A coroner has warned that the illegal use of a powerful prescription drug up to 100 times more potent than morphine "kills more people in Northern Ireland than ecstasy and cocaine combined".
Joe McCrisken told the Belfast Telegraph that the misuse of the opioid fentanyl, which has reportedly been found on sale in Northern Ireland for the first time, poses a "significant threat to public safety in Northern Ireland" and said he is "deeply concerned about the future dangers to our community posed by fentanyl".
Fentanyl has so far been responsible for two deaths in Northern Ireland and 68 deaths across the UK. One of those to lose their lives to the drug was 39-year-old Coagh father-of-two Darren Taylor, who died after taking fentanyl obtained from an "illicit source" in November 2016.
During his inquest, a PSNI Detective Constable revealed that some drug addicts were "sucking fentanyl from patches to get a quicker hit".
The BBC has reported that fentanyl has been discovered mixed into heroin seized by the PSNI. Chief executive of Forensic Science Northern Ireland, Stan Brown, told Good Morning Ulster that besides the sample from the police, his organisation had encountered four or five reports from the State Pathologist where the drug had been present, although it was not certain it was the cause of death in each case.
Director of Addiction NI, Thelma Abernethy, described the appearance of fentanyl on Northern Ireland's streets as "frightening".
"People are looking for highs and the end result could be fatal," she said. "People are taking fentanyl with heroin, and in some cases they believe they are just taking heroin, but it could be laced with fentanyl.
"Fentanyl is very, very powerful and when it's cut with other drugs its potency is maximised.
"Over the last six to nine months, there has been an increase in people coming through our doors due to prescription drugs misuse, although alcohol continues to be the drug of choice and a gateway to other drugs. We are seeing poly-drugs misuse, using alcohol with other forms of drugs. We help about 2,000 people across Northern Ireland each year and our services are stretched to breaking point, at the moment there is a two-month waiting list."
Meanwhile, Extern worker Chris Rintoul, who manages some of the charity's addiction services, warned that every heroin user in Northern Ireland could be at risk of using heroin laced with fentanyl.
He said: "Fentanyl users tend to be split into two groups: those who direct pharmaceutical supplies to others who are at risk of developing addiction, and another small but growing group of people who inject heroin, which is the most at-risk group. We have to make the assumption that anybody that is using heroin could be using contaminated heroin."
Detective PSNI Superintendent Bobby Singleton said: "We are aware that recently fentanyl has been added into heroin in England and has likely been a contributory factor in heroin associated deaths there. The PSNI is also aware that fentanyl has now reached Northern Ireland and we suspect it may have been a contributory factor in a small number of deaths. Police will continue to target drugs dealers and those in the supply chain in Northern Ireland to try and remove this danger from society. However, this is not a problem that police can solve alone. We can tackle the symptom and will continue to work with our partners in other sectors, including health and education, to address the wider causes."