A class of synthetic drugs called orphines is throwing a new wrench into the ever-evolving opioid crisis in the United States. These drugs have tenfold the potency of fentanyl and have led to numerous overdose deaths in 2026. Experts say removing them from the streets, or even identifying them, could be extremely difficult.
What are orphines?
They are a “class of opioids that was created in the 1960s,” said The New York Times, as part of a project to find “rapid, safe pain relievers for surgery.” Orphines were developed by Paul Janssen, a Belgian doctor, the same man who originally synthesized fentanyl. It was soon discovered that “orphines had life-threatening side effects such as acute respiratory depression and were highly addictive,” which halted their development.
Orphines are generally considered to be at least “10 times more powerful than fentanyl, even in quantities no greater than a few sand-size grains,” said the Times. Like fentanyl, orphines can be “lethal with stunning speed, with victims slumping over abruptly, respiration shutting down, chest walls rigid.” Naloxone, a drug that reverses the effects of opioids, is effective against orphine, but “numerous doses may be required, many more than the one or two doses typically needed for fentanyl.”
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Why are they prevalent now?
Orphines started to become ubiquitous among street drugs in the “wake of global crackdowns on fentanyl,” said the Times. The “emergence of orphines appears to follow regulatory actions targeting fentanyl analogues,” said the industry outlet Pharmacy Times, forcing dealers and users to pivot to new drugs. Most experts “believe the drug is produced at scale by international, multilevel drug distribution networks, likely originating from regions like South Asia or China,” and is then funneled to the U.S., said The Independent.
By the end of January 2026, orphine usage had been “detected in New York, Pennsylvania, Tennessee, Illinois, Louisiana, Texas, Washington, Nevada and California,” said The Hill. Overdose deaths from the drug have been reported in nearly all these states. At least 41 deaths from an orphine called cychlorphine occurred in Tennessee alone between July 2025 and February 2026, according to the Knox County Regional Forensic Center.
What next?
Doctors and researchers are trying to find ways to stem the flow of orphines. Doing so is difficult because it is “not hard for labs to pump it out,” said The Hill. The drug isn’t simply coming from a bathroom brew made “from a couple of products or in the U.S.,” Timothy Wiegand of the American Society of Addiction Medicine told The Hill. It is coming from international “drug distribution networks, some of the cartels or other isolated networks.”
As orphines continue to plague U.S. cities, medical examiners have “become frontline drug detectives, pressing to identify the new substances causing deaths,” said the Times. Many are “coordinating with law enforcement and local health departments to swiftly warn communities about the latest killer in their midst,” though local medical examiners’ offices are often chronically underfunded.
These drugs represent a “dangerous shift in the opioid crisis,” Dr. Rachel Wirginis, an addiction medicine and family medicine physician at the Oklahoma State University Addiction Recovery Clinic, said in a press release. Physicians are “seeing increasingly powerful synthetic opioids that require rapid recognition and aggressive intervention to prevent fatal outcomes.”
