New synthetic drug hidden in heroin and cannabis vapes is flooding Scotland

Scotland's drug harms early warning system has issued an alert for a synthetic drug which is being detected in overdoses and deaths across Scotland.

The alert for xylazine has been issued by Rapid Action Drug Alerts and Response (RADAR), led by PHS, and highlights that the unregulated drug supply is becoming increasingly toxic and unpredictable due to an increase in new synthetic drugs.

Xylazine is a non-opioid tranquilliser used in veterinary medicine as a sedative, muscle relaxant and painkiller. It reduces breathing, heart rate and blood pressure.

Drug users may may not even be aware of the potential presence of xylazine in the supply with PHS warning it is most likely to be consumed unintentionally and is commonly found as an adulterant in brown powders sold as heroin.

Around the UK it has also been detected in the wider drug supply, including in counterfeit opioid painkillers like codeine and tramadol and in liquids sold as THC (a psychoactive component of cannabis) vapes.

Data within the latest RADAR report indicates that nitazenes, a new synthetic opioid which was first identified in Scotland in early 2022, was detected during post-mortem toxicology in 12 deaths between October 1 and December 31 last year.

Dr Tara Shivaji, Consultant at Public Health Scotland, said: “We are very concerned about the emergence of synthetic drugs like xylazine and nitazenes within the unregulated drugs market across Scotland.

“These drugs pose a significant and increased risk of harm to people who use drugs.

“Many overdoses involve the use of multiple drugs at the same time. Xylazine has largely been identified alongside other substances including heroin, therefore it’s important that people who are likely to witness an overdose carry naloxone - a medicine that temporarily reverses an opioid overdose.

“Xylazine use is associated with the development of severe wounds and skin damage. Wounds can appear as spots, blisters or open sores anywhere on the body, and require prompt medical attention to prevent serious infections developing.”

Emergency care staff attending suspected incidents of drug intoxication and overdose have been told to consider xylazine as a possible reason for the condition.

The highest risk of harm is associated with injection.

The risk of skin and wound infections is increased with poor hygiene which emphasises the need for safe, clean injecting spaces, and a focus on reducing injecting-related injuries.

PHS said: “Scottish Government should consider how to support the scale up of wound care packages in primary care, secondary care, drug treatment and harm reduction or low threshold services as part of its urgent response to emergent substances.”

Ten days ago the latest figures for drug deaths showed an 11% spike from the previous quarter and for the first time there was been evidence of a growing number of deaths because of synthetic nitazenes.

Public Health Scotland confirmed: “Based on the latest post-mortem toxicology testing, nitazenes were detected in 38 deaths (from the first detection in June 2022 to 31 December 2023).”

Scottish Lib-Dem leader Alex Cole-Hamilton warned: “We still have a crisis on our hands. Scotland’s drug deaths emergency continues to end lives and blight communities.

“I have been warning for months that we aren’t ready for the tidal wave of synthetic opioid deaths."

He continued: “We are seeing increasing evidence of nitazenes, a synthetic opioid 50 times stronger than heroin, contributing significantly to the crisis.

“I have joined with campaigners in warning that these substances represent a growing part of the drugs death crisis, highlighting that their presence in Scotland will require an immediate response.

“That’s why I asked Humza Yousaf about nitazenes during First Minister’s Questions in early January.

“Despite these emerging threats, the Scottish Government have delivered a brutal real-terms cut to drug services.”

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