Fentanyl is a powerful synthetic opioid derived from a combination of chemicals. Originally developed for medical use, it is approved as a potent pain reliever, particularly for managing severe pain in cancer patients, post-surgical recovery and palliative care.1 But the fact its potency is estimated to be 50 to 100 times stronger than morphine, has also led to its widespread misuse and contribution to the ongoing opioid crisis. Beyond its legitimate medical applications, fentanyl has become a major factor in opioid-related overdose deaths. Unlawfully manufactured fentanyl is often mixed with other drugs, such as heroin, cocaine and counterfeit prescription tablets, significantly increasing the risk of overdose.2
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The rise in fentanyl-related overdoses has placed a significant strain on healthcare systems requiring increased efforts in harm reduction, public education and emergency response. Healthcare professionals, including nurses and paramedics, play a crucial role in recognising opioid toxicity; administering naloxone (a life-saving opioid reversal agent); and supporting individuals struggling with opioid dependence through treatment and rehabilitation services.
The United Kingdom’s public health approach to addressing the fentanyl crisis involves a multifaceted strategy that combines policy interventions, addiction treatment programmes and enhanced access to harm reduction measures. Primary care nurses play a crucial role in any public health approach aimed at reducing the burden of drug overdose. As highly accessible healthcare professionals, they often serve as the first point of contact for those individuals who are at risk of substance misuse. Their established relationships with patients places the primary care nurse in a unique position to identify early signs of drug dependence and to intervene before an overdose occurs.
The role of the primary care nurse in early identification, harm reduction, mental health support, multi-agency collaboration and public health education makes them key players in any comprehensive public health strategy. In order to maximise their impact, there must be continued investment in the provision of education and training, resources and policy support to ensure that they can deliver effective interventions and improve outcomes for those people, their families and communities who are affected by substance misuse.
Ian Peate, Visiting Professor, Northumbria University; Senior Clinical Fellow, University of Hertfordshire; Professorial Fellow, University of Roehampton
References
1. Joint Formulary Committee. 2024. British National Formulary 89. BMJ Group and Pharmaceutical Press. London
2. Office for Health Improvement and Disparities 2024. Deaths Linked to Potent Synthetic Opioids. https://www.gov.uk/government/publications/deaths-linked-to-potent-synthetic-opioids/deaths-linked-to-potent-synthetic-opioids (Accessed 27 February 2025)