February 27, 2026 — Appalachian Regional Healthcare (ARH) is warning the public about a dangerous synthetic opioid called cychlorphine that has recently been detected in Kentucky and has been linked to overdose deaths in neighboring states.

According to the Kentucky Office of Homeland Security, cychlorphine has been identified in central Kentucky after previously being found more commonly in Tennessee. Public health officials expect the drug may continue to spread throughout Kentucky.

Cychlorphine is an extremely potent synthetic opioid estimated to be about 10 times stronger than fentanyl, making it highly dangerous and potentially deadly even in very small amounts. Authorities warn that a single exposure may result in a fatal overdose.

“This is a very dangerous substance, and many people who encounter it may not even know they have taken it because it is being mixed with other illicit drugs,” said Maria Braman, MD, ARH Chief Medical Officer. “Individuals using illicit substances often do not know the drug is present. The strength and unpredictability of today’s drug supply significantly increase the risk of accidental overdose and make overdose prevention and rapid response more important than ever.”

What the Public Should Know

• Recently detected in central Kentucky and expected to rapidly spread to other parts of the state.
• Approximately 10 times stronger than fentanyl.
• Often mixed with other drugs, so users are frequently unaware it is present.

Overdose Treatment

Naloxone (Narcan®) remains the recommended emergency treatment for opioid overdose.

Naloxone may only partly reverse cychlorphine overdoses due to its potency, but it can still save lives and should always be used for suspected opioid overdoses. Multiple doses may be needed.

“Many overdoses involving powerful synthetic opioids still respond to naloxone,” said Michael Herald, PharmD, BCPS, Associate Vice President of Pharmaceutical Services. “We strongly encourage individuals and families who might find themselves in an overdose situation to carry naloxone whenever possible.”

Anyone witnessing a suspected overdose should:

• Call 911 immediately!
• Administer naloxone if available.
• Stay with the individual until help arrives.

Naloxone is available through many pharmacies, health departments, and community distribution programs.

ARH urges everyone to stay informed, report suspicious drugs, and work together to protect our communities. We will continue partnering with public health and emergency response teams to monitor threats and provide timely updates.