Victoria Storey
PFD Report
Partially Responded
Ref: 2023-0222
Coroner's Concerns (AI summary)
A highly potent, illicitly traded synthetic opiate with high fatal overdose risk is not yet controlled as a Class A, Schedule 1 drug, despite official advice for its urgent inclusion.
View full coroner's concerns
Victoria had a history of opioid dependency to assist with her mental health struggles. She had previously admitted to healthcare professionals purchasing illicit opioids from the internet and there was evidence of this from 2019 and 2020 on her electronic devices.
- is illicitly traded and marketed as common pharmaceutical opiates. It has potent analgesic effects but is not approved for medicinal use due to the increased risk of adverse events.
- The Home Office requested advice from the Advisory Council on the Misuse of Drugs (ACMD) on the appropriate domestic control of , and was advised by the ACMD on 18th July 2022 that (and other similar compounds) should be placed in schedule 1 of the Misuse of Drugs Regulations 2001 and listed as Class A drugs under the Misuse of Drugs Act 1971. However, at present the Act and Regulations have not been amended to include and it is unclear if and when this will take place. is not therefore currently controlled under Class A, Schedule 1, Misuse of Drugs Act 1971 despite its heroin-like effects with a high risk of fatal overdose.
- Due to the nature of the trade in potent synthetic opiates, there is no way for the end user to know what the illicit substance
- is illicitly traded and marketed as common pharmaceutical opiates. It has potent analgesic effects but is not approved for medicinal use due to the increased risk of adverse events.
- The Home Office requested advice from the Advisory Council on the Misuse of Drugs (ACMD) on the appropriate domestic control of , and was advised by the ACMD on 18th July 2022 that (and other similar compounds) should be placed in schedule 1 of the Misuse of Drugs Regulations 2001 and listed as Class A drugs under the Misuse of Drugs Act 1971. However, at present the Act and Regulations have not been amended to include and it is unclear if and when this will take place. is not therefore currently controlled under Class A, Schedule 1, Misuse of Drugs Act 1971 despite its heroin-like effects with a high risk of fatal overdose.
- Due to the nature of the trade in potent synthetic opiates, there is no way for the end user to know what the illicit substance
Responses
Action Planned
The government accepted ACMD recommendations to control synthetic opioids, including , under the Misuse of Drugs Act 1971 and intends to bring forward this legislation by the end of the year to come into force in early 2024. (AI summary)
The government accepted ACMD recommendations to control synthetic opioids, including , under the Misuse of Drugs Act 1971 and intends to bring forward this legislation by the end of the year to come into force in early 2024. (AI summary)
View full response
Dear Ms Loxton,
Thank you for your report under Regulation 28 of the Coroner (Investigations) Regulation 2013, dated 30 June and addressed to the Home Secretary and the Secretary of State for Justice, about the death of Ms Victoria Storey. I am responding as the Minister of State for Crime, Policing and Fire.
At present, is subject to the Psychoactive Substances Act 2016. Those who supply who know, or who are reckless as to whether, it will be used for its psychoactive effect may be subject to a maximum sentence of seven years’ imprisonment, an unlimited fine, or both under the Act.
As you note in your report, following a Government commission, the Advisory Council on the Misuse of Drugs (ACMD) provided advice in July 2022 on the harms of
opioids. The ACMD recommended that they are controlled under Class A of the Misuse of Drugs Act 1971 (the 1971 Act) and Schedule 1 of the Misuse of Drugs Regulations 2001. Class A drugs are considered the most harmful to individuals and society, and those placed in Schedule 1 have no known medicinal use in the UK.
The Government accepted these recommendations in February, committing to control 11 synthetic opioids, including , under the 1971 Act and associated Regulations. In light of ongoing drug-related deaths and non-fatal overdoses associated with synthetic opioids in the UK, we intend to bring forward this legislation by the end of the year to come into force in early 2024. This letter can be found on GOV.UK here: Government response to the ACMD’s advice on 2-benzyl benzimidazole and piperidine benzimidazolone opioids (publishing.service.gov.uk)
The presence of synthetic opioids in the UK’s illicit drug market, as well as the health harms associated with this, is a live issue within Government. The Home Office has convened a Synthetic Opioid Taskforce to review latest evidence, assess the risk of synthetic opioids to the UK, and explore options for responding should the level of risk
escalate. Membership of the Taskforce includes the National Crime Agency (NCA), the National Police Chiefs’ Councils, the Department of Health and Social Care (DHSC), Border Force, the Ministry of Justice and the Joint Intelligence Organisation.
The Office for Health Improvement and Disparities (OHID) has issued a National Patient Safety Alert, which provides awareness and clear instructions for staff in health settings across the country to ensure they are prepared for anyone that may present with an overdose caused by synthetic opioids. This includes ensuring the opioid overdose- reversal drug, naloxone, is more widely available. To further support incident response planning, OHID has also updated guidance for local areas on preparing for potent synthetic opioid incidents, and this is available at: Potent synthetic opioids: preparing for a future threat - GOV.UK (www.gov.uk). As you may be aware, alongside this the NCA wrote to the Chief Coroner to ask him to alert coroners of the potential presence of synthetic opioids in apparent heroin deaths.
The Government’s long-term drug strategy, From Harm to Hope: A ten-year drugs plan to cut crime and save lives, sets out our ambitious plans to improve treatment and recovery systems and reduce overall drug use towards a historic 30-year low. The drug strategy is underpinned by significant new investment totalling almost £900 million over 3 years, £532 million of which was allocated to the DHSC to improve local authority drug and alcohol treatment services. This includes creating 21,000 new places for opiate and crack users, who are most at risk from the presence of synthetic opioids in the UK’s illicit drug market. More information can be found at: www.gov.uk/government/publications/from-harm-to- hope-a-10-year-drugs-plan-to-cut-crime-and-save-lives.
Our aim is that through the drug strategy, we will reduce drug related deaths and create a world-class treatment and recovery system, including being better able to respond to any future threat from synthetic opioids.
The Medicines & Healthcare Products Regulatory Agency (MHRA) is the UK regulator for human medicines - responsible for enforcing the Human Medicines Regulations 2012 (HMR 2012). The illegal sale and supplying of medicines online is a global problem. Buying medicines this way is potentially dangerous as they may be unsuitable for the patient, and may contain too much or too little of the stated active pharmaceutical ingredient. Medicines sold illegally online may also be entirely fake, sometimes containing harmful non-medicinal substances not present in the genuine product.
The MHRA collaborates with partners to enforce the HMR 2012 by disrupting the illegal trade in medicines and preventing falsified, unlicensed and substandard medicines from reaching the public. Robust and proportionate enforcement action is taken on a case-by- case basis, including prosecution where appropriate.
The MHRA discourages the public from purchasing medicinal products from unregulated sources and to report any suspicious offers, or side effects from taking such medicines, to its Yellow Card scheme - the UK system for recording adverse drug reactions. The Agency also provides regular updates to the public via its #FAKEMEDS campaign, with advice on how to avoid fake and unlicenced medicinal products, particularly when shopping online.
Given we are already in the process of controlling , and the other measures which I have outlined above, I consider that appropriate measures to reduce the risk of deaths like this from happening are already coming into place. I hope that you agree with my assessment, and I would like to thank you for bringing this matter to my attention.
Thank you for your report under Regulation 28 of the Coroner (Investigations) Regulation 2013, dated 30 June and addressed to the Home Secretary and the Secretary of State for Justice, about the death of Ms Victoria Storey. I am responding as the Minister of State for Crime, Policing and Fire.
At present, is subject to the Psychoactive Substances Act 2016. Those who supply who know, or who are reckless as to whether, it will be used for its psychoactive effect may be subject to a maximum sentence of seven years’ imprisonment, an unlimited fine, or both under the Act.
As you note in your report, following a Government commission, the Advisory Council on the Misuse of Drugs (ACMD) provided advice in July 2022 on the harms of
opioids. The ACMD recommended that they are controlled under Class A of the Misuse of Drugs Act 1971 (the 1971 Act) and Schedule 1 of the Misuse of Drugs Regulations 2001. Class A drugs are considered the most harmful to individuals and society, and those placed in Schedule 1 have no known medicinal use in the UK.
The Government accepted these recommendations in February, committing to control 11 synthetic opioids, including , under the 1971 Act and associated Regulations. In light of ongoing drug-related deaths and non-fatal overdoses associated with synthetic opioids in the UK, we intend to bring forward this legislation by the end of the year to come into force in early 2024. This letter can be found on GOV.UK here: Government response to the ACMD’s advice on 2-benzyl benzimidazole and piperidine benzimidazolone opioids (publishing.service.gov.uk)
The presence of synthetic opioids in the UK’s illicit drug market, as well as the health harms associated with this, is a live issue within Government. The Home Office has convened a Synthetic Opioid Taskforce to review latest evidence, assess the risk of synthetic opioids to the UK, and explore options for responding should the level of risk
escalate. Membership of the Taskforce includes the National Crime Agency (NCA), the National Police Chiefs’ Councils, the Department of Health and Social Care (DHSC), Border Force, the Ministry of Justice and the Joint Intelligence Organisation.
The Office for Health Improvement and Disparities (OHID) has issued a National Patient Safety Alert, which provides awareness and clear instructions for staff in health settings across the country to ensure they are prepared for anyone that may present with an overdose caused by synthetic opioids. This includes ensuring the opioid overdose- reversal drug, naloxone, is more widely available. To further support incident response planning, OHID has also updated guidance for local areas on preparing for potent synthetic opioid incidents, and this is available at: Potent synthetic opioids: preparing for a future threat - GOV.UK (www.gov.uk). As you may be aware, alongside this the NCA wrote to the Chief Coroner to ask him to alert coroners of the potential presence of synthetic opioids in apparent heroin deaths.
The Government’s long-term drug strategy, From Harm to Hope: A ten-year drugs plan to cut crime and save lives, sets out our ambitious plans to improve treatment and recovery systems and reduce overall drug use towards a historic 30-year low. The drug strategy is underpinned by significant new investment totalling almost £900 million over 3 years, £532 million of which was allocated to the DHSC to improve local authority drug and alcohol treatment services. This includes creating 21,000 new places for opiate and crack users, who are most at risk from the presence of synthetic opioids in the UK’s illicit drug market. More information can be found at: www.gov.uk/government/publications/from-harm-to- hope-a-10-year-drugs-plan-to-cut-crime-and-save-lives.
Our aim is that through the drug strategy, we will reduce drug related deaths and create a world-class treatment and recovery system, including being better able to respond to any future threat from synthetic opioids.
The Medicines & Healthcare Products Regulatory Agency (MHRA) is the UK regulator for human medicines - responsible for enforcing the Human Medicines Regulations 2012 (HMR 2012). The illegal sale and supplying of medicines online is a global problem. Buying medicines this way is potentially dangerous as they may be unsuitable for the patient, and may contain too much or too little of the stated active pharmaceutical ingredient. Medicines sold illegally online may also be entirely fake, sometimes containing harmful non-medicinal substances not present in the genuine product.
The MHRA collaborates with partners to enforce the HMR 2012 by disrupting the illegal trade in medicines and preventing falsified, unlicensed and substandard medicines from reaching the public. Robust and proportionate enforcement action is taken on a case-by- case basis, including prosecution where appropriate.
The MHRA discourages the public from purchasing medicinal products from unregulated sources and to report any suspicious offers, or side effects from taking such medicines, to its Yellow Card scheme - the UK system for recording adverse drug reactions. The Agency also provides regular updates to the public via its #FAKEMEDS campaign, with advice on how to avoid fake and unlicenced medicinal products, particularly when shopping online.
Given we are already in the process of controlling , and the other measures which I have outlined above, I consider that appropriate measures to reduce the risk of deaths like this from happening are already coming into place. I hope that you agree with my assessment, and I would like to thank you for bringing this matter to my attention.
Sent To
- Department of Health and Social Care
- Ministry of Justice
Response Status
Linked responses
1 of 2
56-Day Deadline
25 Aug 2023
About PFD responses
Organisations named in PFD reports must respond within 56 days explaining what actions they are taking.
Source: Courts and Tribunals Judiciary
Report Sections
Investigation and Inquest
The inquest into the death of Victoria STOREY was opened on 24th January 2023. Evidence was heard and the inquest was concluded on 26th June 2023. I found the medical cause of death to be: 1a. Toxicity
I determined that Victoria took an accidental overdose of , a potent synthetic opioid not licensed for medicinal use. Victoria had a history of opioid dependency, exacerbated by historic necessary medicinal use and to alleviate Post Traumatic Stress Disorder following a traumatic assault aged 18. I did not find any evidence she had intended to take her own life. The source of the could not be traced despite Police interrogation of her electronic devices. I recorded a short form conclusion of Drug Related.
I determined that Victoria took an accidental overdose of , a potent synthetic opioid not licensed for medicinal use. Victoria had a history of opioid dependency, exacerbated by historic necessary medicinal use and to alleviate Post Traumatic Stress Disorder following a traumatic assault aged 18. I did not find any evidence she had intended to take her own life. The source of the could not be traced despite Police interrogation of her electronic devices. I recorded a short form conclusion of Drug Related.
Circumstances of the Death
2 RT4563
Victoria was found deceased in her bedroom on the evening of 3rd September 2022. Toxicology found she had low therapeutic levels of prescribed drugs; a higher level of Venlafaxine consistent with chronic (not acute) dosage and of in her post mortem blood; which the Toxicologist stated “contributed more than minimally, and possibly substantially, to the cause of Ms Storey’s death”. containing were found in Victoria’s bedroom. The Pathologist recorded a cause of death of 1a) Mixed drug (mainly ) toxicity). Having considered the Toxicology evidence in respect of the other drugs being at low levels, save for Venlafaxine which was stated to be at a level consistent with chronic dosage, I amended the cause of death to 1a) Toxicity. I heard evidence from a Drug Expert with Surrey Police that is not sold under that name, but is often marketed as one of the common pharmaceutical opiates, so the danger of taking this illegal substitute would not be known to the end user.
Victoria was found deceased in her bedroom on the evening of 3rd September 2022. Toxicology found she had low therapeutic levels of prescribed drugs; a higher level of Venlafaxine consistent with chronic (not acute) dosage and of in her post mortem blood; which the Toxicologist stated “contributed more than minimally, and possibly substantially, to the cause of Ms Storey’s death”. containing were found in Victoria’s bedroom. The Pathologist recorded a cause of death of 1a) Mixed drug (mainly ) toxicity). Having considered the Toxicology evidence in respect of the other drugs being at low levels, save for Venlafaxine which was stated to be at a level consistent with chronic dosage, I amended the cause of death to 1a) Toxicity. I heard evidence from a Drug Expert with Surrey Police that is not sold under that name, but is often marketed as one of the common pharmaceutical opiates, so the danger of taking this illegal substitute would not be known to the end user.
Copies Sent To
1. See names in paragraph 1 above
Signed
ANNA LOXTON
DATED this 30th day of June 2023
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Data sourced from Courts and Tribunals Judiciary under the Open Government Licence.