Intended for healthcare professionals

Rapid response to:

Feature Briefing

Fentanyl misuse in the UK: will we see a surge in deaths?

BMJ 2018; 361 doi: (Published 09 April 2018) Cite this as: BMJ 2018;361:k1564

Rapid Response:

Re: Fentanyl misuse in the UK: will we see a surge in deaths?

We won't know how many lives will be claimed by Fentanyl as there is a significant time lag between an individual death and an accurate report of the cause. The Home Office is aware of this problem and says it is trying to address it. However this is one of many problems we have in trying to understand how many people lose their lives due to drug use. People who develop problems with drugs and as result die also have a range of physical comorbidities which make a definitive cause of death difficult to pin down. Coroners are human and may well spare the surviving family and friends by recording a death as due to respiratory failure rather than due to an opiate such as Fentanyl. There is also some evidence that gender bias may be at play with predominantly male coroners reluctant to investigate untoward deaths in females.

But the problem seems to start before this point, we know that toxicology reports are not routinely requested and even when they are they either lack sophistication or can be inconclusive, particularly if multiple drugs are involved which is the norm for people who develop problems with drugs.

All of these factors impede our collective understanding of drug related mortality and as with Fenatnyl being quick enough to respond to emerging problem drugs, equally a lack of timely mortality data can create unjustified panic.

Competing interests: No competing interests

09 April 2018
Ian Hamilton
University of York
Health Sciences, University of York