New Threats from Fentanyl-Related Substances: Key Considerations for Emergency Responders
October 6, 2026
The National Highway Traffic Safety Administration’s Office of EMS and National 911 Program are alerting the EMS and 911 communities of a rising threat from fentanyl-related substances in the illicit drug supply.
Why Should EMS and 911 Be Aware of This?
EMS and 911 professionals should understand the prevalence of carfentanil, fluorofentanyl, and methylfentanyl in the illicit drug supply and be prepared to treat opioid overdoses with extra doses of naloxone.
What EMS and 911 Should Know
An Office of National Drug Control Policy Drug Threat Notice issued on September 15 highlighted that key fentanyl analogues, carfentanil, fluorofentanyl, and methylfentanyl, represent the greatest threat to the American people due to their lethality and prevalence across the nation. Carfentanil, fluorofentanyl, and methylfentanyl have been linked to over 12,000 deaths in the United States since 2023.
Key considerations:
- Fluorofentanyl and methylfentanyl are more potent than fentanyl.
- Carfentanil is 100 times more powerful than fentanyl.
- Overdoses require multiple doses of naloxone.
- Fentanyl analogues are not detected by standard drug test strips or routine screens.
- These drugs can be found as counterfeit prescription pills or in powder form.
- These substances can also be added to other drugs such as cocaine, methamphetamine, and heroin.
Where Have Fentanyl Analogues Been Reported?
Carfentanil, fluorofentanyl, and methylfentanyl have been identified in the illicit drug supply in every region of the country. Testing has revealed that carfentanil samples have increased by 206% and methylfentanyl samples grew by 297% since 2024.
