A small but significant minority of people who use illicit opioids such as heroin may unknowingly be using a powerful and dangerous harmful chemical that has been linked to a number of deaths.

This is according to the results of a pilot study carried out by health and social care charity Change Grow Live and researchers from The University of Manchester, which is published for the first time this month in the Journal of Clinical Toxicology. The study was used to improve the understanding of the health risks facing people who used illicit opioids and the steps that could be taken to mitigate these.

For the research pilot, more than 460 people receiving treatment from Change Grow Live, one of the UK's main providers of drug and alcohol treatment, were additionally screened for the presence of fentanyl.

Fentanyl

While fentanyl is a very widely used and valued medication, that is legitimately prescribed for people in pain, around the world it is increasingly being sold illicitly. The results showed a fentanyl-positive rate in adults receiving treatment for opioid use of three per cent. Of those who tested positive for the presence of fentanyl, a majority (80 %) was unaware of having purchased or used fentanyl.

The study was conducted at 14 Change Grow Live sites across all nine geographic regions of England. Urine screening was used to detect the presence of fentanyl, while self-report data was collected from individuals to determine whether fentanyl had been knowingly purchased and used.

The new research comes after the official figures from the Office for National Statistics (ONS) released earlier this year showed an increase in deaths caused by fentanyl. The official figures showed that fatalities involving fentanyl increased by 29 % from 2016 to 2017, from 58 to 75 deaths. The research builds on Change Grow Live's work to understand the growing threat posed by fentanyl.

Sparked by the charity's direct experience of managing and learning from fentanyl-related issues in its cohort of service users in collaboration with Volteface, the independent organization that covers the policy and policy of drugs, it convened an expert round-table last year to discuss the most effective methods of addressing the lethal threat posed by fentanyl and similar substances.

The resulting action plan included recommendations for drug and alcohol treatment providers and those who commission their services based around three key areas: prevention; detection; and control.Commenting on the research findings , Dr. Prun Bijral, Medical Director at Change Grow Live and lead author of the report.

"As with any pilot study, the findings need to be kept in perspective and we should be captive about drawing definitive conclusions.", However, in spite of these important caveats, this research was carried out across each of England's nine regions and we can therefore reasonably say that it does give an indication of the possible prevalence of fentanyl, where there was an absence of data.

"The data suggests that fentanyl is not only present in England, but may be more widespread than originally thought, although we are not seeing a problem on the scale of the USA and Canada, there is no room for complacency.