WASHINGTON — The White House Office of National Drug Control Policy (ONDCP) has issued a Drug Threat Notice warning the public about the growing danger posed by three fentanyl analogues: carfentanil, fluorofentanyl and methylfentanyl.
All three substances are as potent as, or more potent than, fentanyl itself, according to the notice. Carfentanil, originally developed as a tranquilizer for large animals, is up to 100 times more powerful than fentanyl.
The Centers for Disease Control and Prevention estimates the three analogues have been involved in at least 12,500 deaths since 2023. That total includes nearly 12,000 deaths linked to fluorofentanyl, nearly 600 linked to carfentanil and approximately 50 linked to methylfentanyl, according to CDC data cited in the notice.
“Drug traffickers continue to produce and smuggle deadly substances into the United States,” said Drug Czar Sara Carter. “This designation and accompanying notice provide the American people, first responders and medical professionals with actionable information to protect themselves and their loved ones.”
A Growing Presence Nationwide
ONDCP said all three analogues were identified in the illicit drug supply in every region of the country through laboratory testing in 2025. Carfentanil samples increased 206% and methylfentanyl samples increased 297% compared with 2024.
Wastewater analysis conducted by ONDCP in 2026 detected carfentanil and para-fluorofentanyl in samples across all four U.S. census regions, as shown in the map below.
According to the Drug Enforcement Administration’s National Forensic Laboratory Information System, methylfentanyl was detected in 36 states in 2025. Carfentanil and fluorofentanyl were each detected in every state except South Dakota and Hawaii that same year.
Drug traffickers continue to manufacture these analogues and smuggle them into the country, often disguised as counterfeit prescription pills or mixed into other drugs such as cocaine, methamphetamine and heroin.
What the Public Can Do
ONDCP is urging emergency responders, clinicians, law enforcement and the general public to take the following steps.
Be aware. Never take a pill that was not prescribed to you, and assume any illicit drug supply may be contaminated with synthetic opioids.
Be prepared. Because of the potency of these analogues, additional doses of naloxone may be needed to reverse an overdose.
Seek immediate medical care. Anyone who may be witnessing an overdose should call 911 right away.
Emily’s Hope encourages everyone to carry the opioid reversal drug, naloxone, and in the case of these emerging trends, extra doses may be necessary.
Analogues Don’t Show Up on Standard Drug Screens
The notice cautions that standard hospital opioid urine screens do not detect fentanyl analogues. Standard fentanyl urine screens may detect some analogues through cross-reactivity, though results vary by substance and by assay. Fluorofentanyl and methylfentanyl may produce positive results, but carfentanil will not be detected on these screens.
