Public Health Alert: Cychlorphine, a Highly Potent Emerging Synthetic Opioid

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Public health and safety partners nationwide are warning about cychlorphine, an emerging synthetic opioid identified in the illicit drug supply across the United States. Cychlorphine belongs to a class of novel synthetic opioids known as “orphines.” It has been found on its own and in combination with fentanyl and other substances, including methamphetamine, cocaine, and counterfeit pills made to resemble prescription medications.

The Office of National Drug Control Policy (ONDCP) at the White House reported 106 drug-supply reports across 10 states in 2025, with detections in all four U.S. Census regions. Cychlorphine has been linked to at least 55 deaths nationally from 2025 to 2026, with the highest prevalence in Ohio, Texas, and Tennessee. These data are evolving as surveillance and toxicology testing expand.

Why Cychlorphine is Concerning

Cychlorphine may be up to 10 times more potent than fentanyl, and overdoses may require multiple doses of naloxone. Importantly, cychlorphine is not detected by common drug test strips, including fentanyl test strips, or routine hospital opioid urine screens, meaning comprehensive toxicology testing may be needed to confirm exposure.

Because routine testing may not identify cychlorphine, a negative test does not rule out opioid exposure. Clinicians, first responders, and community members should respond to the person’s symptoms rather than relying on a test result.

Recognize the Signs

Like other opioids, cychlorphine can cause profound sedation and respiratory depression—the slowing or stopping of breathing that can be fatal without a rapid response. Its presence in an unpredictable, unregulated drug supply means people may not know they have been exposed.

Possible signs include:

Slow, shallow, irregular, or stopped breathing
Unresponsiveness or inability to wake the person
Blue, gray, or purple lips and fingernails
Pinpoint pupils, limp body, choking, or gurgling sounds

What to do in a suspected overdose

Call 911 immediately
Give naloxone. Naloxone is effective in reversing opioid overdose involving cychlorphine
Provide first aid interventions if trained to do so, such as rescue breathing, while waiting for naloxone to take effect
Stay with the person until emergency help arrives

Naloxone should be administered whenever an opioid overdose is suspected. It will not harm someone if opioids are not involved. Because cychlorphine is highly potent, more than one dose of naloxone may be needed.

More Information and Resources

False and alarming claims about cychlorphine are circulating online, and people should rely on information from public health agencies and credible medical and toxicology organizations.