Fentanyl and the UK: Is the American Opioid Crisis Coming to British Schools?
In the US, fentanyl kills over 70,000 people a year. UK drug monitoring services have confirmed fentanyl's presence in the illicit supply. Schools need to understand the drug, the risk it poses, and what immediate steps to take if a pupil is in opioid overdose.
Photo: Pexels — emergency medical response
What Is Fentanyl?
Fentanyl is a synthetic opioid 50–100 times more potent than morphine. A lethal dose is approximately 2 milligrams — smaller than a few grains of salt. It can be absorbed through the skin, inhaled, and ingested, making accidental exposure a risk for bystanders and first responders.
The UK Situation in 2025
OHID and the National Programme on Substance Abuse Deaths have both recorded a steady increase in fentanyl-related deaths in England since 2020.[1] Fentanyl has been detected in counterfeit prescription pills (sold as oxycodone or tramadol), heroin, cocaine, and MDMA — often without the user's knowledge. The NCA confirms fentanyl is increasingly available through dark web marketplaces with UK delivery, and county lines networks are beginning to integrate it into supply chains.[2]
Recognising an Opioid Overdose
Signs — Act Immediately, Call 999
- Extremely slow, shallow, or stopped breathing (<12 breaths per minute)
- Blue or grey lips or fingertips (cyanosis)
- Pinpoint (very small) pupils
- Unresponsive or unconscious despite stimulation
- Gurgling or choking sounds
Naloxone: What Schools Need to Know
Naloxone (Narcan) rapidly reverses an opioid overdose. It is available without prescription in the UK. The UK Government's drug strategy supports wider naloxone availability, and several local authority public health teams offer free naloxone training for community organisations including schools in high-risk areas. DSLs should:
- Contact the local public health team about naloxone training
- Add opioid overdose recognition to staff first aid training
- Ensure staff know that calling 999 is always the first action — naloxone is a bridging intervention
Citations
[1] OHID/NPSAD (2024). Drug-related Deaths in England and Wales 2022. OHID.
[2] National Crime Agency (2024). National Strategic Assessment of Serious and Organised Crime 2024. NCA.
[3] EMCDDA (2024). European Drug Report 2024. emcdda.europa.eu.
[4] BMJ (2023). Fentanyl in the UK Illicit Drug Supply. BMJ 380:e073498.
[5] FRANK (2024). Opioids and Fentanyl. talktofrank.com.