Synthetic Drug Users Don’t Always Respond to Narcan
By Rick McCann
Blue RAM Media/Gulf Coast News
March 11, 2026
MOBILE, Ala.
In recent months law enforcement in several states including Tennessee have identified a newly emerging synthetic opioid being detected in fatal overdose investigations that does not always respond to Naloxone.
Narcan has long been used by police, firefighters and EMS to treat victims of an overdose on scene and reverse a drug overdose, but now it synthetic drugs may not fully respond to naloxone, prompting forensic officials to advise law enforcement to follow standard fentanyl safety protocols while toxicology data continues to develop.
The drug, N-Propionitrile Chlorphine, also known as cychlorphine, has been identified in 19 overdose death investigations in East Tennessee, with 12 confirmed and seven pending laboratory confirmation, according to the Knox County Regional Forensic Center. Forensic officials say laboratory data indicate the compound may be approximately 10 times more potent than fentanyl.
Synthetic opioids are powerful pain-relieving substances designed in laboratories to mimic the effects of natural opioids (such as morphine) by acting on the same brain receptors. While some are approved for medical use, such as fentanyl and methadone, many are produced illicitly and are often highly potent, causing a significant rise in fatal overdoses globally.
Chris Thomas, chief administrative officer and director of the forensic center in Tennessee, said officers and first responders should treat suspected exposures the same way they would fentanyl.
“There is currently insufficient data to determine whether this compound presents additional dermal exposure risk,” Thomas said. “Follow fentanyl protocols.”
In most confirmed cases, cychlorphine was detected alongside fentanyl and methamphetamine. In one confirmed case, however, it was the only drug identified. That case involved a measured concentration of approximately 0.5 nanograms in femoral blood, which Thomas described as extremely low.
Unlike fentanyl, cychlorphine does not appear on routine toxicology panels. Detection requires expanded laboratory analysis and, in some cases, referral to research laboratories for confirmation. The forensic center submits femoral blood samples to NMS Labs for toxicology testing. If the compound is detected, samples are forwarded to a research laboratory for confirmation.
Illicitly manufactured fentanyl and other synthetics are the primary drivers of the overdose crisis in the United States, with synthetic opioids (excluding methadone) involved in over 70,000 deaths in 2023.
Synthetic drugs have become rapidly the culprit in many overdoes because it’s cheaper to manufacture and is often done in temporary labs and has even been found being made in a dirty bathroom.
Officials caution that the number of confirmed cases may reflect testing capability rather than geographic prevalence. Jurisdictions without expanded analytical panels may not detect the compound even if present.
Thomas said naloxone, commonly known as Narcan, may not be fully effective in reversing overdoses involving cychlorphine but should still be administered. Responders cannot immediately determine which opioid is present at a scene, he said.
“Always try,” Thomas said, referring to naloxone administration.
Cychlorphine belongs to a subclass of synthetic opioids known as orphine analogues. National forensic researchers first identified the compound in 2024, and a January 2026 public alert from the Center for Forensic Science Research and Education reported an increase in fatal overdoses in which the drug was detected.
At this stage, forensic officials are not recommending new field procedures beyond established fentanyl safety measures. Existing opioid response protocols remain appropriate while additional data continues to emerge.
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