Latest reporting
After Fentanyl: The DEA Just Scheduled Another Ketamine Analog. Here’s What’s Already Replacing It.
DEA temporarily scheduled 2-fluorodeschloroketamine on May 22, 2026. 34 nitazene analogues in 37 countries. Medetomidine in opioid supplies. No consumer test strips for any of these compounds.
Cychlorphine Is in the Supply and Your Test Strips Won't Catch It
Cychlorphine — up to 10x stronger than fentanyl — does not appear on standard fentanyl test strips. The White House issued its first-ever Drug Threat Notice. Here's what harm reduction workers need to know.
Medetomidine Is Not Xylazine. That's the Problem.
DEA flagged four new adulterants in the drug supply on May 12. Medetomidine — now appearing in every Massachusetts county — is 100-200x more potent than xylazine and not reversed by naloxone. Here's what changed and what harm reduction needs to do about it.
Through eight lenses
Science
Alpha-2 agonists (xylazine, medetomidine — veterinary sedatives), nitazenes as μ-opioid agonists (synthesized in 1950s, never approved, re-emerging), kratom mitragynine partial μ-agonist + alpha-2, tianeptine atypical antidepressant with opioid activity at high doses.
Biology
Xylazine causes necrotic skin ulcers characteristic + prolonged sedation not reversed by naloxone; nitazenes act like high-potency fentanyl analogs (naloxone-reversible, higher dosing may be needed); kratom has its own withdrawal syndrome; tianeptine "gas station heroin" causing emergency-dept surges.
Psychology
Dependence patterns mirror the parent class but often with gaps in clinical recognition.
Policy
DEA scheduling scramble — xylazine FDA-declared emerging threat, nitazene analogs being scheduled piecemeal, kratom DEA deferred twice, tianeptine state-by-state patchwork.
Trends
Xylazine now in 48 states' supply; medetomidine identified in Chicago-area 2024; kratom retail boom.
Treatment
Xylazine wound care + opioid co-treatment; nitazene overdose reversal with naloxone; kratom dependence — buprenorphine effective; tianeptine dependence — like opioids.
Harm Reduction
Test strips for xylazine + nitazenes (where available), stay with person during prolonged sedation, don't use alone, high-dose naloxone availability.