Ohio officials now contend with a synthetic opioid that most folks haven’t heard of until an overdose hits. Nearly 50 overdoses in the last three months involved cychlorphine, which is 100x deadlier than fentanyl.

Even though Ohio has many programs to battle drugs, including Narcotics Anonymous programs on the ground, new drugs up the ante. These cases represent the latest chapter in an opioid addiction crisis that keeps mutating faster than public awareness.

The Opioid Crisis in The Buckeye State

Synthetic opioids already drive the majority of U.S. overdose deaths. Cychlorphine first surfaced in August 2024 and has since surfaced in pills and in powders disguised as other street drugs. 

Cychlorphine is a synthetic opioid in the nitrile class and binds powerfully to opioid receptors to suppress breathing. But there’s a hitch. “There’s no smell. There’s no color. You can’t detect it,” staff at the Recovery Institute of Ohio relayed, noting that standard fentanyl test strips don’t pick it up.

Jessica Danner of TruHealing in Cincinnati noted clinicians are seeing the compound arrive alongside other street drugs. “Cychlorphine is the new wave.”

Naloxone Still Works

Since cychlorphine acts on opioid receptors, naloxone can reverse an overdose involving it. But a single standard dose may not be enough against a drug this potent. The guidance remains the same:

• Give naloxone immediately if an overdose is suspected and give additional doses if the person doesn’t respond.
• Call 911 every time. Overdose reversal bought by naloxone is temporary.
• Ohio’s Good Samaritan protections apply when someone seeks emergency help during an overdose.

Enroll in NA

Another option is to use medications for opioid use disorder to blunt cravings and block the lethal respiratory effects of street opioids. 

Start with Narcotics Anonymous to find solidarity among your peers. Meetings are free and open to all. To get started, simply browse our directory for chapters anywhere in the USA.

 For guidance for local options, dial 800-934-1582(Sponsored) to chat with an expert.

A new class of synthetic opioids is spreading through the US illicit drug supply as the fentanyl era shifts, and it’s accelerating. Orphine analogs were detected in 22 states. The first on the list is cychlorphine, first detected in 2024 and is the most common orphine listed in the United Nations Office on Drugs and Crime early-warning system.

“The findings provide timely evidence of orphine analogues as an emerging drug threat in the US illicit drug supply,” wrote the investigative team at Virginia Commonwealth University School of Medicine in Richmond.

Orphines in the Storm

Researchers analyzed biospecimens collected through the Center for Forensic Science Research and Education’s NPS Discovery early-warning program from 2020-2026. Of 14,261 specimens tested, 142 were positive for orphines, about 1%.

The pattern consisted of two waves. The first in 2020 was dominated by brorphine. A second larger wave began in 2025. Cychlorphine accounted for 100 of 102 orphine cases.

Geographically, 53% of positive specimens originated in the South and 37% in the Midwest. Tennessee placed first with 50 specimens, followed by Illinois with 37, Texas with 14 and Minnesota with 10. All detections in Tennessee and Texas involved cychlorphine, while Minnesota’s involved brorphine and Illinois showed a mixture.

Drivers of the Trend

In July 2025, China generically scheduled nitazene analogues, disrupting supply chains. Cychlorphine specimens rose rapidly immediately afterwards and only a minority of orphine specimens contained nitazene-related compounds. Suppliers facing pressure on one class of synthetic opioid appear to have pivoted to another.

Scheduling has slowly followed. Brorphine is permanently on Schedule I. In August 2026, the DEA moved cychlorphine, spirochlorphine and SR-17018 into Schedule I under a temporary order until August 2028. Four of the five analogues analyzed are on the Controlled Substances Act’s Schedule I list.

Orphines Compared to Fentanyl

Orphine analogues are mu-opioid receptor agonists that first arrived in pharmaceutical programs back in the 1960s. Some are up to 10x deadlier than fentanyl and cause respiratory depression. 

Polysubstance exposure was the norm rather than the exception. Benzodiazepine-related compounds appeared in 37% of orphine specimens, fentanyl and methamphetamine or other amphetamines in 36% and cocaine-related compounds in 20%. Nitazenes showed up in 9%, medetomidine in 11% and xylazine in 8%. That mixing raises the risk of fatal overdoses since the depressants compound each other.

Standard Testing Misses Them

The authors called for clinical guidance on managing Cychlorphine and other overdoses, greater access to testing and naloxone and looking out for additional analogues. 

They cautioned that submitted specimens came through random and for-cause testing and weren’t systematically drawn from all jurisdictions. So the findings might not be nationally representative.

Harm Reduction & Treatment

Naloxone remains the recommended first response for any suspected opioid overdose, and people who use any street substance should carry it. High-potency opioids can require repeated naloxone doses and close monitoring for re-sedation and calling 911 remains essential.

Medication-assisted treatment remains one of the most effective care programs to thwart withdrawal.

Peer support through Narcotics Anonymous meetings is free and available in most communities. NA works alongside medical treatment.

About NA

Narcotic addictions are treatable, so don’t wait for a crisis to hit. NA remains a first step to a healthier future, and the process is made simpler with our searchable directory organized by city and format.

You can also chat with an expert by dialing 800-934-1582(Sponsored) to explore opioid treatment programs that offer medication-assisted treatment.

Diagnoses of opioid addiction among commercially insured Americans climbed 32.7% between 2022 and 2025, according to FAIR Health’s Opioid Tracker’s report. The national rate rose from 449 patients per 100,000 in 2022 to 596 per 100,000 in 2025.

The Opioid Tracker is a free interactive map of opioid use disorders among commercially insured patients.

The Opioid Crisis Continues

State-level variation is stark. Tennessee recorded the highest rate of commercially insured patients receiving treatment for opioid addiction at 1,551 patients per 100,000. After Tennessee came West Virginia at 1,528, Mississippi at 1,373, Arkansas at 1,320 and Delaware at 1,256. Even though all top five states have access to inpatient care and local Narcotics Anonymous chapters at the community level, each had more than twice the national rate.

Middle aged adults accounted for the largest share at 28%t of the national age distribution, and males made up 56% of diagnosed patients versus 43% female.

In general, opioid addiction is a chronic condition from prescription painkillers, heroin or illicit fentanyl. It changes brain chemistry in ways that make stopping without support extremely difficult. Withdrawal and overdose risk both rise after periods of reduced tolerance. The condition is diagnosed clinically and effective treatment combines medication with counseling rather than relying on willpower alone.

Changes in the Flow

The tracker shows where treatment dollars actually flow. Nationally, alcohol and substance abuse services accounted for 39% of all claim lines carrying an opioid use disorder diagnosis in 2025. The single highest-cost procedure was the weekly methadone medication-assisted treatment bundle, which made up 9.4%.

The treatment workforce is shifting too. Nurse practitioners were the fastest-growing specialty involved in drug treatment, with their share up 67% in 2025, followed by psychiatric nurses at 47% and emergency medicine at 44%. That expansion matters in rural counties hit hardest by fentanyl and other street opioids, where physician shortages have limited access to meds. 

Rising diagnosis rates also reflect more folks developing opioid addiction and being identified and connected to care, and the claims data alone cannot separate the two effects.

Harm Reduction & Treatment

Medication-assisted treatment remains the standard for opioid addiction. Tracker data shows it reaches more patients through a broader mix of providers. 

Carrying naloxone remains essential for anyone using street opioids, since fentanyl and its replacements continue to drive unpredictable potency. 

Peer support through Narcotics Anonymous meetings is free, anonymous and available in most communities.

NA Still a Top Tier Option

Opioid addiction responds to treatment, and the growing workforce numbers suggest care is becoming easier to reach. Feel free to browse our directory to find meetings filtered by location and format. 

Call 800-934-1582(Sponsored) to speak with an expert and to explore local options.

Hamilton County in Tennessee hit 89 overdose-related opioid deaths up to September 2026. That compares with 141 deaths reported for 2025. Fentanyl was involved in six out of 10 deaths in the county’s midyear report.

To be clear, Tennessee and its sister states have resources to combat narcotics, including local Narcotics Anonymous chapters in most neighborhoods. Nevertheless, too many people still die. 

The Tennessee Council for Recovery and the American Addiction Recovery Association responded to the numbers with outreach teams. Volunteers distributed naloxone, clothing and essential supplies and spoke with community members about recovery.

Meet People Where They Are

Outreach volunteers included folks with addiction and recovery experience. Participants also worked to reduce stigma by treating addiction as a medical condition rather than a moral failure. Maurice Draine, a territory manager involved in the effort, relayed, “I’m just here to get you the help you need, want, and deserve.”

Naloxone Access Matters

Naloxone can reverse an opioid overdose if administered quickly. Distributing it through street outreach makes the medication available to folks who don’t feel comfortable entering a clinic or treatment office.

Fentanyl is a synthetic opioid that’s deadlier than many other opioids. Its ubiquitousness shows why public health agencies emphasize education and naloxone access. 

People may not be ready or able to visit a clinic, treatment office or recovery meeting. Street outreach lowers that barrier by bringing supplies and peer support. Volunteers with recovery experience speak without judgment. The Chattanooga effort combined naloxone with basic essentials and tickets intended to connect people with recovery resources.

Naloxone meets the immediate risk of overdose, while conversation and peer support encourage an overdose survivor to find care. Otherwise, they may face the same risk again after leaving the emergency department.

Turn Naloxone Access Into Lasting Recovery

Sustained recovery often requires ongoing support. Treatment may also include medication for opioid use disorder or rehab counseling. 

Narcotics Anonymous meetings provide free, peer-led meetings where people can build connection, accountability, and experience with staying drug-free. People looking for local help can search NA meetings via our browsable directory for groups anywhere in the country and compare opioid addiction treatment programs that offer evidence-based care.

Feel free to also dial 800-934-1582(Sponsored) to chat with an expert regarding medication and continuing care after detox or residential treatment.

The first national study of nitazene detections in the United States emphasized the dangers about synthetic drugs circling the streets. Forensic lab reports of this new class of synthetic opioids surged from 43 in 2019 to 1,905 in 2024. 

Families facing opioid addiction risk or attending Narcotics Anonymous meetings to sustain recovery know that the illegal street trade in drugs can shift at any time. Any movement can lead to relapse or an overdose in their community.

Researchers analyzed the DEA’s National Forensic Laboratory Information System, which covers 284 labs in all 50 states and DC, and the Center for Forensic Science Research and Education’s NPS Discovery program that tests biospecimens from crime labs and medical examiners. 

The Opioid Crisis Shifts

Let’s start with the growth curve. Between 2019 and 2024, 7,117 nitazene analog reports were submitted to NFLIS from just 43 in 2019 to 1,905 in 2024. From 2019 and 2021, counts multiplied sevenfold. After that, the curve flattened, indicating that the drugs found a steady spot in the supply.

Data from NPS Discovery showed 361 nitazene-positive biospecimens, up from 11 in 2019 to 113 in 2024, increasing roughly 45% per year. Ohio and Tennessee were the first to identify nitazene fatalities. Despite the increases, nitazene still remains unscheduled because the benzimidazole ring appears in common medicines from antiparasitics to blood pressure drugs.

Defining Nitazenes

Nitazene are also called 2-benzylbenzimidazoles or simply nitazenes, are synthetics derived from etonitazene. Pharmaceutical companies first synthesized them in the 1950s while searching for alternatives to morphine, but they were never approved for clinical use because of their deadliness and poor safety profiles. Isotonitazene shows in vitro potency up to 500x that of morphine.

Today these compounds are produced in industrial laboratories overseas, sold online, then pressed into counterfeit tablets or adulterated into heroin and fentanyl powders. It’s all illegal, and the problem is made worse because fentanyl test strips can’t detect them in the first place.

Polysubstance Patterns Raise the Stakes

Nearly all nitazene biospecimens contained at least one co-detected substance and fentanyl topped the list at 54.6%. The CDC tracks nitazenes because these mixtures are complicated and unpredictable.

The researchers connect the emergence of nitazenes to the DEA’s 2018 class-wide scheduling of fentanyl-related substances. The pattern since then has seen like whack-a-mole: schedule one analog and the supply rotates to another. The authors call for stronger drug testing capacity, expanded surveillance and targeted public health interventions rather than scheduling alone.

Harm Reduction & Treatment

Despite nitazene’s deadliness, victims aren’t totally helpless. Naloxone reverses nitazene overdoses, but multiple doses are needed with multiple drugs. Assume any powder or pill contains synthetic opioids. Keep naloxone within reach and tell folks where it’s stored..

Medication remains effective for long-term recovery. Methadone and buprenorphine reduce cravings and mortality risks. 

Peer support through NA meetings adds the ongoing structure that helps people stay in treatment while the supply keeps shifting.

Narcotics Anonymous Still a Top Choice

Getting started is made easier by browsing our online directory. Search by location and find formats that fit your circumstances.

An expert can guide you through local options once you dial 800-934-1582(Sponsored) .

A veterinary sedative 200x deadlier than xylazine now complicates opioid addiction treatment in Philadelphia. Withdrawal is severe enough to require intensive care. A study shows that medetomidine, now seeping in fentanyl street drugs throughout Pennsylvania, pushed the number of patients needing ICU-level withdrawal care from 6% to 32% in three years.

Researchers at the University of Pennsylvania examined data from two Philadelphia hospitals from early 2020 through September 2025. Medetomidine’s emergence in fentanyl was traced to mid-2024, so the team split the data around that point. 

Despite the wide array of treatment programs in The Keystone State, including local Narcotics Anonymous chapters, overdose numbers have started climbing again.

The Opioid Crisis in Philly

Right before medetomidine hit the scene, dexmedetomidine, the infusion medication used to treat withdrawal, was administered to just under 6% of patients with opioid use disorder. After medetomidine entered the supply, that figure jumped to 20%. In the summer of 2025, it climbed to 32%.

Patients suspected of medetomidine withdrawal also needed meds at higher doses. Almost 79% received methadone compared with half of patients who didn’t require dexmedetomidine. Buprenorphine was given to 36% of the withdrawal group. Patients receiving dexmedetomidine also spent more time recovering in the ICU.

“Clinically, we recognize that we are in a new era of withdrawal management,” one researcher noted.

Medetomidine Withdrawal Hits So Hard

Medetomidine is a sedative-anesthetic used in veterinary medicine for large animals. On the street, it intensifies fentanyl’s effects. The danger comes during withdrawal. Symptoms arrive quickly and include tachycardia, extreme anxiety and vomiting. Reports link severe untreated cases to organ damage.

Harm Reduction in Philly

Naloxone remains the first response to any opioid exposure. This includes medetomidine mixed into fentanyl. Fentanyl test strips don’t detect medetomidine, so be wary.

Folks can take heart that medication assisted treatment works. Methadone and buprenorphine reduce cravings and overdose risks. 

Peer support via NA meetings in Philadelphia adds the camaraderie and fellowship for good times and bad.

NA Still a Vital Resource

NA is a starting point for anyone entering or sustaining recovery. It’s free and chapters dot the landscape. Simply browse our directory to find groups in any location in the USA.

You might also consider calling 800-934-1582(Sponsored) to find opioid treatment programs alongside an expert.

A report draws attention to dependence and withdrawal with kratom-based tonics sold in gas stations and other retail locations. Kratom packs are often marketed as plant-based options for energy and relaxation but some folks have found out that quitting is unexpectedly difficult.

Kratom Sold at Gas Stations

These products contain kratom. It’s a botanical leaf with chemicals that trigger opioid receptors. Kratom products vary widely in concentration and frequent use may lead to dependence and end in overdose. Some users might start with occasional consumption and later find that they need more to achieve the same effect or simply to avoid feeling unwell.

Kratom Dependence & Withdrawal Symptoms

Possible withdrawal symptoms include irritability, insomnia, muscle aches, sweating, nausea and cravings. 

That kratom has spread to retail stores can create the impression that it has a low risk. Legal status and marketing language don’t guarantee safety or predict how a person’s body will respond. In other words, concentrated products may contain substantially more active chemicals than traditional kratom leaves.

The concerns don’t mean teens and adults who tried kratom products will develop dependence. They show why transparent labeling, realistic marketing and clearer public education are needed. You should understand what they’re consuming, how often use may become difficult to stop and when medical support is appropriate.

Some people use kratom to manage pain, improve energy or reduce other drug use. Those circumstances require a careful clinical assessment rather than judgment. 

NA Battles Kratom

Anyone who finds it hard to cut back or feels physically unwell after stopping should consider speaking with a healthcare professional. Peer groups like Narcotics Anonymous remain on the front line of fighting opioids and kratom on the community level. These chapters offer free peer support without judgment. 

Getting started is made simpler with our browsable directory. Simply search by location and filter by format.

Dial 800-934-1582(Sponsored) to speak with an expert about educational information about kratom, opioid-like substances, dependence and treatment options for people concerned about their substance use.

A new analysis of teen overdose deaths that these fatalities often had multiple substances in their systems. Specifically, there’s a growing presence of cannabis and fentanyl in adolescent overdose toxicology reports.

First, let’s be clear about marijuana. Cannabis isn’t an opioid and doesn’t produce the same fatal results as fentanyl. The presence of cannabis doesn’t mean that it caused death or that it has the same risk as synthetic drugs.

Adding Fentanyl

Fentanyl’s potency makes any street drug dangerous. Fentanyl turns up in counterfeit pills or is blended with other substances without anyone’s knowledge. 

Adolescents with limited experience with fentanyl don’t know that a single exposure can lead to overdose and death.

Response is Pivotal

Prevention messages are a good starting point for those at risk. But be specific. SImply saying that cannabis and fentanyl have identical risks when they don’t undermines trust. At the same time, downplaying co-use or assuming a familiar product is safe can leave adolescents unprepared for a changing drug supply.

Rather, parents, schools and healthcare professionals can help by discussing narcotics openly, storing medications securely and making naloxone available where opioid exposure is possible. If an adolescent is unresponsive, breathing slowly or showing other signs of an overdose, naloxone should be given and contact emergency services immediately.

NA Can Help

Narcotics Anonymous and other peer groups remain a top option for anyone of any age dealing with drug issues. In fact, teens often open up with others in their age group who understand their background and experiences. They can point to educational information about fentanyl, other narcotics, dependence and treatment options.

Getting started is made simpler with our online directory. We list chapters from all over the USA, filtered by format and location.

Feel free to also speak with an expert by calling 800-934-1582(Sponsored) and exploring local options.

The nation’s drug supply is getting more dangerous than ever. Despite prior warnings, The White House Office of National Drug Control Policy issued a formal drug threat notice warning that fentanyl analogues. These include carfentanil, fluorofentanyl and methylfentanyl. All are spreading fast and deepening the opioid epidemic.

The notice is the first of its kind aimed at this group of synthetic opioids. Even though all 50 states and Washington D.C. have programs to battle opioids, including local Narcotics Anonymous grassroots efforts, the numbers refuse to drop to zero.

The Opioid Crisis Takes a Turn

According to figures cited in the notice, the three analogues have popped up in various states and killed at least 12,500 deaths since 2023. The compounds have appeared often mixed into supplies sold as heroin or prescription pills and frequently combined with other drugs such as xylazine.

Overdose deaths nationally have been declining over the past year, but this trend makes the spread of stronger analogues even more dire. Public health officials treat these compounds as a threat capable of reversing gains anywhere.

Fentanyl & Analogues Raise the Stakes

Fentanyl is a synthetic opioid roughly 50x more lethal than heroin. Carfentanil, originally developed as a large-animal tranquilizer, can be up to 100x deadlier than fentanyl and overcome a naloxone dose. Even a dot of these synthetics small enough to fit on the tip of a pencil can be lethal, and users have no reliable way to know which batch contains these compounds.

Harm Reduction & Treatment

Despite the concern, harm reduction has proven to work. Naloxone, the opioid overdose reversal medication sold as Narcan, is now available without a prescription, and fentanyl test strips can detect the presence of synthetic opioids in a supply. Naloxone remains effective against fentanyl analogues, though very potent supplies can require multiple doses.

Medication for opioid use disorder works best for cutting down on cravings and withdrawal. These prescriptions assist even after years of heavy use. 

Peer support through Narcotics Anonymous meetings adds community and accountability that medication alone does not provide.

NA Still a Strong Option

NA remains a top tier option for many folks. Camaraderie and fellowship build a network that carries all members through good times and bad. They understand your background and don’t judge.

Getting started is made simpler with our browsable directory. Simply look up chapters anywhere in the country.

Calling 800-934-1582(Sponsored) is another option if you’d like to speak with an expert. They can guide you through opioid addiction treatment options.

Women who give birth in rural communities are significantly likelier to leave their hospitals with opioid prescriptions after a cesarean section than their urban peers, according to one study of 540,000+ C-sections. People tracking where opioid addiction risk takes root can see that a new mother’s discharge day is often a turning point for the mother’s life.

The analysis comes from researchers at Truveta, a health data and analytics company. The team compared pain-management prescriptions tied to C-sections performed between January 2018 and July 2026. The gap between rural and urban discharge prescribing held steady.

The Opioid Crisis Hits Women Hard

C-sections are common. They account for about 1 in 3 births nationally and recovery typically involves several types of pain medication used together. Truveta evaluated three groups: acetaminophen (Tylenol), non-steroidal anti-inflammatory drugs such as ibuprofen and opioids including oxycodone and fentanyl.

In-hospital pain medication use was consistent. The differences appeared after discharge. For every 100 women who had a C-section, 10 more women in rural communities received an opioid prescription than those in cities. Rural women also had higher rates for prescribed acetaminophen and NSAIDs.

The stakes extend beyond postsurgical recovery. Substance use disorders and mental health conditions are leading underlying causes of maternal death. They contribute to more than 1 in 5 pregnancy-related deaths.

Explaining the Gap

The analysis doesn’t answer why rural women leave with more opioid prescriptions, even if they don’t use them. Madhura Vachon is the analysis’s lead researcher and a former CDC epidemiologist and explains:

Possible explanations aren’t hard to imagine. Fewer follow-up care options in rural areas, longer distances back to a hospital if pain flares or different prescribing norms. The data doesn’t indicate if any of these are responsible.

Race and Substance Use History

The researchers also examined prescribing by race, ethnicity and documented history of substance use disorder. Unadjusted findings showed somewhat higher opioid prescribing after discharge among Black women and among women with a documented history of substance use disorder. 

The team didn’t see if those differences had statistical significance or adjust the findings for other factors.

Postsurgical Prescribing Matters

Opioids like oxycodone are effective pain relievers for managing pain after major surgery and caring for a newborn. But every prescription carries some risk. A person with no history of substance use can develop physical dependence on opioids within days and leftover pills can lead to abuse for anyone who has access to them.

Some hospital systems want to curb opioid prescriptions via new non-opioid procedures or cutting back where evidence shows smaller supplies work just as well. This analysis suggests discharge practices still vary widely and mothers are often caught in the middle.

Harm Reduction & Treatment

Those who are prescribed opioids after surgery can form a few habits to reduce risk. Take the med only as directed and ask if non-opioid options can work. Store pills locked and out of sight and dispose of leftovers through a drug take-back program or pharmacy drop box. 

Naloxone can reverse overdoses. Even though it’s not as plentiful in rural areas, keep it in the house whenever opioids are present, and it is available without a personal prescription in most states.

Medications such as buprenorphine treat opioid use disorder during pregnancy and reduce risk for both mother and baby, and treatment improves outcomes. 

Narcotics Anonymous meetings offer peer support that works alongside medical care. 

NA Still a Top Tier Choice

NA might seem like a small step to take, but it actually opens doors to camaraderie and fellowship that lasts a lifetime. Your peers are there for you and understand your background without judgment. For good days and bad, NA has your back.

Getting started is easy. Look through our directory for chapters in any neighborhood, including those just for women and new moms just starting out. You can also call 800-934-1582(Sponsored) and connect with an expert for local assistance.