Two state alerts and local overdose deaths point the same direction in Northeast Ohio. Even though The Buckeye State features a wide range of programs to deal with substance misuse, including local Narcotics Anonymous chapters on the local level, a new wave of substances like xylazine threaten to increase the human toll. 

This time, there’s a catch. The substances driving opioid overdose deaths are increasingly not the ones people think they are buying.

Matthew Vanyo, director of the Westshore Enforcement Bureau Drug Task Force, reported that 18 overdose deaths in Cuyahoga County have been directly linked to xylazine, often mixed with other drugs, from 2025 through the present.

“If you are buying illegal drugs on the street, just know you never know what’s going to be in that drug,” Vanyo relayed. “You have no clue.”

The Ohio Alerts

The Ohio Narcotics Intelligence Center recently issued two public safety alerts.

The first covers orphine analogs, a group of potent synthetic opioids. Like other opioids, they suppress breathing, and their potency raises the risk of a fatal overdose.

The second covers xylazine and medetomidine, two veterinary sedatives that now turn up mixed into the illicit drug supply. Neither has approval for human use.

Vanyo described how people receive combinations of contaminated drugs they never chose.

“The user thinks they’re only getting drug A, but they’re getting xylazine and medetomidine and fentanyl, and that’s aiding or the cause of a fatal overdose,” Vanyo pointed out.

The Substances Involved

Fentanyl is a synthetic opioid many times deadlier than morphine. It’s now common in the illicit supply across drug classes, including in counterfeit pills.

Xylazine and medetomidine are sedatives, not opioids. They slow heart rate and breathing through a different mechanism, which is what makes them dangerous alongside opioids like fentanyl. Two depressants acting at once compound the effect on breathing.

Xylazine also causes wounds that worsen quickly without care.

“The one unfortunate byproduct of xylazine abuse is open wounds that, if not taken care of, will eat down the skin,” Vanyo pointed out.

Anyone who develops a wound after using drugs should have it seen by a clinician early. These wounds respond to treatment, and delaying care turns them serious.

Naloxone Still Matters in an Opioid Overdose

Officials noted that naloxone, sold under the brand name Narcan, may not fully reverse an overdose involving these combinations, because naloxone works only on opioids. Many local Ohio neighborhoods have made Narcan readily available.

Authorities recommend giving naloxone faster and calling 911. Naloxone reverses the opioid portion of the overdose, which usually stops someone’s breathing. When a non-opioid sedative is also involved, additional doses or emergency medical care may be needed, and the person might stay sedated after the opioid effect is reversed.

Basically, give naloxone, call 911, stay with the person, and stand ready to give another dose. Someone who’s breathing again but still unresponsive still needs medical attention.

Enforcement’s Limits

Vanyo directly stated that arrests alone won’t lower the death count. Rather, connecting people to care remains essential to the task force’s job.

“For those who want to go into recovery,” Vanyo reaffirmed, “we help them get onto that pathway of care for themselves.”

The task force plans to host Operation Bridge on August 26 from 2 to 6 p.m. at the Lakewood Women’s Pavilion on Lake Avenue in Lakewood, Ohio. Nearly 40 organizations will be on hand with resources, including treatment providers, recovery services and the Homeless Coalition.

Vanyo concluded that the reach of the problem extends past the people using drugs. “It affects communities abroad, the county and the entire state.”

NA: Help for Opioid Addiction

Treatment for opioid addiction includes medications such as buprenorphine, methadone and naltrexone, which reduce cravings and withdrawal and help reduce overdose death rates. These work alongside counseling and peer support rather than in competition with it.

Speaking of peer support, Narcotics Anonymous meetings are among the most effective steps to take to get help. Meetings offer free peer support and run throughout every neighborhood in Ohio and the rest of the country, including evening and virtual options. 

Feel free to use our online directory to find NA meetings by city and meeting type. You can also call 800-934-1582(Sponsored) to speak with an expert and discuss treatment options.

Most people given opioids for short-term pain stop taking them well before the pain is gone. That’s the reassuring finding from a large new federally supported study. The harder finding is what stays behind in the medicine cabinet, and why leftover pills should be properly trashed. However, many prescriptions stay in the cabinet, which leads to risks of opioid addiction and overdose.

Researchers reported that roughly two in three patients had unused opioid tablets after an acute pain episode. The study was backed by the Food and Drug Administration and is intended to inform FDA guidance on prescribing for specific conditions.

Opioids and Overdose Risk

Let’s take a step back and look at the bigger picture. Opioids include prescription medications such as oxycodone, hydrocodone, morphine and codeine alongside heroin and fentanyl. With sustained use the body adapts, so more is needed for the same effect and stopping produces withdrawal.

Most overdose deaths in the United States now involve illicitly manufactured fentanyl rather than prescribed medication. So, leftover pills matter less as a direct overdose source than as a first exposure on a path toward opioid addiction. An opioid overdose produces unresponsiveness, very slow or stopped breathing, and blue or gray lips and fingertips.

The Study Tracked Opioid Pills

The prospective cohort study followed 1,708 opioid-naive patients between September 2020 and March 2023. They came from Cedars-Sinai Medical Center, Mayo Clinic, Monument Health, the University of Alabama at Birmingham and Yale-New Haven Health. Dental practices in several Southeastern states also participated. Molly Moore Jeffery of Mayo Clinic led the study. The analysis ran from April 2023 to February 2026.

Patients were enrolled from emergency departments, primary and urgent care clinics, dental practices, and after cesarean delivery or knee replacement who opted for opioids following surgery rather than without. All were adults who had never used opioids, apart from adolescents aged 15 to 17 having impacted molars removed at one site. Participants completed digital surveys for up to 180 days tracking pain, medication use, and side effects.

Opioid Use Ended Before Pain Did

Among the 1,502 patients who reported a pain level at least once, pain took a median of 20 days to resolve, regardless of which treatment they received. Median opioid use lasted 7 days.

That gap is the study’s central observation. Most participants stopped taking opioids while still in some pain, which suggests they used their meds for the worst stretch of the episode rather than until full recovery. This find correlated with other research that shows opioids don’t ease long-term pain.

Recovery time varied sharply by condition. Surgical pain took a median of 74 days to resolve and low back pain 69 days, while kidney stone pain resolved in a median of 8 days.

The authors concluded that many patients are well served by current guidance recommending a short initial opioid prescription. Some patients needed opioids longer and that treatment should be tailored to individual needs.

Leftover Pills and Opioid Addiction Risk

About 67% of participants reported having leftover opioids. The study documented that surplus but did not track what happened to it.

That distinction matters. Unused opioids sitting in homes create routes to diversion, accidental ingestion by children, and unsupervised use later by the patient or someone else. The FDA has previously noted that studies of post-surgical prescribing commonly find a majority of dispensed tablets go unused.

The practical response is unglamorous. One simple way to decrease the risk of addiction is to ask for the smallest quantity that covers the worst days, store it securely, and dispose of the rest.

Those Who Kept Using Longest

Roughly 10% of participants continued using opioids for at least 90 days. Persistence was highest among those who reported frequent pain in the six months before enrolling.

Prolonged use isn’t the same as opioid addiction, and the study diagnosed no one. It measured how long people took medication, not who developed a disorder. Extended use is, however, a recognized signal that warrants clinical attention rather than an automatic refill.

The findings are descriptive and can’t establish cause and effect. Treatment data came from patient self-report rather than confirmation against pharmacy or health records. Enrollment was complicated by the COVID-19 pandemic and by technical problems linking patient accounts to health records. The study also didn’t compare opioids against nonopioid treatment head to head.

Harm Reduction and Treatment Options

Naloxone reverses an opioid overdose and works within minutes. Fentanyl test strips can detect fentanyl in a supply, though not how much is present.

Medication for opioid use disorder, including methadone, buprenorphine, and naltrexone, reduces overdose death. 

Peer support is a complementary path. Narcotics Anonymous meetings are free and require no insurance, referral, or diagnosis, and many people use medication and peer support together.

NA Fights Opioid Addiction

To dispose of leftover medication, the Drug Enforcement Administration maintains a year-round collection site locator, and many pharmacies accept returns.

If you want support, feel free to browse our directory to find NA meetings by state and city, including online and Spanish-language options. For those seeking treatment, call 800-934-1582(Sponsored) and ask our experts specifically about medications and whether it continues after any inpatient stay.

For years, the working assumption in overdose prevention was that injecting carried the highest risk and that moving away from it lowered that risk. A new analysis of people affected by heroin addiction in Baltimore complicates the picture. It found no evidence that any one route of use was riskier than another. In this case, higher overdose odds correlated with using several routes during the same period.

The study matters because the way folks in the United States use opioids has changed sharply since 2020. Even though states like Maryland feature a wide range of addiction treatment programs, from inpatient care in modern facilities to local Narcotics Anonymous chapters, the shifting drug scene continues to take its toll on residents and their families.

The Opioid Crisis in Baltimore

Drug overdoses have caused more than one million deaths in the United States since 1999, according to the Centers for Disease Control and Prevention. Despite efforts and funding to lower overdose numbers, the rates remain near historic highs.

The mix has shifted underneath those totals. Multiple studies documented a move away from injecting and toward smoking and nasal inhalation starting during the COVID-19 pandemic. By 2022, CDC data showed smoking-related overdose deaths had passed injection-related overdose deaths.

The Baltimore Study’s Findings

Researchers used the ALIVE cohort, a community-recruited study of adults in Baltimore who have a history of injecting drugs. Participants attend visits twice a year and report their drug use over the previous six months.

The heroin analysis covered 1,121 participants across 4,396 study visits. Of those visits, nearly 890% were from adults aged 40 to 79, 33% by women, and 77% by Black participants. Past-six-month overdose was reported at 11.6% of visits.

Injection alone was the most common pattern at 34% of visits, followed by injection with nasal inhalation at 29% and nasal inhalation alone at 28%. All three routes together accounted for 4%.

Using all three routes associated with higher overdose odds than injecting alone, with an adjusted odds ratio of 2.37. Compared with nasal inhalation, the adjusted odds ratio was 2.87. Using both injection and nasal inhalation associated with higher odds than just nasal inhalation, at 1.78. The authors reported similar patterns for cocaine.

The Design Matters Regardless of Location

Earlier research on this question was largely cross-sectional. This means it compared different people at a single point in time. That approach cannot separate the effect of a route from everything else that differs between people, including which drugs they use, how often, and at what potency.

This analysis instead looked at within-person change. It asked whether the same participant had different overdose odds during periods when they used drugs differently. This was the first study to examine the relationship this way in a longitudinal, community-recruited sample.

The finding doesn’t offer a direct proof of cause. It’s also based on one cohort in one city whose participants all have a history of injecting, even as the overdose rates in Maryland have fallen from its peak. It shouldn’t be read as guidance for any individual.

Fentanyl’s Role in the Shift

The authors situate their work against a changing drug supply. Fentanyl became more common in non-injection formulations before and during the pandemic. Xylazine emerged as a contaminant. Harm reduction services, routine health care and treatment access were all disrupted.

Fentanyl’s presence means the contents and strength of a given supply are frequently unknown to the person using it. That unpredictability partly explains why the authors treat unfamiliar or shifting use practices as worth studying.

Opioids and How to Handle Overdose

Opioid classifications include heroin, fentanyl and prescription meds. They act on receptors in the brain and spinal cord that regulate pain, and at high enough doses they slow or stop breathing, which is what makes an overdose fatal.

Naloxone, sold under brand names including Narcan, reverses an opioid overdose by displacing opioids from those receptors. It is available over the counter and works within minutes.

Harm reduction programs supplying sterile equipment for drug administration may help people who use drugs reduce overdose risk. That is their recommendation based on these findings, and approaches to equipment distribution vary by state and locality.

Beyond equipment, medication for opioid use disorder remains the most established treatment for heroin addiction. Buprenorphine and methadone reduce withdrawal and cravings by acting on the same receptors, and naltrexone blocks opioid effects after withdrawal is complete. These medications are typically paired with counseling.

Peer support runs alongside treatment rather than replacing it. Narcotics Anonymous meetings give people in recovery from heroin addiction and other opioid use disorders regular contact with others working through the same thing, and meetings are free to attend.

NA a First Defense Against Heroin Addiction

If you or someone close to you is dealing with heroin addiction or another opioid use disorder, several steps are available now.

• Get naloxone and keep it accessible. Pharmacies stock it over the counter, and many local harm reduction programs distribute it at no cost.
• Ask about fentanyl test strips, where they’re legal and available.
• Contact an opioid treatment program or a buprenorphine prescriber to discuss medication options.

Our online directory lists NA meetings by state and city, with filters for meeting type and virtual options. You can find something nearby without waiting for an appointment. Feel free to browse our listings or call 800-934-1582(Sponsored) to speak with an expert.

The leader of an international drug trafficking organization operating through Southern California was sentenced on July 9 to 240 months, or 20 years, in federal prison. 

For people living with narcotic addiction and the families around them, it’s a reason to celebrate. To be sure, The Golden State offers a wide breadth of programs ranging from inpatient care to grassroots Narcotics Anonymous programs to combat substance misuse. However, cases like this one shape the illicit supply without changing the day-to-day work of finding treatment and staying safe.

The Court’s Findings

United States District Judge John A. Kronstadt sentenced Guramrit Sidhu in the Central District of California. Sidhu pled guilty on March 26 to one count of engaging in a continuing criminal enterprise. That charge, brought under the federal statute known as the kingpin statute, applies to those who organize or supervise a large-scale drug operation rather than simply participate in one.

Under his plea agreement, Sidhu led an organization that trafficked drugs out of the United States between September 2020 and February 2023. Over six weeks from mid-September to October 2022, he orchestrated eight separate drug loads totaling approximately 1,150 pounds of methamphetamine and 765 pounds of cocaine. Law enforcement seized all of it. Prosecutors estimated the wholesale value at roughly $15 million to $17 million.

After purchasing bulk quantities in the United States, Sidhu arranged transport by long-haul semi-truck across interstate highways. Couriers used phone numbers and currency serial numbers as identifying tokens during handoffs.

Sidhu came into federal custody in October 2024 after the Justice Department’s Office of International Affairs secured his extradition. He’s the eighth defendant in this case to plead guilty thus far. Others received federal prison terms ranging from 27-108 months.

The investigation involved the FBI, the Los Angeles Police Department, the Los Angeles Interagency Metropolitan Police Apprehension Crime Task Force, federal authorities, and international law enforcement partners.

Stimulants in the Current Supply

Methamphetamine and cocaine are stimulants. They increase alertness, heart rate, and blood pressure, and they carry their own overdose risk, which can present as chest pain, agitation, seizures, hyperthermia, or stroke rather than the slowed breathing seen with opioids.

Stimulant use disorder doesn’t currently have an FDA-approved medication comparable to methadone or buprenorphine for opioid use disorder. Treatment relies on behavioral approaches, contingency management and peer support. That’s one reason support groups matter so much for people recovering from stimulant use.

A separate and important point: the loads described in this case were methamphetamine and cocaine. Court documents don’t describe fentanyl in these seizures, and nothing here should be read as saying otherwise. Nationally, however, fentanyl contamination of the stimulant supply remains a documented risk, which is why the harm reduction guidance below applies to stimulants and not just opioids.

Enforcement in Action

Large seizures remove products from the market and can disrupt distribution networks. But they don’t reduce the number of people who wake up tomorrow with cravings, withdrawal, or a use disorder they want help with. Supply disruption can also push the illicit market toward substitutes of unknown or mixed composition.

Even though the number of fentanyl cases in LA County has declined in recent years, residents need to stay vigilant lest an addiction or overdose strike. If you or someone you care about is using stimulants or opioids, the next step is the same today as it was last week.

NA Fights Narcotic Addiction

Recovery paths vary and none of them require choosing just one. Options include:

• Medically supervised detox and inpatient or outpatient treatment
• Medication for opioid use disorder, including methadone, buprenorphine, and naltrexone, where clinically appropriate
• NA meetings, including open, closed, virtual and Spanish-language formats
• 988 Suicide and Crisis Lifeline for anyone in crisis

NA remains a free, confidential and easy-to-join way to fight addiction. Local chapters dot the landscape nationwide. To find one, simply browse our directory or call 800-934-1582(Sponsored) to speak with an expert about treatment options for narcotic addiction.

Nearly 17% of people testing positive for fentanyl also test positive for xylazine, a veterinary sedative with no approved use in humans, according to a national study of urine drug tests. The number is climbing, especially in parts of the country where xylazine barely showed up just two years ago.

The Opioid Crisis in Wastewater

Researchers analyzed 42,307 urine drug tests collected from patients in primary care, behavioral health, and substance use treatment settings between March 2023 and September 2025. All tested positive for fentanyl. Of those, 7,156 samples, or 16.91%, also tested positive for xylazine.

The trend lines tell the real story. In the Eastern United States, where xylazine has circulated for years, positivity climbed from 11.11% to 19.63% over the study period. The numbers peaked at 42.31% of samples in a single month. 

In the West, where xylazine essentially had no presence at the start of the study, positivity rose from 0% to 13.46%. It’s a sign that the drug has actively spread into markets that hadn’t seen it before.

Testing also found that people whose samples tested positive for heroin were more than twice as likely to also test positive for xylazine. Higher fentanyl concentrations also strongly linked to higher odds of xylazine detection. In other words, xylazine doesn’t show up at random. It travels with the heaviest exposure to other substances.

Driving the Trend

Interestingly, while more people test positive for xylazine, the actual concentration found in positive samples has dropped. In eastern states like New York, median xylazine levels fell sharply after an early 2023 peak. Researchers think manufacturers and distributors may be adjusting how much xylazine they mix into fentanyl, whether in response to reports of severe skin wounds and prolonged sedation, or because new state laws and restrictions on veterinary xylazine supplies make it harder to source in bulk.

That’s a mixed signal for people who use drugs. More positive tests means more people are being exposed to xylazine somewhere in their supply, even if any individual dose tends to be smaller than it once was.

Fentanyl’s Role

Fentanyl remains the driver of the opioid crisis, and this study only counted samples where fentanyl was already present. Now, xylazine rides along inside a fentanyl supply that’s already dangerous. Since xylazine isn’t an opioid, naloxone doesn’t reverse its sedative effects, so more people testing positive for both drugs together matters for how overdoses get treated on the ground.

Researchers also flagged medetomidine, a chemically similar veterinary sedative. Medtomidine is starting to show up as a possible replacement for xylazine in some markets, but wasn’t part of this study’s testing panel. That means the true scope of veterinary sedatives mixed into the fentanyl supply right now may be larger than these numbers capture.

Harm Reduction and Treatment Works

People who use drugs have a practical takeaway. A fentanyl test strip might confirm fentanyl but says nothing about what else it contains. Xylazine-specific test strips exist and are increasingly available through harm reduction programs, though access still varies by state and city.

Naloxone remains essential and should be carried by anyone using opioids or spending time with someone who does. Since xylazine keeps a person sedated even after naloxone reverses the opioid component of an overdose, calling emergency services after administering naloxone matters more than ever when xylazine exposure is a possibility.

Medication for opioid use disorder (MOUD), including methadone and buprenorphine, remains a first-line treatment option regardless of what adulterants are present in someone’s supply. 

Narcotics Anonymous meetings also offer ongoing peer support for people building a recovery plan around opioid use, whether or not they are using MOUD alongside it.

NA Still a Top Option

NA meetings remain a critical first step to recovery, from either fentanyl or any other substance. Meetings are free, confidential, and build fellowship that lasts a lifetime, through the good times and bad.

Getting started is easy. Just dial 800-934-1582(Sponsored) to speak with an expert about local opioid addiction treatment options. Or browse our directory to find chapters anywhere across the United States.

AI software designed to catch drug theft in hospitals failed to flag months of fentanyl diversion by a nurse anesthetist at a Tennessee hospital, according to a state disciplinary order. The hospital joins the ranks of other organizations, alongside inpatient service centers and community Narcotics Anonymous chapters, in The Volunteer State that assist with narcotics dependencies.

The case raises questions about how much hospitals should rely on automated systems to catch fentanyl and other narcotic theft before someone gets hurt. AI has revolutionized treatment for opioid use disorders. But issues like this one raises questions about the efficacy of relying on technology to watch over potentially lethal medications.

The Incident at the Tennessee Hospital

At Erlanger Baroness, the largest hospital in Chattanooga, anesthesia staff noticed a nurse anesthetist slurring words and falling asleep while on duty in the surgery center in mid-2025, according to the Tennessee Board of Nursing. That nurse, identified as John Stevenson, soon failed a drug test and was fired. He later told investigators he had diverted fentanyl left over after surgical procedures since March 2025, using it once or twice a week at first before increasing to daily use by June.

The hospital uses Sentri7, medication monitoring software powered by AI to detect suspicious patterns in how clinicians dispense and discard controlled substances. When Erlanger audited Stevenson’s dispensing records over the four months, it found five instances where Sentri7 didn’t flag missing drugs, along with other inconsistencies between what medications that staffers dispensed and documented as wasted. All these should have been caught by the automated system.

Fentanyl and Drug Diversion

Fentanyl is a synthetic opioid roughly 50x stronger than heroin. Even small amounts diverted from a hospital setting creates a serious overdose risk. In Tennessee, street level fentanyl causes thousands of overdose cases per year, especially among children and other vulnerable populations.

Drug diversion, the unlawful taking of controlled substances from a healthcare facility, occurs at nearly every hospital in the country in some form. It usually involves leftover medication supposedly destroyed after a procedure, the same way that someone might take unused opioid prescriptions from a medicine cabinet. That pattern, sometimes called waste diversion, is easily detectable, which explains why the Erlanger case has drawn scrutiny.

The Tennessee Board of Nursing’s order offered a possible explanation. They stated that Sentri7 was in its “initial learning phase” at Erlanger, though the board didn’t provide further detail. A source familiar with the software’s design pushed back on that framing in an interview. They noted that these systems typically require 9-12 months of training on historical data before use at a new hospital and lack separate learning phases after that. 

Terri Vidals, founder of Rxpert Solutions, questioned whether the failure reflected a problem with how the hospital staff configured the software rather than a flaw in the tool itself. Vidals called missed waste diversion “the most basics of basics” for this kind of software to catch.

Harm Reduction & Treatment

Cases like this are a reminder that opioid use disorder can develop in anyone with regular access to opioids, including healthcare workers, and that catching it early matters. In addition, while AI tools have helped clinicians, the technology still has a long way to go as a partner for clinical or administrative care.

Naloxone rapidly reverses an opioid overdose and remains a critical safety net regardless of how someone started using opioids. Distribution sites remain available throughout the state, including one in Chattanooga’s Miller Park. Fentanyl test strips also help identify the drug in doses. 

Medication assisted treatment, including buprenorphine and methadone, greatly enhances recovery from cravings and withdrawal symptoms. Clinicians often pair medications with counseling and peer support such as Narcotics Anonymous meetings.

Help for Opioid Addiction Begins with NA

Whether an opioid use disorder started with a prescription or something else entirely, the path forward usually starts with an honest conversation with a medical provider about treatment options. 

That’s where NA comes in. Groups offer free peer support for folks working through narcotics and opioid addiction. Our browsable directory can help you find NA meetings anywhere in the country, and dialing 800-934-1582(Sponsored) to speak with an expert can also guide you to local treatment programs.

Seven deaths in Cook County, Illinois, have now been linked to cychlorphine, a synthetic opioid federal officials describe as up to 10x stronger than fentanyl. Even though The Land of Lincoln features a wide range of addiction treatment options, including Narcotics Anonymous chapters dotting the landscape, new synthetic drugs have taken officials and health providers by surprise, as overdose fatalities begin to mount.

The Opioid Crisis Grips Illinois

The Cook County Medical Examiner’s Office has confirmed seven cychlorphine-linked deaths so far this year, compared with one death attributed to the drug in the county last year. The Drug Enforcement Administration noted the youngest victim was 16 years old. Nationally, researcher Alex Krotulski has tracked 140 deaths linked to cychlorphine across 20 states and Canada, with Illinois accounting for 15 of those deaths, the third-highest total of any state.

Cychlorphine first registered with the DEA in 2024 and first appeared in a Cook County toxicology report last year, according to DEA public information officer Luis Agostini. “We are still analyzing its strength and its power, but we are seeing it more often in our fentanyl seizures and in drug overdose deaths,” Agostini relayed.

Understanding Narcotics and Opioids

More broadly, opioids are a class of drugs that includes prescription pain medications and now newer synthetic compounds like cychlorphine. All of them work by binding to opioid receptors in the brain. However, higher-potency compounds can suppress breathing to the point of overdose death even at very small doses. 

Even though opioid death figures have declined in Illinois, cychlorphine’s potency makes it so dangerous even in small quantities that a person using drugs may not be able to detect or dose safely. Folks might unknowingly take a far more potent opioid than expected, which sharply raises overdose risk.

The Trend and Underlying Fentanyl

Experts say drug dealers often use cychlorphine as a cutting agent, mixed into other illicit drugs without the buyer’s knowledge. Krotulski pointed out that many newer synthetic opioids originate in labs overseas, including in China, then shipped into the United States. This trafficking makes it difficult for public health officials to predict when and where a new compound will surface until drug testing catches up.

Cychlorphine currently isn’t a scheduled substance, despite the elevated alarm, including a notice from the White House. This means no one can be prosecuted specifically for deaths tied to it under current law.

Harm Reduction and Treatment

Since standard fentanyl test strips don’t reliably detect cychlorphine, harm reduction workers say people who use drugs in the Chicago area should treat any unregulated supply as unpredictable right now. 

Naloxone, popularly called Narcan, can reverse an opioid overdose by blocking those receptors, though highly potent synthetic opioids sometimes require more than one dose to be effective.

Carrying naloxone and never using drugs alone remain two of the most effective ways to reduce the risk of a fatal overdose while testing capacity catches up with the drug’s spread.

For people with an opioid use disorder involving cychlorphine or any other opioid, medication-assisted treatment options can reduce overall cravings and withdrawal symptoms. 

NA meetings also offer peer support for anyone working toward recovery, regardless of any other treatment options.

Help for Opioid Addiction Can Start with NA

No matter your location, NA meetings and peer support are available today. Getting started is easy. Simply call 800-934-1582(Sponsored) for opioid addiction treatment options and NA meeting information anywhere in the U.S., including online options. You can also browse our directory, which has NA chapters organized by location.

Animal rescuers working in Los Angeles‘ Skid Row have spotted a disturbing pattern take hold in one of the country’s largest homeless encampments. There, they see dogs exposed to narcotics, including fentanyl, in an apparent effort to check whether a drug supply is safe before a person uses it.

California offers an abundance of programs to help folks impacted by substance misuse, ranging from inpatient care to local Narcotics Anonymous chapters. Nevertheless, many people continue to slip through the cracks, especially the unhoused. 

Volunteers with the nonprofit Starts With One Today have worked with dogs in the area for years. They note the practice reflects part of a much larger crisis of animal neglect playing out in the same blocks where the opioid crisis and chronic homelessness intersect.

Rescuers Report

Victoriah Parker, co-founder of Starts With One Today, relayed how she and other volunteers have repeatedly seen dogs used this way. “What they also use their dogs for is to test their drugs to make sure there is not fentanyl, they are not laced. So we have had several dogs overdose on fentanyl down here,” Parker observed.

Let’s use caution about how this gets framed. The people involved are, in almost every case, themselves living with substance use disorder and chronic homelessnes. These conditions come with their own unhealthy behavioral behaoviors, mental trauma, and lack of access to care. 

Co-founder Jennifer Sims pushed back on framing this as simply a conflict between homeless people and their pets. “There are drug users and mentally ill people who are using animals for their gain,” she pointed out. Sims distinguished the broader population of people who use drugs from those specifically exploiting animals.

Rescuers describe a range of additional hardships facing dogs on Skid Row. Abuse includes pit bulls confined in wire crates through extreme heat, animals bred repeatedly and exchanged for opioids or small amounts of cash and limited veterinary care. 

Still, pets often form a central part of recovery. A 2024 RAND survey of unsheltered people in three LA neighborhoods, including Skid Row, found that 40% listed having a pet as a top housing-related need. The findings underscore how animals play a central role in their owners’ sense of stability even amid extreme hardship.

A Response Advocates Say Has Fallen Short

Los Angeles County District Attorney Nathan Hochman announced in May 2025 that his office had filed 25 animal cruelty cases, including 18 felonies, over six weeks. In November 2025, Mayor Karen Bass announced a pilot program pairing LAPD officers with an embedded Animal Services employee. Advocates say the officers rescued dozens of dogs before losing momentum. 

Indeed, in a February 2026 letter to Governor Gavin Newsom, the advocacy group PETA reported the task force might have been quietly disbanded after only a handful of training sessions. At the same time, inpatient and outpatient care options remain limited.

Fentanyl Exposure and Keeping People Safe

Testing an unknown supply on a dog isn’t a reliable way to detect fentanyl, and it puts an animal at direct risk of overdose. You can obtain fentanyl test strips through many harm reduction services, and public health programs offer a far safer way for a person to check a substance before use. 

Another option is Naloxone, which reverses an opioid overdose in progress. Naloxone remains one of the most effective tools available to prevent a fatal outcome for both the person who used the substance and anyone nearby.

Addressing what’s happening on Skid Row likely requires progress on more than one front at once. No problem exists in isolation from the others. This means expanded harm reduction resources, consistent enforcement against animal cruelty, and continued access to treatment and stable housing for the people living there. 

Help for Opioid Addiction Begins with NA

Anyone concerned about their own drug use, or a loved one’s, doesn’t need to wait for a crisis to reach out. Narcotics Anonymous meetings remains among the most effective ways to get someone started on recovery. Meetings remain free, confidential, and based right in participants’ home communities.

To begin NA, simply dial 800-934-1582(Sponsored) and speak with an expert to browse our directory for chapters listed across the nation.

Authorities out in New Mexico weigh whether to pursue civil damages against the federal government because of a decision from the DEA to let known fentanyl shipments enter the state between 2023 and 2025. 

The number of opioid-related deaths has fallen nationwide, but each death takes a toll. The Land of Enchantment offers programs like inpatient care and community Narcotics Anonymous chapters. But these services run the risk of becoming overwhelmed as more narcotics pour into the city streets.

The Controversy Over Fentanyl

DEA agents monitored but didn’t intercept fentanyl so that they could build up cases against trafficking networks. A DEA whistleblower relayed that this strategy risked public safety due to fentanyl’s dangerous effects and countered Justice Department rules meant to protect communities. The inaction coincides with Justice Department guidance revisions in 2024 to give agents discretion over when to seize fentanyl. This move contradicts earlier orders to seize shipments whenever “practicable.”

The DEA has since asked the Justice Department’s independent inspector general to investigate the allegations. New Mexico’s attorney general separately opened a state criminal investigation into whether federal officials may have broken state law by knowingly allowing fentanyl to reach New Mexico communities.

New Mexico’s Response

Governor Michelle Lujan Grisham relayed that the state could seek billions of dollars in civil damages over the DEA’s handling of the fentanyl shipments. She called the situation “a stunning failure by the federal government.” Grisham pointed to New Mexico’s 21% increase in overdose deaths even as overdose deaths fell nationally by 14% over the same period. The governor also cited the death of a 15-month-old child who reportedly ingested a parent’s drugs in Española.

Albuquerque Mayor Tim Keller also weighed in. He called fentanyl the city’s “No. 1 challenge” and described its effect on crime, homelessness and strain on local health care resources.

The Federal Response

A White House spokesperson asserted that President Trump has classified fentanyl a “weapon of mass destruction” and signed legislation targeting synthetic opioid trafficking while attributing ongoing fentanyl harms in part to previous administrations. The Justice Department offered a similar statement. The DEA hasn’t issued a detailed public response beyond calling for the inspector general’s review.

It remains unclear whether any specific overdose deaths in New Mexico are directly linked to the unseized shipments described in the reporting. Both sides continue to dispute how much responsibility rests with which administration or agency.

An Overview of Fentanyl and Harm Reduction

The controversy reflects the deadly nature of the opioid crisis. Fentanyl is a synthetic opioid much more powerful than most street drugs. Even small amounts can be fatal especially when mixed into other drugs without a person’s knowledge. 

Naloxone, sold under brand names including Narcan, can reverse an opioid overdose if administered quickly and is available without a prescription in most states. Fentanyl test strips can also help people identify fentanyl in a substance before use. 

Medication-assisted treatment with buprenorphine or methadone and inpatient or outpatient rehab programs are all part of the response available to people affected by opioid addiction in New Mexico and nationally.

No method fully substitutes for calling emergency services during a suspected overdose.

NA Can Help Those Impacted

Regardless of how the investigation unfolds, public health officials on both sides of the debate agree that expanding access to treatment remains critical. 

Those who aren’t sure how to take the first step towards recovery can take heart. Narcotics Anonymous offers a free and friendly way to build a network of fellowship. Meet your peers in a local setting, share stories and resources and even offer a shoulder to cry on—or do just that.

NA chapters exist all across the country. Simply browse our directory to find one in any location. Or call 800-934-1582(Sponsored) for confidential guidance on treatment options.

New research helps explain two things people in recovery from opioid use disorder have reported for years. Quitting fentanyl feels different, and relapse and overdose risk after time away from the drug is far more dangerous than people expect. 

A UCLA-led study finds that people who use illicit fentanyl daily in Los Angeles can build a tolerance to amounts that’s lethal for someone without that tolerance. That tolerance isn’t permanent, but explains why relapse after a period of abstinence is so often fatal. It also shows why folks who use fentanyl daily often have trouble starting medication for opioid use disorders, or MAT.

The Research Findings

The study was led by Drug Checking Los Angeles, a community-based public health program. It’s one of many centers out in The Golden State, which offers an impressive range of programs from inpatient care to local Narcotics Anonymous chapters.

Researchers analyzed the purity of more than 500 fentanyl samples tested between September 2023 and January 2026, then surveyed 47 people who reported using fentanyl daily or near-daily about their consumption patterns. The findings describe this specific group of frequent users, not fentanyl users as a whole.

Using morphine milligram equivalents (MME), a standard unit that lets researchers compare opioids of different strengths, the team calculated that this group of daily users consumed an average of about 8,887 MME per day. For context, the CDC considers 2 milligrams of fentanyl potentially lethal for someone with no opioid tolerance. Daily users in the study consumed roughly 60x that amount each day. Due to the tolerance built up through sustained daily use, they didn’t overdose at that level. That tolerance, built gradually, is the entire reason they could survive doses that would kill someone without it.

Raising Overdose Risk After Relapse

This is the main point for anyone in or near recovery: tolerance built through daily fentanyl use isn’t lethal for the person who built it, but it’s also not permanent. Tolerance begins dropping within days of stopping, whether that break comes from detox, incarceration, hospitalization, or completing a treatment program. If someone relapses and returns to the amount they used before stopping, that same amount can now be fatal because their body lost the tolerance that once made it survivable. 

This is one of the best-documented and most dangerous patterns in opioid overdose deaths. The study’s data on just how extreme fentanyl tolerance can become shows why the drop after even a short break risks your life.

Complicating Treatment

The same tolerance pattern has direct implications for anyone trying to start MAT. Buprenorphine is an effective medications for treating opioid addiction but can trigger precipitated withdrawal, a sudden and severe withdrawal reaction, if it’s started too early or at too low a dose for someone with this level of built-up tolerance. Clinicians have increasingly moved toward faster, higher-dose buprenorphine induction protocols specifically because standard low-dose approaches didn’t account for tolerance levels like the ones documented in daily users in this study.

Chelsea Shover, the study’s senior author and an associate professor at UCLA, relayed even a less pure fentanyl supply in other regions would still produce dramatic tolerance levels among daily users. “It’s no longer ‘how do we treat someone who smokes a gram of fentanyl per day,’ it’s ‘how do we treat someone using thousands of MMEs of oral morphine in fentanyl per day,'” Shover noted.

Harm Reduction After Any Break From Use

Anyone who has stopped using fentanyl, for any reason and for any length of time, faces heightened overdose risk if they return to it. Naloxone can save a life by displacing opioids from receptors in the brain. But for someone whose tolerance has dropped, even a single dose is no longer strong enough. Using a smaller amount of drugs than before, avoiding using alone, and having naloxone on hand are basic protections during this specific window of risk.

Methadone remains available as an alternative for people who need a different approach than buprenorphine, particularly those for whom induction has been difficult. Both medications work, and neither is a lesser path than the other.

NA Meetings & Peer Support During Recovery

Starting treatment after daily fentanyl use and staying in recovery afterward is rarely accomplished alone. NA meetings can provide steady peer support both during a demanding induction period and in the vulnerable weeks after any break from use, when relapse overdose risk is highest. Meeting with others who understand this specific risk can make the difference between a slip and a fatal overdose.

If you or someone you love uses fentanyl daily, or is returning to use after any period of abstinence, seek out others who understand what you’re going through before the problem escalates. Remember that NA meetings are free and confidential, and the fellowship there offers peer support during withdrawal, induction, and the early weeks after any break from use.

Simply call 800-934-1582(Sponsored) to get started or browse our directory for chapters located anywhere in the USA.