Exclusive: About 30 deaths in two months being examined for involvement of heroin substitute nitazenes and tranquilliser xylazine. Nitazenes are up to times more powerful than heroin. Varney said his area normally sees six to eight drug fatalities a month, making the spike in June and July around double the normal rate. Police have launched a crackdown on dealers that has led to seizures and arrests. There was a cluster in Birmingham, Bristol, London and Coventry. On Thursday, the coroner for Birmingham and Solihull, James Bennett, concluded nitazenes were the primary cause of death of two drug addicts in one night in July at a hostel in the Lozells area of the city.

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Patients with the disease often experience acute or chronic pain. However, some clinicians have biases against opioid use. VOC occurs when sickle-shaped red blood cells block small blood vessels so that the blood cannot flow normally. This leads to tissue damage and causes pain. Pain is defined as chronic if it lasts three to six months or more. The cause of chronic pain in sickle cell anemia is unclear, but it may be an extension of recurrent painful episodes.

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Morphine is used in the treatment of cough and breathlessness at rest in palliative care, D but is not licensed for these indications. The MHRA reminds healthcare professionals that opioids co-prescribed with benzodiazepines and benzodiazepine-like drugs can produce additive CNS depressant effects, thereby increasing the risk of sedation, respiratory depression, coma, and death. Healthcare professionals are advised to only co-prescribe if there is no alternative and, if necessary, the lowest possible doses should be given for the shortest duration. Patients should be closely monitored for signs of respiratory depression at initiation of treatment and when there is any change in prescribing, such as dose adjustments or new interactions. If methadone is co-prescribed with a benzodiazepine or benzodiazepine-like drug, the respiratory depressant effect of methadone may be delayed; patients should be monitored for at least 2 weeks after initiation or changes in prescribing. Acute respiratory depression; comatose patients; head injury opioid analgesics interfere with pupillary responses vital for neurological assessment ; raised intracranial pressure opioid analgesics interfere with pupillary responses vital for neurological assessment ; risk of paralytic ileus.

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