A wave of homemade, synthetic drugs sweeps US and deepens crisis

The story in context

Synthetic drug mixtures are creating new dangers for users and complicating efforts to tackle addiction in the United States, according to BBC News reporting published on 18 October 2026. Reporting from Columbus, Ohio, and Chicago, the BBC describes a changing supply in which fentanyl is combined with animal tranquillisers and other substances. It reports that annual US overdose deaths fell from about 110,000 in 2022 to roughly 70,000 in 2025, but recovery workers warn that the decline does not mean the crisis has ended.

Among the substances appearing alongside fentanyl are xylazine and medetomidine, sedatives whose effects cannot be reversed by naloxone, the medicine used against opioid overdoses. Xylazine can also cause severe wounds. In Columbus, the Hope Dealer Community helps monitor the drug supply through a sampling programme involving the Centers for Disease Control and Prevention. The BBC reports that equipment submitted by Mike, a 48-year-old veteran with a longstanding opioid addiction, tested positive for medetomidine.

Recovery workers also describe risks to people buying stimulants without knowing they contain opioids. Hope Dealer Community leader Scott Sanders told the BBC that users purchasing crack cocaine could receive mixtures containing fentanyl and other drugs. In the Chicago area, Liv4Lali recovery worker Karen Bell distributes testing strips and supports people affected by addiction. She described increasingly unpredictable mixtures and serious health consequences.

At Chicago’s Cook County jail, Sheriff Tom Dart linked a rise in fatal seizures in 2023 to synthetic cannabinoids carried on drug-soaked paper. Eight inmates died that year, compared with the facility’s usual one or two annual overdose deaths, the BBC reports. Mail screening and searches now target this route of entry. Dart argued that enforcement alone cannot resolve a crisis increasingly involving drugs made domestically, and called for substance-use treatment to play a central role.