A powerful new synthetic opioid has been detected in Missouri and a growing number of states, bringing with it a particularly troubling danger: fentanyl test strips cannot detect it.
Cychlorphine, also known as N-propionitrile chlorphine, is part of a newer class of synthetic opioids called “orphines.” It acts on the same opioid receptors as fentanyl and can dangerously slow or stop breathing.
DEA data published in August show 225 cychlorphine encounters in 19 states since 2022, including Missouri. Kansas was not among the states listed. Separate testing data released Sept. 21 by Aegis Sciences also showed detections in Missouri and 17 other states, but none in Kansas.
Laboratory research suggests cychlorphine may be approximately 10 times more potent than fentanyl, although researchers caution that laboratory potency does not translate directly into an exact human dose comparison.
A Negative Fentanyl Test Doesn’t Mean the Drug Is Safe
Perhaps most concerning, the United Nations Office on Drugs and Crime says cychlorphine and other orphines are not detected by fentanyl test strips. Routine opioid drug screens may miss them as well.
That means a counterfeit pill or powder could test negative for fentanyl and still contain cychlorphine.
A strip could still test positive if fentanyl is mixed into the drug, but it would be detecting the fentanyl — not the cychlorphine also present.
Naloxone Can Still Save a Life
The good news is that because cychlorphine is an opioid, naloxone — commonly sold as Narcan — can reverse its effects. However, DEA warns that cychlorphine and some other powerful synthetic opioids may require multiple doses.
For people who carry naloxone, that makes carrying at least two doses instead of just one a sensible precaution.
If you suspect an opioid overdose:
- Give one dose of naloxone immediately and call 911. For nasal spray, place the nozzle in one nostril and press the plunger completely.
- Wait two to three minutes. If the person does not begin breathing normally or respond, give a second dose, preferably in the other nostril. Additional doses may be needed until help arrives.
- Try to keep the person breathing. Give rescue breaths or CPR if you are trained. If they are breathing but unconscious, turn them onto their side to help prevent choking.
- Stay with them until emergency personnel arrive. Even if they wake up, the effects of naloxone can wear off while the opioid remains in the body, allowing breathing problems to return.
The emergence of cychlorphine adds another complication to an already unpredictable illicit drug supply: a negative fentanyl test no longer means a substance is free of a potentially deadly synthetic opioid.