09/17/2026
ONDCP DRUG THREAT NOTICE:
September 15, 2026
Key fentanyl analogues, involved in at least 12,500 deaths since 2023, pose heightened threat to nation
Pursuant to its authority to monitor evolving and emerging drug threats, the White House Office of National Drug Control Policy assesses that carfentanil, fluorofentanyl, and methylfentanyl currently represent the greatest threat from fentanyl analogues to the American people due to their lethality and prevalence across the nation.
What Can I Do? EMS, clinicians, law enforcement, and the general public should:
1) Be Aware of the prevalence of deadly fentanyl analogues in the illicit drug supply:
Never take a pill that was not prescribed to you.
Know that all illicit drugs can be contaminated with synthetic opioids.
2) Be Prepared to treat opioid overdoses with extra doses of naloxone.
3) Seek Immediate Medical Care for people who may be overdosing. Call 911.
CDC: How to Recognize an Overdose
Poison Help Line: Call 1-800-222-1222 for advice if exposed to potentially toxic substances.
To access substance use treatment, visit findtreatment.gov or call 1-800-662-HELP (4357).
For Hospitals: Standard hospital opioid urine screens do not detect fentanyl analogues. Standard fentanyl urine screens may detect some fentanyl analogues through cross-reactivity, but this varies by analogue and assay. While fluorofentanyl and methylfentanyl may produce positive results, carfentanil will not be detected.
Email [email protected] to request testing of clinical samples not explained by other testing.
Call the National Clinician Consultation Center for assistance in treating patients for withdrawal or addiction at 1-844-ASK-NCCC (275-6222).
Figure 1. Detection of carfentanil and para-fluorofentanyl in U.S. wastewater samples, 2026. Methylfentanyl is not currently tested for in wastewater. Source: ONDCP
Where are They? In 2025, carfentanil, fluorofentanyl, and methylfentanyl were identified in the illicit drug supply in every region of the country through lab testing, with carfentanil samples increasing by 206% and methylfentanyl samples increasing by 297% since 2024. In 2026, ONDCP wastewater analysis identified carfentanil and para fluorofentanyl in samples across all four census regions (Figure 1). According to the DEA’s National Forensic Laboratory Information System (NFLIS), methylfentanyl was detected in 36 states in 2025 (Figure 2). Carfentanil and fluorofentanyl were each detected in every state except South Dakota and Hawaii in 2025 (not pictured).
Figure 2. Methylfentanyl samples submitted to NFLIS, 2025. Map courtesy of DEA.
Key Information: Carfentanil is 100x more powerful than fentanyl; fluorofentanyl, methylfentanyl, and related substances are as potent or more potent than fentanyl. While fentanyl-related substances have been federally controlled since 2018, drug traffickers continue to produce these illicit substances and smuggle them into the United States as counterfeit prescription pills or in powder form, to be added to other drugs such as co***ne, methamphetamine, and he**in. CDC estimates indicate these three fentanyl analogues and their isomers were involved in at least 12,500 deaths since 2023 (carfentanil: nearly 600 deaths; fluorofentanyl: nearly 12,000 deaths; methylfentanyl: approximately 50 deaths)
Data References: ONDCP Wastewater Analytics, DEA NFLIS, CDC SUDORS
