The Office of National Drug Control Policy (ONDCP) released a Drug Threat Notice to warn the public about the threat posed by fentanyl analogues carfentanil, fluorofentanyl, and methylfentanyl due to their increasing prevalence and potency.

The stats:

• The Centers for Disease Control and Prevention (CDC) estimates the three analogues were involved in at least 12,500 deaths since 2023.
• In 2025, the substances were identified in the illicit drug supply in every region of the country, with carfentanil samples increasing by 206% and methylfentanyl increasing by 297% since 2024. In 2026, wastewater analysis identified carfentanil and parafluorofentanyl in samples across all four census regions.
• According to the Drug Enforcement Administration (DEA), methylfentanyl was detected in 36 states in 2025, and carfentanil and fluorofentanyl were detected in 48 states.

The guidance:

• The notice instructs EMS, clinicians, law enforcement, and the public to be aware of the prevalence of these analogues, be prepared to use extra doses of naloxone, and seek immediate medical care for people who may be overdosing.
• For hospitals, it notes that standard hospital opioid urine screens do not detect fentanyl analogues.