Published: 07/30/2026 | Author: Quentin Blount

A synthetic opioid additive that can be considerably more potent than fentanyl has turned up in the illicit drug supply in Maryland and other states. It belongs to a class first identified internationally in 2019. 

Marylanders have good reason for concern. Even though The Free State boasts a wealth of treatment programs and grassroots organizations like Narcotics Anonymous to assist residents with drug misuse, this emergence marks a new chapter in the opioid crisis. Anyone using opioids, or supporting someone who does, knows that stronger potency turns a familiar amount into an overdose.

Orphines in Maryland 

Maryland officials have expressed alarm at the report, and testing programs offer the clearest details thus far. The Maryland Department of Health runs Rapid Analysis of Drugs, which tests illicit supply samples to identify what is circulating. It has detected one compound from the new class, N-Propionitrile Chlorphine, in Baltimore City and Calvert County.

Chlorphines belong to a group called orphines, a class of synthetic opioids that the United Nations Office on Drugs and Crime says first appeared back in 2019. Several compounds fall under that heading, and Maryland has identified only this one so far.

Maggie Ryback, the state’s coordinator for the testing program, reported that chlorphine is up to”10 times more potent than fentanyl,” depending on how it is produced. She noted that the potency raises overdose risk and that the presence of these compounds is highly regional.

Eight documented samples is a small number. So far, the picture shows an emerging threat rather than an evenly distributed national crisis.

Chlorphines Compare to Fentanyl

For scale, The Drug Enforcement Administration describes fentanyl as roughly 50x more potent than heroin, and fentanyl drives the majority of overdose deaths in Maryland. A compound reaching several times fentanyl’s potency narrows the margin between a typical dose and a fatal one.

For clarification, potency describes how little of a substance produces an effect. When a potent compound is mixed unevenly into a batch, two portions of the same supply can differ enormously, which is why unpredictability drives overdose risk.

Adulterants Already in Baltimore’s Drug Supply

Ryback relayed that Marylanders have seen an influx of adulterants as regulators control existing compounds as new chemicals become available and supply chains shift. Baltimore has already dealt with several:

• Xylazine, a veterinary tranquilizer associated with severe skin wounds

• Medetomidine, another tranquilizer that produces extreme withdrawal symptoms

• Benzodiazepines, which were mixed into the supply during three mass overdose events in the city last year

Each complicates overdose response differently, because none respond to naloxone.

Opioids and Overdose Risk

Let’s take a step back and look at the bigger picture. Opioids act on receptors in the brain and brainstem that regulate pain and breathing. Overdose kills by suppressing respiration. Signs include very slow or stopped breathing, blue or gray lips and fingertips, pinpoint pupils, limp body and unresponsiveness to shouting or a sternal rub.

Naloxone, sold as Narcan and available over the counter, reverses opioid overdose by displacing opioids from those receptors. It works within minutes and carries no risk if opioids are not involved.

An important caveat applies. Kathrina Hlela, a scientific affairs associate at the United Nations, argued this emerging threat calls for expanding access to prevention and intervention including naloxone. But she noted more research is needed on how naloxone performs against orphines specifically. Indeed, some tests have shown that orphines might overwhelm a naloxone dose.

Until that research exists, the guidance is unchanged: use naloxone, use more than one dose if breathing does not return, and call 911.

Harm Reduction & Treatment Work

Harm reduction is evidence-based public health that often makes available naloxone through local health departments and community distribution programs. Fentanyl test strips don’t detect every novel compound, a limitation worth knowing.

For opioid use disorder, medication remains the best-supported treatment. Buprenorphine and methadone reduce cravings and withdrawal and substantially lower overdose death risk. Naltrexone is an option after a period without opioids. These work alongside counseling and peer support.

Peer support helps many people sustain recovery. Narcotics Anonymous meetings are free, widely available, and require no insurance or referral. Some people use NA alone, some combine it with prescriptions, and others choose other paths, including SMART Recovery.

NA a Good Starting Point

NA meetings have proven an effective first step towards a long-term recovery. Fellowship often lasts a lifetime, and your colleagues are often neighbors and folks you see in your community every day..

Getting started is easy. Simply dial 800-934-1582(Sponsored) to speak with an expert. Also, feel free to browse our directory for NA chapters anywhere in the country.