Drug Checking Findings: January-June 2025

Authors: Tracy Esteves Camacho, MPH; Rose Laurano MPH; Daniel Teixeira da Silva MD, MSHP

Between January and June 2025, the Philadelphia Department of Public Health (PDPH) Division of Substance Use Prevention & Harm Reduction (SUPHR) received results for 262 drug samples submitted for laboratory analysis. Most samples were drug litter found in public spaces by PDPH SUPHR staff.

Samples were tested by the Center for Forensic Science Research and Education (CFSRE) using advanced toxicology methods. The findings highlight a highly unpredictable and adulterated drug supply and polysubstance use.

Overview

Sample Collection

PDPH SUPHR staff collected primarily drug litter samples, including glassine bags, centrifuge tubes, and other paraphernalia, found in public spaces between January and June 2025 (Table 1). While these samples provide valuable insight into drug use patterns, their origin and handling introduce uncertainty. It is often unclear whether the detected substances were sold together, mixed by the person who consumed the drug, or contaminated after disposal.

Most samples were collected in the Kensington area (Table 2). Center City accounted for 44 samples, while smaller numbers came from South/Southwest (n=16) and North/Northeast (n=10). These areas still show the presence of drug litter, indicating that increased harm reduction efforts are needed. Three sample locations were unknown.

A table showing the number of drug litter samples collected each month from January through June of 2025.
A table showing the number of samples collected in each Philadelphia neighborhood. Most samples were collected in Kensington.

The CFSRE laboratory utilizes innovative analytical techniques for drug testing, employing comprehensive non-targeted data acquisition through gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-quadrupole time-of-flight mass spectrometry (LC-QTOF).

The testing panel includes over 1,100 substances, including a wide range of novel psychoactive substances (NPS) and other relevant compounds.

Samples were categorized according to the primary active substance identified through laboratory analysis, rather than the drug type initially suspected at the time of submission. For example, seven samples originally believed to be dope were reclassified as cocaine since it was the primary substance detected. Additionally, one sample suspected to be cocaine was reclassified as dope because fentanyl was the primary substance detected.

Laboratory Analysis

An average of 5.8 substances were identified in suspected dope samples (range: 1 to 17). Ten suspected dope samples were excluded because no active substances were detected. Fentanyl remains the dominant opioid in the city's drug supply (Table 3), with medetomidine, a veterinary sedative, frequently co-detected. While xylazine continues to circulate, medetomidine has emerged as the more prevalent tranquilizer present in suspected dope samples (Figure 1). Their presence further complicates overdose reversal efforts using naloxone, which does not reverse sedative effects. Symptoms of medetomidine withdrawal include intractable vomiting, excessive diaphoresis, hypertensive emergency, waxing and waning hypoactive encephalopathy, tremors, and tachycardia.1,2 In a chart review of 165 patients who presented to a Philadelphia hospital with suspected medetomidine withdrawal, over 90% required admission to the intensive care unit, and nearly a quarter were intubated.3

Dope Samples (n=109)

The frequent detection of local anesthetics (i.e., lidocaine, procaine, tetracaine) in the dope supply may indicate changes in cutting practices to add mass or to mimic the numbing effects of heroin. Fentanyl overdoses with local anesthetics on board have been reported to have atypical presentations that include numbness, bradycardia, hypotension, lightheadedness, confusion, acute anxiety, methemoglobinemia, respiratory depression, and seizures.4
A table listing the most frequently identified substances in the suspected dope samples. Fentanyl was the most frequent, followed by medetomidine and lidocaine.
Nearly a quarter (23%) of suspected dope samples contained cocaine in addition to opioids and sedatives. The detection of stimulants in suspected dope samples illustrates the ongoing trend of polysubstance use, potentially as people who use dope attempt to counteract the sedative effects of the drug supply. Commonly referred to as “speed balling”, this practice carries serious health risks, including coma, stroke, respiratory failure, heart attack, brain aneurysm, and death.6
A pie chart showing the the amount of different types of seatives in the dope samples. 68 percent of samples contained medetomdine only, 5 percent of samples contained xylazine only. Ten percent of samples contained both medetomidine and xylazine.

An average of 2.4 substances were identified in suspected cocaine samples (range: 1 to 13). Three suspected cocaine samples were excluded because no active substances were detected.

While most cocaine samples contained relatively few adulterants, several included tranquilizers and other depressants (Table 4). Notably, seven samples initially suspected to be dope were reclassified as cocaine after laboratory analysis identified cocaine as the primary substance. Like the dope samples with codetection of stimulants, these results also underscore the continuing trend of polysubstance use.

Cocaine Samples (n=115)

A table showing the most frequently identifed substances in the cocaine samples.

An average of 1.5 substances were detected in suspected methamphetamine samples (range: 1 to 5). No suspected methamphetamine samples were excluded, but a larger number of methamphetamine samples is needed to strengthen future analysis.

Methamphetamine was confirmed in all 13 samples analyzed (Table 5), though several also contained additional substances. Notably, one sample consisting of two pills marked to resemble Adderall 30mg contained only methamphetamine, indicating the presence of counterfeit prescription stimulants.

Methamphetamine Samples (n=13)

A table showing the most frequently identified substances in methamphetamine samples.

  • Thirteen samples with no active substances were excluded from all analyses.

  • Eleven samples containing K2 (n=6), cannabis (n=2), nitazenes (n=2), and oxycodone (n=1) were excluded from this report due to the limited sample size, which was insufficient for meaningful analysis.

  • Additional samples collected during this timeframe are pending analysis.

  • Drug litter samples, while non-invasive and informative, limit conclusions about the illicit drug supply.

Additional Notes

  1. Philadelphia Department of Public Health. Health Alert: Hospitals and behavioral health providers are reporting severe and worsening presentations of withdrawal among people who use drugs (PWUD) in Philadelphia. Published online December 10, 2024.

  2. Philadelphia Department of Public Health. Health Update: Responding to overdose and withdrawal involving medetomidine. Published online June 10, 2025.

  3. Huo S, London K, Murphy L, et al. Notes from the Field: Suspected Medetomidine Withdrawal Syndrome Among Fentanyl-Exposed Patients — Philadelphia, Pennsylvania, September 2024–January 2025. MMWR Morb Mortal Wkly Rep. 2025;74(15):266-268. doi:10.15585/mmwr.mm7415a2

  4. Palamar JJ, DeBord JS, Krotulski AJ, Goldberger BA. Local Anesthetics Adulterating the Illicit Fentanyl Supply. JAMA Psychiatry. Published online May 21, 2025. doi:10.1001/jamapsychiatry.2025.0952

  5. Philadelphia Department of Public Health. Unintentional Drug Overdose Fatalities in Philadelphia, 2023. Published online February 2025.

  6. Lee-Easton M, Magura S, Abu-Obaid R, et al. Polysubstance use patterns among individuals applying for opioid-use disorder treatment in the U.S. J Subst Use. 2024;0(0):1-8. doi:10.1080/14659891.2024.2372093

References