The drug has been found on its own and mixed with fentanyl, methamphetamine, cocaine and sedatives, according to Discover. It also shows up in counterfeit pills made to look like legitimate prescription medicine.

A detection problem

One feature makes cychlorphine especially dangerous: standard tests cannot find it.

"Cychlorphine is not detected by drug test strips or in routine hospital opioid urine screens," ONDCP warned.

That matters for two reasons. People who use drugs cannot check their supply with the fentanyl test strips many harm-reduction programs distribute. And hospital toxicology screens will miss the drug, so deaths are likely being undercounted, according to an editorial published recently in the Journal of Pain Research.

The authors — led by Robert Raffa, professor emeritus at Temple University's School of Pharmacy in Philadelphia — confirmed that the drug takes specialized lab testing to detect.

Does naloxone work?

ONDCP urges anyone who might respond to an overdose to be ready with extra doses of naloxone (Narcan), a medicine that reverses opioid overdoses by blocking opioid receptors in the brain.

Some warnings have suggested naloxone may not work against cychlorphine. But the editorial's authors said no published clinical evidence backs that up.

They expect naloxone to work as it does for other opioids, though cychlorphine's strength means multiple doses may be needed. When an overdose doesn't respond to the medication, they said, other drugs are the more likely culprit. Naloxone cannot reverse sedatives called benzodiazepines, which often turn up alongside cychlorphine in the drug supply.

Teens and fake pills

Teens may face particular risks from counterfeit pills purchased online or offered by a peer. While awareness of fake pills has grown, many teenagers remain too trusting about accepting pills from people they know. Only 1 in 3 consider a pill from someone close to them to be dangerous, compared with nearly 9 in 10 for a pill from a stranger, Discover reported.

Anyone who may be overdosing needs emergency care. ONDCP advises calling 911 right away, even after naloxone has been given, because the overdose can return as the medication wears off.

The picture is still preliminary. Cychlorphine surveillance is new, testing gaps make the death count uncertain, and researchers are only beginning to characterize the drug's effects. Still, the trend line from one sample in 2024 to 106 in 2025 suggests a rapidly emerging threat — one that ONDCP expects could keep spreading.