Changing drug supply
Last updated September 2025
Philadelphia’s drug supply is always changing. Opioids are the primary substance involved in fatal overdoses, but stimulants (like cocaine and meth), sedatives (like medetomidine and xylazine), and other adulterants are increasingly common in overdose deaths. PDPH partners with the Center for Forensic Science Research & Education (CFSRE) to monitor the local drug supply, which enables SUPHR to inform the public and area healthcare providers about the city’s substance use landscape.
Philly’s drug supply at a glance:
In 2023, 70% of opioid overdose deaths also involved a stimulant. Polysubstance use, or the use of a combination of different drugs at the same time or close together, can be on purpose, to change the experience or counter side effects, or by accident, like when drugs are mixed without the person knowing.
Medetomidine was detected in 78 percent of dope samples in 2025 and has been linked with withdrawal and treatment complications. Before 2025, xylazine was the most common sedative in Philly’s illicit drug supply and was involved in 38 percent of overdose deaths in 2023. Learn more at the medetomidine and xylazine pages.
In the past couple of years, multiple new drugs have been found in our drug supply, including carfentanil, BTMPS and nitazene analogs. Read more about them below.
SUPHR drug checking reports
Drug supply adulterants
Contaminants in Philly’s drug supply have made the environment more unpredictable and dangerous for people who use. The most common type of adulterant in the dope supply is sedatives - mainly medetomidine, but also xylazine - but other substances have become more common during the past couple of years. Read more about them below and download the community alert PDFs for each.
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Drug description & effects
Carfentanil is an opioid up to 100 times stronger than the usual opioids found in the street dope and pill supply.
An amount as small as a grain of salt of this drug can cause overdose death.
Withdrawal from this supply can happen quicker and can be more severe.
Where has it been found?
Carfentanil was first identified in the Philly drug supply in 2017, both through lab tests of our local drug supply and in autopsy reports of people who died by overdoses.
At this point, carfentanil has only been confirmed in dope, but people who use other substances should be cautious and use safety measures just in case.
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Drug description & effects
Nitazenes are opioids that can be the same or stronger than the usual supply that have been found in the street drug and pill supply.
Any amount of this drug can cause overdose death.
Withdrawal from this supply can happen quicker and can be more severe.
Where has it been found?
Since December 2022, four distinct nitazene analogs have been identified in overdose decedents in Philadelphia.
At this point, nitazenes have only been confirmed in dope, but people who use other substances should be cautious and use safety measures just in case.
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Drug description and effects
BTMPS is an industrial chemical that is not approved for human use. It’s used in manufacturing plastics and as an ingredient in fragrances and candles.
People who have smoked drugs with BTMPS reported sensations including ear ringing, blurred vision, bloody cough and unusual taste. People who have injected drugs with BTMPS reported feeling burning sensations.
The health effects of BTMPS are not yet known. There are no studies on the effect of the substance on the human body.
Where has it been found?
BTMPS was first identified in samples from the Philly drug supply in June 2024.
BTMPS was found in drug samples that also contained fentanyl, xylazine and medetomidine.
BTMPS was detected in 16% of samples tested in June 2024 and 11% in July 2024. However, it is not known how widespread the substance is in the city’s drug supply overall.
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Drug description & effects
Local anesthetics are medications used to temporarily numb parts of the body. They are used in medical and dental settings for pain management and minor surgical procedures. They have become very common in Philly’s street opioid supply. The most common in Philly’s dope supply are lidocaine, procaine, and tetracaine.
Opioid overdoses that involve local anesthetics can have additional symptoms, including numbness, low blood pressure, lightheadedness, confusion, anxiety, and seizures. Some of these symptoms are associated with Local Anesthetic Systemic Toxicity (LAST). LAST is a rare but life-threatening condition that occurs when local anesthetics enter the bloodstream and affect the central nervous system and cardiovascular system. Symptoms can include tinnitus (ringing in the ears), altered mental status, seizures, abnormal heart rhythms (arrhythmias), severe hypotension, and cardiac arrest.
Where have they been found?
Local anesthetics have been found in most dope samples tested in Philly. At least one local anesthetic was detected in 97% of dope samples tested in Quarter 4 of 2025.
They have also been detected in the cocaine and methamphetamine supply.
Connect With Us.
Sign up for SUPHR’s drug checking listserv by filling out the form below. Want to learn more? Check out our events calendar to register for upcoming trainings, print more materials from our materials library, view data on our data dashboard, and read recent substance use alerts and advisories.