Drug Supply Intelligence

What's circulating in your region

Quarterly intelligence briefs drawn from DEA NFLIS surveillance data, state forensic lab reports, and anonymized detection data from Subcheck's client network nationwide. Actionable intelligence for program planning.

Detection Data Points
2.4M+
From Subcheck client programs
States Covered
38
Active program data
Update Frequency
Quarterly
Next brief: July 2026
Analog Tracking
100+
Fentanyl variants monitored

Regional threat overview

Top threats by region based on cumulative detection data through Q1 2026.

Northeast

Critical
NY, NJ, PA, CT, MA, MD, DC
→para-Fluorofentanyl — 28% of positive tests, up 340%
→Xylazine — 72% co-occurrence in Philadelphia
→Medetomidine — 37% prevalence, emerging rapidly

Southeast

High
VA, WV, NC, SC, GA, FL, TN, KY
→Orphines — detected in 12+ states, 19 deaths in East TN
→Carfentanil — outbreak clusters in Appalachian corridor
→Xylazine — 35% co-occurrence, expanding south

Midwest

High
OH, MI, IN, WI, IL, MN
→Nitazenes — 4.2% of positive tests in OH, MI, IN, WI
→Stimulant contamination — 23% of nitazene hits in meth samples
→Xylazine — 30-35%, expanding westward

West Coast

Moderate
CA, OR, WA, NV
→Stimulant contamination — 21% of meth, 14% of cocaine
→Xylazine — <10% but sporadic detections rising
→para-Fluorofentanyl — emerging, 6 months behind East Coast

Southwest

Moderate
AZ, NM, TX, CO, UT, OK
→Highest analog diversity — multiple variants per batch
→Stimulant contamination — 14% cocaine, TX border cities
→Acetyl/butyryl/furanyl fentanyl all detected alongside core

Recent intelligence briefs

Q1 2026Northeast & Mid-Atlantic

Fluorofentanyl Surge in Eastern Seaboard

para-Fluorofentanyl detections increased 340% quarter-over-quarter across Subcheck client programs in the NE corridor. Now the second most common analog after fentanyl itself in NY, NJ, PA, and MD.

Key Findings
01para-Fluorofentanyl detected in 28% of positive SC-X tests (up from 7% in Q4 2025)
02Co-occurrence with xylazine in 61% of fluorofentanyl-positive samples
03Highest concentration in urban centers: Philadelphia, Newark, Baltimore
04Rural spread accelerating — first detections in 14 new counties
Recommended Actions
→Increase SSP allocation in affected counties
→Update training materials with fluorofentanyl-specific guidance
→Alert naloxone programs — higher doses may be needed for fluorofentanyl
Q1 2026Great Lakes & Upper Midwest

Nitazene Class Emergence in Midwest

Isotonitazene and metonitazene detected for the first time in community-level Subcheck testing across OH, MI, IN, and WI. Nitazenes are non-fentanyl synthetic opioids with potency comparable to or exceeding fentanyl.

Key Findings
01Nitazene-class detections in 4.2% of positive tests (from near-zero in 2025)
02Concentrated in OH (Dayton, Columbus) and MI (Detroit metro)
03Appearing in stimulant supply — 23% of nitazene detections were in presumed methamphetamine samples
04Subcheck detection panel successfully detecting nitazenes at validated thresholds
Recommended Actions
→Distribute naloxone advisories — nitazenes may require higher naloxone doses
→Brief SSP staff on nitazene recognition
→Consider SC-X deployment for controlled testing on borderline detections
Q1 2026Southeast & Appalachia

Orphines: A New Synthetic Opioid Class Emerges

Orphines (benzimidazol-2-ones) — a structurally novel class of synthetic opioids distinct from both fentanyl and nitazenes — have been identified in 12+ US states. Unlike nitazenes, orphines are completely undetectable by all currently available rapid immunoassay test strips, including fentanyl, nitazene, and opioid panels.

Key Findings
01Cychlorphine, the most common orphine variant, is estimated at ~10x fentanyl potency
0219 overdose death investigations in East Tennessee linked to orphine compounds (Q4 2025 - Q1 2026)
03Orphines emerged following China's 2025 blanket scheduling of nitazenes — a predictable supply-side pivot
04No rapid immunoassay test strip currently exists for orphine detection — laboratory confirmation (GCMS/LCMS) is the only identification method
Recommended Actions
→Alert clinical and EMS partners — orphine overdoses may present with atypical naloxone resistance
→Monitor CFSRE and UNODC early warning advisories for orphine prevalence updates
→Ensure naloxone co-distribution at all FTS sites — high-potency unknowns require immediate reversal capability
→Brief program staff: a negative fentanyl test does NOT rule out a potent synthetic opioid
Q4 2025National

Xylazine Contamination Rates Stabilizing

After rapid expansion in 2023-2024, xylazine co-contamination rates appear to be stabilizing at ~35% of fentanyl-positive samples nationally. Regional variation remains significant.

Key Findings
01National xylazine co-occurrence rate: 34.7% (down from 38.1% in Q3)
02Highest rates persist in Philadelphia (72%), Newark (64%), Baltimore (58%)
03Western states remain lower: <10% in CA, OR, WA
04Subcheck test strips reliably detect fentanyl component in xylazine-adulterated samples
Recommended Actions
→Maintain xylazine awareness in training
→Consider xylazine-specific test strips as a complement (separate product)
→Update wound care guidance for field staff in high-xylazine areas
Q4 2025West Coast & Southwest

Stimulant Supply Contamination Expanding

Fentanyl contamination of methamphetamine and cocaine supply continues expanding. 18% of Subcheck positive detections in CA, AZ, NV, and CO came from users testing stimulant samples.

Key Findings
01Fentanyl-positive rate in presumed stimulant samples: 18.3% (up from 12.1% in Q3)
02Methamphetamine contamination higher (21%) than cocaine (14%)
03Users testing stimulants were less likely to carry naloxone (34% vs. 78% for opioid users)
04Programs distributing FTS alongside stimulant-focused harm reduction reporting highest engagement
Recommended Actions
→Expand FTS distribution to stimulant-focused programs
→Co-distribute naloxone with FTS at stimulant-focused sites
→Update community messaging — fentanyl is not only an opioid-supply issue