Public safety and health officials are warning about an increasingly dangerous illicit drug supply as fentanyl continues to be mixed with emerging synthetic substances that significantly increase overdose risks.
Officials said illicit fentanyl is now commonly combined with drugs including xylazine, nitazenes, cychlorphine and medetomidine, many of which are not approved for human use and may be unknown to users.
According to authorities, xylazine and medetomidine are veterinary sedatives, while nitazenes and cychlorphine are powerful synthetic opioids.
Officials said new nitazene compounds frequently emerge as enforcement actions and drug scheduling efforts target existing substances. The Drug Enforcement Administration has identified 22 unique nitazene compounds since 2020, with 21 classified as Schedule I controlled substances.
Authorities warned that these substances can be significantly more potent than fentanyl and may dramatically increase the risk of fatal overdose.
Officials also said many of the drugs are being mixed into counterfeit pills or fentanyl powder without users’ knowledge.
Public health officials cautioned that naloxone, commonly used to reverse opioid overdoses, may not fully reverse the effects of substances such as xylazine and medetomidine because they are not opioids. Other synthetic drugs, including nitazenes and cychlorphine, may require multiple naloxone doses during overdose response efforts.
Authorities said xylazine has also been linked to severe soft tissue damage, infections and prolonged sedation.
Officials urged the public never to take pills that were not prescribed by a doctor and dispensed through a licensed pharmacy and to assume illicit drugs may contain fentanyl or other dangerous additives.
They also encouraged residents to carry naloxone, learn how to administer it and immediately call 911 during suspected overdoses.
“Today’s illicit drug supply is more dangerous, more deceptive, and more deadly than ever before,” officials warned. “One pill, one try can kill.”
Additional information is available at DEA.gov/fentanyl and DEA.gov/onepill.
