Substance Use & Emerging Drug Risks in New Jersey

The opioid crisis continues to take a devastating toll on individuals, families, and communities across the United States. Tens of thousands of people die each year from overdoses involving heroin and other opioids, and countless more live with the long-term consequences of substance use and stigma. First responders remain on the front lines of this emergency—saving lives every day by administering naloxone, providing medical care, offering support, and connecting people to resources.

While heroin and prescription opioids have long been central to the overdose crisis, the drug supply continues to evolve. Increasingly, substances are being mixed—or “adulterated”—with powerful additives that increase the risk of overdose, severe injury, and death. Some of the most concerning additives include fentanyl, xylazine, and medetomidine, each of which can dramatically affect how a person responds during and after an overdose event.

These additives are not always known to the person who uses the drugs. Because they can change the way the body reacts, traditional responses—including naloxone use—may not address every symptom. This makes awareness, compassionate communication, and linkage to care more important than ever.

Below, you will find introductory information about commonly encountered additives in today’s drug supply. These summaries offer a starting point for recognizing the risks and challenges associated with substances like fentanyl, xylazine, and medetomidine. Each one presents unique health concerns and may require specialized knowledge to respond safely and effectively.

Xylazine

Xylazine Fact Sheet – from the New Jersey Intelligence Center

Xylazine: What to Know – NJDOH Brochure

Fentanyl

Drug Facts – Fentanyl 

Medetomidine

Notes from the Field:Suspected Medetomidine Withdrawal Syndrome Among Fentanyl-Exposed Patients — Philadelphia, Pennsylvania, September 2024–January 2025

The Shifting Landscape of a Fentanyl Adulterant: Moving From 

Xylazine to Medetomidine

Substance Uses Philly - Medetomidine