LA County Confirms First Cychlorphine Death as Fentanyl-Evading Opioid Spreads Across US

Since the White House Office of National Drug Control Policy (ONDCP) issued its April 30 threat notice on cychlorphine, the synthetic opioid has been tied to deaths in more states, on college campuses, and now in Los Angeles County.

The LA County Department of Public Health issued an urgent warning after the county Medical Examiner identified the drug as a cause of death in a February 2026 case. County officials called it the first confirmed presence of cychlorphine, chemically N-propionitrile chlorphine, in the county's illicit drug supply.

Another cychlorphine death was recorded in Northern California in April. That was a 16-year-old in San Francisco, Dante Lacourte, whose autopsy showed the drug. His mother told The New York Times she had always feared fentanyl, not this. The California Department of Public Health says it knows of three cychlorphine deaths statewide: one in 2025 and two in 2026.

What the drug is and why it slips through

Cychlorphine is not a fentanyl analog. It belongs to a newer family of synthetic opioids called orphines. Like other opioids, it slows breathing until it stops.

ONDCP says it may be up to 10 times stronger than fentanyl. LA County officials say it is substantially more potent but have not offered a precise comparison.

The detection problem is the core danger. ONDCP said the drug is "not detected by drug test strips or in routine hospital opioid urine screens." Users can take it without knowing, because it has been found alone and mixed with fentanyl, methamphetamine, cocaine and sedatives. It shows up in powders, liquids, crystals and counterfeit prescription pills.

Anita Gupta, an anesthesiology and pain medicine specialist at Johns Hopkins, told Healio the gap creates "a dangerous diagnostic blind spot in emergency care."

The numbers so far

ONDCP's April 30 notice counted 106 cychlorphine reports across 10 states in 2025, up from one in 2024. It linked at least 55 deaths to the drug in 2025 and 2026, with Tennessee accounting for 41 of them between July 2025 and February 2026. Ohio, Texas and Tennessee were the most affected.

The geographic count has grown. LA County says the drug has been detected in 19 states. Data in the Journal of Pain Research, published in July, show at least 24 states reporting related overdoses or deaths as of March.

A separate tally of global surveillance data puts the total higher: nearly 200 seizures in 10 countries and at least 78 deaths. The authors of the Journal of Pain Research editorial, led by Temple University pharmacologist Robert Raffa, say deaths are likely undercounted because confirming the drug takes specialized lab testing.

In Columbus, Ohio, five people died and one was critically ill in a single day. DEA Special Agent Brian Mulcahy told 10TV that cychlorphine can be "10 times more potent than fentanyl" and said it is coming into the U.S. from China. Mulcahy also said roughly 100,000 Americans a year are dying from synthetic opioids.

The supply chain has a history. International controls on brorphines took effect in 2022. China banned the nitazene class in 2025. Each crackdown opened room for a replacement compound, and cychlorphine filled it.

Law enforcement and naloxone

The DEA classified cychlorphine as a Schedule I controlled substance in August 2026, making it illegal to possess or sell. The FDA has never approved it for any use.

On naloxone, the advice is to keep it close and use more of it. LA County says nasal spray and injection both work, though multiple doses may be needed. A doctor who spoke to CBS, Dr. Janette Nesheiwat, said an overdose requires multiple doses of Narcan.

Some warnings have claimed naloxone may not work on cychlorphine at all. Raffa's editorial authors say no published clinical evidence supports that. They expect it to work as it does on other opioids. When an overdose doesn't respond, they say, the likelier culprit is a benzodiazepine, a sedative naloxone can't reverse that often turns up alongside the drug.

Campuses and teens

The drug is reaching younger users. An advisory was issued ahead of the University of Tennessee's football game in Knoxville, and KLTV reported it turning up on campuses in counterfeit pills.

Published survey figures cited by Discover show only 1 in 3 teens consider a pill from someone close to them dangerous, versus nearly 9 in 10 for a pill from a stranger.

What LA officials are telling residents

County health officials urged residents to avoid illicit drugs, never use alone, not mix drugs, and carry naloxone. Witnesses to a suspected overdose should call 911 and give naloxone right away.

Naloxone is available at community health stations, county public health centers, retail pharmacies and through medical providers. Residents can also have drug samples tested specifically for cychlorphine at no cost through Drug Checking LA.

LA County said cychlorphine has been more common elsewhere in the country, and officials say they are monitoring for changes in its local presence. With standard screens blind to it, the county's one confirmed death may not reflect how much is already circulating.