What Are Today's Synthetic Drugs?

Fentanyl isn't the only dangerous synthetic driving the U.S. overdose crisis. New substances are constantly emerging—here's a closer look at the compounds reshaping today's drug supply and what parents need to know about them.

What does "synthetic" mean in this context?

For most of the last century, the drugs in circulation came from plants—marijuana from the marijuana plant, cocaine from the coca leaf, heroin from opium poppy. Today, a large portion of the supply is synthetic, made from chemicals in unregulated, underground labs.

The most well-known synthetic is fentanyl, an opioid that has caused more overdose deaths in the U.S. than any drug before it. But fentanyl is one of many. Nitazenes—a class of synthetic opioids originally developed in the 1950s and never approved for use—are now appearing in the illicit drug supply at up to 10 times the strength of fentanyl. Cychlorphine, another unregulated synthetic opioid, is showing up in counterfeit pills and powders—and is significantly more potent than fentanyl.

Xylazine—often called "tranq" or "the zombie drug" on the street—and medetomidine are animal tranquilizers also being mixed into opioid products. Neither responds to naloxone, meaning the overdose-reversal drug works on the fentanyl component but not on the tranquilizer.¹

Most of these synthetic compounds are now reaching teenagers in one specific form: counterfeit prescription pills.

Why are synthetic drugs showing up in pills?

Drug traffickers have shifted toward pressing fake prescription pills made with fentanyl and other dangerous chemicals because young people are comfortable with pills. They recognize names like oxycodone, Percocet and Xanax, and the pill format feels safer than a powder or a needle. Counterfeit prescription pills are pressed to look exactly like real ones.

But it’s a world of deceptive marketing and no quality control. The pill from a friend or online seller that a teen thinks they're taking is almost never the pill they're actually taking. And the mix of chemicals in a counterfeit prescription pill can vary wildly from one pill to the next, even within the same batch.

What does this mean for teens?

Teens generally don't think of themselves as using drugs when they take a pill. Pills feel medical, measured and safe—because that's what real pharmaceutical pills are. A teen who would never touch heroin might take a pill a friend offers them at a party.

Any counterfeit pill could contain a random, lethal combination of fentanyl and other potent synthetics. In this environment, one impulsive decision can have tragic results.

How can parents bring it up?

Research commissioned by Song for Charlie shows that only about half of U.S. teens are aware that fake prescription pills made with fentanyl are in circulation. Most parents have to be the ones to start this conversation.

Start with curiosity. Ask first what your teen already knows: "Have you heard about fake prescription pills going around at school or online? What's your sense of the risk?"

Share the facts. Say,"Any pill that doesn't come from a pharmacy bottle with your name on it could be a fake prescription pill made with fentanyl and other dangerous chemicals—even if a friend says it's Xanax, even if it looks exactly right. There's no reliable way to know what's inside. I'm telling you because it's happening right now."

Keep the door open. Share, "If you're ever offered a pill, or you've already taken one and feel weird, I want you to call me. No judgment, no consequences. Just call."

Sources:

References:

Dr. Keith Humphreys, Esther Ting Memorial Professor, Stanford University School of Medicine
Dr. Dolly Klock, Family Medicine Physician, Founder, Adolessons
Dr. Jill Pearson, Board-Certified Pediatrician, President, Pathways Pediatric Consulting
Rhana Hashemi, M.S., Founder, Know Drugs, Ph.D. Candidate, Stanford University