San Francisco health officials have issued an urgent alert following the detection of a potent synthetic opioid in the city, believed to be linked to a fatal overdose earlier this month. This marks the first time the drug has been identified in the area.

The San Francisco Department of Public Health has identified the drug as cychlorphine, which recently appeared in a counterfeit pill, raising significant concerns about its dangerous strength and erratic emergence in the illegal drug market.

“We suspect cychlorphine is even more potent than fentanyl and was discovered in a counterfeit pill,” explained Daniel Tsai, director of the San Francisco Department of Public Health, in an interview with ABC7.

The drug was first recognized by law enforcement last year. Bob Beris, special agent in charge of the DEA San Francisco Field Division, told ABC that “the DEA initially detected it in 2024 at one of our Florida labs. Pills can move rapidly across the country, arriving in San Francisco from places like Chicago in just over a day via major highways like I-80, 99, and I-5.”

Authorities caution that cychlorphine is not limited to counterfeit pills; it can be mixed with various street drugs, complicating efforts to detect and avoid it.

Authorities warn that cychlorphine is not confined to pills alone and can be hidden across multiple street drugs, making detection and avoidance especially difficult.

“It can be mixed into a pill. It can be sold as a powder. It can be mixed in with cocaine. It can be sold as cocaine. Again, just because we haven’t seen some of these examples yet doesn’t mean it’s not out there,” Beris said.

Public health experts are also sounding the alarm over testing limitations, saying current drug-checking tools may not catch the substance.

“Importantly, it’s not detected on the available fentanyl test strips that are out there. So it’s very important to really try to avoid counterfeit pills altogether,” Dr. Philip Coffin, director of the Center on Substance Use and Health at SFDPH told ABC.

Another major concern is its suspected resistance to overdose reversal drugs like Narcan, potentially requiring multiple doses to be effective.

Community organizations on the front lines say they are responding by expanding emergency resources.

“Code Tenderloin has doubled the amount of Narcan we pass out per night. And also informing the community, we work in promotional preventative rehabilitative care. 

And we have to inform the community and educate them,” Douglas Liu, executive director of Community Health Workers Code Tenderloin told ABC.

Health officials from both the DEA and SFDPH are urging the public to avoid counterfeit pills entirely, warning the illicit supply is becoming increasingly unpredictable and dangerous.

Meanwhile, the crisis is unfolding alongside other alarming developments in the drug supply nationwide.

At the same time, officials in New York City have identified two additional dangerous substances in circulation for the first time: carfentanil, a sedative so powerful it is used to tranquilize elephants, and medetomidine, an animal tranquilizer described by experts as even stronger than the street drug xylazine.

Recognizing drug use as a public health reality rather than a moral failing, officials are championing harm-reduction efforts to protect the most vulnerable in a dangerous drug landscape, emphasizing that community care, through clean needle distribution and shared supervision, is the most effective way to save lives.