A new drug called cychlorphine has been reported in different parts of the country, including Ohio. The synthetic opioid poses a threat to public safety due to its high potency and difficulty detecting it through standard drug screening methods.
Kate Cottrill works at the Athens City-County Health Department as the regional public health coordinator for preparedness and response for the southeast central region of Ohio. She said cychlorphine is potentially the newest synthetic opioid substance the U.S. is currently encountering, and might make its way to Athens.
The U.S. Office of National Drug Control Policy noted in a press release in April 2026 that Ohio is one of three states in the country with the most reports of cyclorphine identified. There have been no confirmed cases of cychlorphine in Athens or at Ohio University.
Cottrill has seen reports of cychlorphine in both Cleveland and Columbus and commented on the likelihood of the drug reaching Southeast Ohio.
“We know that there are certain drug trafficking pathways that move across the state that place those areas at a higher risk,” Cottrill said. “But we have to assume that they will eventually make it into our area.”
Cottrill said a challenge cychlorphine poses is the difficulty detecting where it is in a given area and where it will show up next.
“It is mixed with other substances, and we don't know where it's going to show up next,” Cottrill said. “We can really only guess, and it is possible that initial surveillance in an area that had not previously experienced cychlorphine overdoses or deaths might miss it, and that's a real concern. That's what makes this emergent public health threat particularly concerning and should be noted as dangerous.”
That is partly because cychlorphine is not detectable by standard fentanyl test strips and most urine drug screens, and it is often mixed with different substances including methamphetamine and cocaine.
Cottrill emphasized the importance of understanding the risk of cychlorphine and said it is safest to assume any illicit substance someone may take contains the drug, as it is extremely difficult to know otherwise ahead of time.
“Unless the medication is your own prescription, you have to assume that the drug that you have, and it tends to be in pill form, tablet form, but can be found in fentanyl, meth, methamphetamines and cocaine, you have to assume that it’s likely that cychlorphine is present in that drug supply,” Cottrill said.
The difficulties in detecting cychlorphine cause additional problems for Dr. Christopher Meyer, addiction medicine specialist at OhioHealth O’Bleness Hospital, when treating his patients.
“Most of the urine drug screens that are used in clinics like this will not detect them, and they have to be sent away,” Meyer said. “The urine specimen has to be sent away for an extensive test called mass spectroscopy, which will identify the analog.”
According to Dr. Stephen Bergmeier, chemistry professor, test strips fail to detect cychlorphine because of its unique structure that differs from fentanyl.
Additionally, Bergmeier said what makes cychlorphine extremely addictive is how quickly it can reach the brain, despite having a blood-brain barrier that is designed to block substances from going from the bloodstream to the brain.
“Many of these synthetic things are, what I would call, a greasier or non-polar lipophilic molecule, and so they can get across that blood-brain barrier better than morphine, which actually doesn't get across all that well,” Bergmeier said.
According to Addiction Policy Reform, cychlorphine may be up to 10 times more potent than fentanyl.
“It is more potent, and it sinks the hook of addiction deeper into the patient, and can be harder to treat,” Meyer said. “But it is treatable.”
According to a July 2026 study by the National Library of Medicine, there is evidence that naloxone, the life-saving medication used to reverse opioid overdoses, is still at least partially effective in reversing cychlorphine overdoses
They recommend administering naloxone promptly and repeating as needed every 2-3 minutes until emergency services arrive. They also say to maintain airway support and rescue breathing throughout.
Cychlorphine can cause symptoms including the slowing and stopping of breathing, choking, pinpoint pupils, limp body and unresponsiveness, according to the Addiction Policy Reform.
The chemical potency of cychlorphine is only one part of the threat of the drug. The social conditions within the Appalachian region create an environment for cychlorphine to easily spread.
Dr. Cory Cronin is an associate professor and department chair for social and public health, as well as co-director for the Institute to Advance Population Health. Cronin said the vulnerability of substance use disorder follows social conditions.
“Things like unemployment, isolation, poverty, untreated pain, trauma, those types of things are things that we can kind of overlap with different incidents,” Cronin said.
Cronin said rural Ohio lacks a significant number of health care providers for its demand, which could make the Southeast and Appalachian region of the state particularly vulnerable to cychlorphine.
“Often short staff, long delays for appointments, the need for emergency responders, overall, I would say resources are thin, particularly in rural counties, Appalachian region,” Cronin said. “So anytime we would see maybe a spike, it’s not like the baseline need is going down at the same time. It will only stretch too few resources even thinner.”
Struggles with substance use and the opioid crisis have deep roots in Appalachian Ohio. Ohio ranks extremely high among other Appalachian states concerning the opioid crisis and ranks second in the country for the rate of drug overdose deaths.
The region has seen extreme over-diagnosing of opioids through “pill mills,” which were physician-operated clinics pretending to be pain management centers. Pill mills flooded the region with opioids after many in the region suffered chronic pain from the difficult manual labor the local industry required, according to a study by the National Library of Medicine.
To help reduce the spread and risk of cychlorphine, Cronin emphasizes the need to reduce stigma. He urges people to see substance use issues through a moral lens, not a medical one.
Cronin believes in a long-term investment in social conditions to best protect people from dangerous substances.
“We need an investment in social conditions in people’s connectedness, decreasing things like isolation, increasing opportunities for employment, security, safety in their life and especially in some of the social areas,” Cronin said.
