In the US, fentanyl is mixed with synthetic sedatives — BBC News

Drug mixtures containing fentanyl, synthetic sedatives and other adulterants are spreading in the United States, complicating assistance in overdose cases. As BBC News reports, specialists in Ohio and Illinois are detecting xylazine and medetomidine — synthetic veterinary tranquilizers — in drugs.

Fentanyl is a fully synthetic opioid that is 50–100 times more potent than heroin. Naloxone is used to reverse the effects of opioid overdoses, but it does not work on xylazine or medetomidine. These substances slow breathing, and xylazine has also been linked to severe necrotic skin lesions.

Adulterants and overdoses

According to the report, at the peak in 2022, around 110,000 people in the United States died from overdoses, mainly because of opioids. In 2025, this figure fell to approximately 70,000, but the overdose problem persists.

Scott Sanders, head of the Hope Dealers support group, said that over the past 12 months in Franklin County, where Columbus is located, 78% of fatal overdoses were associated with stimulants. According to him, people buying crack cocaine may not know that the substance has been mixed with fentanyl or other opioids.

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Hope Dealers works with the US Centers for Disease Control and Prevention in a sample-testing program. Participants bring in needles or smoking pipes for analysis, and the samples are sent to a CDC laboratory in North Carolina. One of the kits provided by Mike tested positive for medetomidine.

Synthetic substances in a Chicago jail

At the Cook County jail in Chicago, eight inmates died as a result of seizures in 2023. The facility would normally record one or two overdose deaths per year. Sheriff Tom Dart said that burnt paper was found near people who died or were successfully resuscitated.

According to him, drugs, including K2 synthetic cannabinoids, were sent to the jail in letters and on book pages. Inmates set the soaked paper on fire and inhaled the smoke. Now all correspondence is checked for moisture; from one-fifth to one-quarter of letters and parcels fail this check and are rejected.

In Chicago, the Liv4Lali group distributes test strips to detect fentanyl, medetomidine, xylazine and other adulterants. Sheriff Dart believes that addressing the crisis cannot be limited to supply control and requires large-scale addiction treatment programs.