ToxIC report describes cychlorphine, a new non-fentanyl synthetic opioid

A ToxIC NOSE report from the American College of Medical Toxicology describes cychlorphine, a non-fentanyl synthetic opioid of the orphine class that emerged in the US in late 2025 and has been detected in the illicit drug supply in at least 10 states, most prevalently Ohio, Texas, and Tennessee. The report states cychlorphine is thought to be as potent or more potent than fentanyl, often co-occurs with other opioids, stimulants, or novel benzodiazepines, and carries a significant risk of fatal respiratory depression in overdose. The report also notes that standard hospital urine opiate and fentanyl screens, as well as fentanyl or nitazene test strips, will not detect cychlorphine, based on a case identified through the ToxIC Fentalog Study.

Most relevant for: Emergency department clinicians evaluating patients with suspected opioid overdose, particularly in regions with reported illicit drug supply contamination.

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