaths are tragically at record highs, and we are committed to tackling this problem through working across health, policing, and wider public services. Your report raises concerns over the presence of synthetic opioids adulterating other substances including non-opioid substances. You also raise concerns about the presence of synthetic opioids in vapes and the availability of naloxone for cannabinoid vape users.
To enable us to monitor the presence of synthetic opioids, DHSC, alongside other government departments, has a surveillance system in place which tracks changing drug markets and harms. Within this system we have established several new data streams, including collection of toxicology results from coroner post-mortem toxicology labs, and implemented a structured process for assessing the threat posed by synthetic opioids and other drugs. This process includes working closely with the Synthetic Opioids Taskforce in the Joint Combating Drugs Unit. The Synthetic Opioids Taskforce works with partner
agencies such as the National Crime Agency (NCA) and the National Police Chiefs’ Council to counter the distribution and use of dangerous substances. Additionally, the NCA, working closely with policing, Border Force and international partners has established Project HOUSEBUILDER to ensure that lines of enquiry are prioritised and vigorously pursued to stem the supply of nitazenes and other synthetic opioids to and within the UK.
Based on our long-standing surveillance, vape liquids containing nitazenes are extremely rare, with no confirmed casualties attributed. However, fake medicines containing synthetic opioids have become more common and have recently caused several deaths. This has especially been the case among people buying them online for the purpose of selfmedication. The nitazene found in Mr Ireland-Rose’s examination, n-pyrrolidino isotonitazene, is one of a number of common adulterants in fake oxycodone tablets, which are often bought online.
Where there are incidents of synthetic cannabinoids in THC vapes, the local authority public health team and the police force should act with partners to warn and protect their communities. The Government also provides funding to National Trading Standards to crack down on illegal sellers and undertake testing of products.
To further combat the threat of synthetic opioids, including their presence within fake medicines, a number of legislative changes have been implemented. On 20th March 2024, the UK controlled 15 named synthetic opioids (14 nitazenes) under Class A of the Misuse of Drugs Act 1971. Class A drugs are the most harmful substances and consequently carry the highest sentencing tariffs. Additionally, on 15th January 2025, a generic definition of nitazenes as Class A substances, became law. This aims to prevent drug gangs from trying to adjust drug recipes to attempt to bypass UK drug law. This means that anyone caught producing or supplying nitazenes could now face up to life in prison, an unlimited fine, or both. The Government will continue to take an agile approach to legislating against synthetic drugs, and we remain alert to the need for changes.
Alongside legislative changes, this Government has also published guidance for local commissioners and service providers on planning to deal with, and responding to, potent synthetic opioids. Furthermore, the report ‘Local preparedness for synthetic opioids’. provides evidence and insights for Combating Drugs Partnerships to help strengthen their preparedness for an evolving threat.
Your report also raised concerns about availability of naloxone for cannabinoid vape users. DHSC has an action plan to reduce drug and alcohol-related deaths which includes widening the availability and access to naloxone. Last year, the Government amended the Human Medicines Regulations 2012 to expand access to naloxone. The legislation means more services and professionals can supply this medication without prescription, which in turn means easier access to it for people at risk, and for their loved ones. DHSC has recently published guidance that sets out essential practical information such as who can supply naloxone, the products available, how to use naloxone and other basic lifesaving tools, and the training required.
Raising awareness of naloxone and its lifesaving potential among the general public is important. The Government has a drug and alcohol information and advice service called FRANK. This aims to reduce drug and alcohol use and their harms by providing information
and increasing awareness for young people, parents, and concerned others. The FRANK website has a page providing detailed information on when and how to use naloxone, which is available at the following link: https://www.talktofrank.com/get-help/what-to-do-in- anemergency.
There is no doubt that illicit drugs have a devastating impact on our communities. This Government will continue to respond and adapt to the changing landscape of threats caused by synthetic opioids. These harms are preventable, and this Government is committed, through our Health Mission, to ensure people live longer, healthier lives. I hope this response is helpful. Thank you for bringing these concerns to my attention.
Thank you for the Regulation 28 report of 6 June 2025 sent to Professor , Chief Medical Officer at the Department of Health and Social Care (DHSC) about the death of Frederick Ireland-Rose. I am replying as the Minister with responsibility for Public Health and Prevention.
Firstly, I would like to say how saddened I was to read of the circumstances of Mr Ireland- Rose’s death, and I offer my sincere condolences to their family and loved ones. The circumstances your report describes are deeply concerning and I am grateful to you for bringing these important matters to my attention.
The Government is taking the threat from potent synthetic drugs, including synthetic opioids such as fentanyl and nitazenes, very seriously. Drug-related deaths are tragically at record highs, and we are committed to tackling this problem through working across health, policing, and wider public services. Your report raises concerns over the presence of synthetic opioids adulterating other substances including non-opioid substances. You also raise concerns about the presence of synthetic opioids in vapes and the availability of naloxone for cannabinoid vape users.
To enable us to monitor the presence of synthetic opioids, DHSC, alongside other government departments, has a surveillance system in place which tracks changing drug markets and harms. Within this system we have established several new data streams, including collection of toxicology results from coroner post-mortem toxicology labs, and implemented a structured process for assessing the threat posed by synthetic opioids and other drugs. This process includes working closely with the Synthetic Opioids Taskforce in the Joint Combating Drugs Unit. The Synthetic Opioids Taskforce works with partner
agencies such as the National Crime Agency (NCA) and the National Police Chiefs’ Council to counter the distribution and use of dangerous substances. Additionally, the NCA, working closely with policing, Border Force and international partners has established Project HOUSEBUILDER to ensure that lines of enquiry are prioritised and vigorously pursued to stem the supply of nitazenes and other synthetic opioids to and within the UK.
Based on our long-standing surveillance, vape liquids containing nitazenes are extremely rare, with no confirmed casualties attributed. However, fake medicines containing synthetic opioids have become more common and have recently caused several deaths. This has especially been the case among people buying them online for the purpose of selfmedication. The nitazene found in Mr Ireland-Rose’s examination, n-pyrrolidino isotonitazene, is one of a number of common adulterants in fake oxycodone tablets, which are often bought online.
Where there are incidents of synthetic cannabinoids in THC vapes, the local authority public health team and the police force should act with partners to warn and protect their communities. The Government also provides funding to National Trading Standards to crack down on illegal sellers and undertake testing of products.
To further combat the threat of synthetic opioids, including their presence within fake medicines, a number of legislative changes have been implemented. On 20th March 2024, the UK controlled 15 named synthetic opioids (14 nitazenes) under Class A of the Misuse of Drugs Act 1971. Class A drugs are the most harmful substances and consequently carry the highest sentencing tariffs. Additionally, on 15th January 2025, a generic definition of nitazenes as Class A substances, became law. This aims to prevent drug gangs from trying to adjust drug recipes to attempt to bypass UK drug law. This means that anyone caught producing or supplying nitazenes could now face up to life in prison, an unlimited fine, or both. The Government will continue to take an agile approach to legislating against synthetic drugs, and we remain alert to the need for changes.
Alongside legislative changes, this Government has also published guidance for local commissioners and service providers on planning to deal with, and responding to, potent synthetic opioids. Furthermore, the report ‘Local preparedness for synthetic opioids’. provides evidence and insights for Combating Drugs Partnerships to help strengthen their preparedness for an evolving threat.
Your report also raised concerns about availability of naloxone for cannabinoid vape users. DHSC has an action plan to reduce drug and alcohol-related deaths which includes widening the availability and access to naloxone. Last year, the Government amended the Human Medicines Regulations 2012 to expand access to naloxone. The legislation means more services and professionals can supply this medication without prescription, which in turn means easier access to it for people at risk, and for their loved ones. DHSC has recently published guidance that sets out essential practical information such as who can supply naloxone, the products available, how to use naloxone and other basic lifesaving tools, and the training required.
Raising awareness of naloxone and its lifesaving potential among the general public is important. The Government has a drug and alcohol information and advice service called FRANK. This aims to reduce drug and alcohol use and their harms by providing information
and increasing awareness for young people, parents, and concerned others. The FRANK website has a page providing detailed information on when and how to use naloxone, which is available at the following link: https://www.talktofrank.com/get-help/what-to-do-in- anemergency.
There is no doubt that illicit drugs have a devastating impact on our communities. This Government will continue to respond and adapt to the changing landscape of threats caused by synthetic opioids. These harms are preventable, and this Government is committed, through our Health Mission, to ensure people live longer, healthier lives. I hope this response is helpful. Thank you for bringing these concerns to my attention.