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Fentanyl remains one of the most serious threats in New Jersey’s illegal drug supply, but fentanyl itself is only part of the concern.
The illicit drug market is becoming increasingly unpredictable as fentanyl is combined with veterinary sedatives, synthetic benzodiazepines, other synthetic opioids and substances that may dramatically change the effects of a drug.
Someone may believe they are using heroin, cocaine or a prescription pill without realizing that fentanyl or another substance is present. Even people who expect fentanyl may have no way of knowing what else has been added.
New Jersey officials have raised concerns about a changing polydrug supply involving fentanyl, xylazine, medetomidine, bromazolam, nitazenes and other emerging synthetic substances.
At Green Springs Wellness, we help adults in New Jersey continue recovery through structured addiction and mental health treatment, including PHP, IOP, outpatient services and continuing care.
Why Is Fentanyl Being Mixed With Other Drugs?
Illicitly manufactured fentanyl is a powerful synthetic opioid that has become deeply embedded in the illegal drug supply.
New Jersey authorities report that illicit fentanyl may appear with heroin and cocaine or be pressed into counterfeit pills. A pill that appears to be oxycodone or another prescription medication may contain fentanyl, heroin, fentanyl analogs or other substances instead.
This creates two different risks. Some people may unknowingly encounter fentanyl in another drug, while others may knowingly use fentanyl but unknowingly encounter additional substances mixed into it.
Both situations make the effects of an illicit drug difficult to predict.
What Drugs Are Being Mixed With Fentanyl in New Jersey?
The illegal drug supply can change rapidly. Not every fentanyl sample contains another drug, and the substances present can vary by community, supplier and time period.
Several substances deserve particular attention in New Jersey, including veterinary sedatives, synthetic benzodiazepine-like drugs, potent synthetic opioids and counterfeit pills.
Medetomidine
Medetomidine may be one of the most important emerging fentanyl adulterants for New Jersey residents to understand in 2026.
Medetomidine is a powerful veterinary sedative that is not approved for use in humans.
CDC surveillance has found medetomidine appearing primarily with illegally manufactured fentanyl, with detections particularly concentrated in the Northeastern United States.
National forensic laboratory reports involving medetomidine increased sharply between 2023 and 2025. CDC-supported testing also found that among medetomidine-positive drug product samples evaluated from July through December 2025, 98% also contained fentanyl.
Why Is Medetomidine Dangerous?
Medetomidine is not an opioid. Naloxone can reverse opioid effects from fentanyl, but it does not directly reverse medetomidine.
Naloxone should still be administered during a suspected opioid overdose because fentanyl or another opioid may be present. Emergency medical care remains necessary because sedation and other effects caused by non-opioid substances may continue.
Regular medetomidine exposure has also been associated with potentially severe withdrawal that may require urgent medical care.
Xylazine
Xylazine is another veterinary sedative associated with fentanyl.
Often called “tranq,” xylazine is not an opioid and is not approved for human use.
New Jersey health officials have specifically warned residents about xylazine appearing in the illicit fentanyl supply.
What Happens When Xylazine Is Mixed With Fentanyl?
Fentanyl is an opioid. Xylazine is a sedative. Together they can contribute to profound sedation and make overdose situations more complicated.
Naloxone can reverse the fentanyl component but does not reverse xylazine itself. That does not mean naloxone should be withheld.
If opioid overdose is suspected, administer naloxone and call 911.
Xylazine has also been associated with significant skin and soft-tissue injuries that can require medical treatment.
Medetomidine vs. Xylazine
Medetomidine
A veterinary sedative increasingly detected with illicit fentanyl, particularly in the Northeast. Severe withdrawal after repeated exposure has become an important clinical concern.
Xylazine
A veterinary sedative often called tranq. It has been linked to profound sedation as well as serious skin and soft-tissue injuries.
Neither substance is an opioid, and neither is directly reversed by naloxone. Naloxone should still be used when fentanyl or another opioid may be involved.
Bromazolam
Bromazolam is a synthetic benzodiazepine-like substance that has never been approved as a prescription medication in the United States.
New Jersey forensic testing has identified bromazolam in the illicit drug market, including in combination with fentanyl and in counterfeit pills designed to resemble Xanax.
Why Are Benzodiazepine-Like Drugs and Fentanyl Dangerous Together?
Both can contribute to profound sedation and impaired consciousness.
Naloxone can reverse fentanyl’s opioid effects but does not reverse bromazolam. Anyone experiencing suspected overdose symptoms needs emergency medical attention.
Nitazenes
Nitazenes are a group of synthetic opioids appearing in the changing illicit drug market.
Some nitazene compounds can be extraordinarily potent. Federal authorities have identified numerous nitazene compounds in the U.S. drug supply, while New Jersey investigators have also identified the category as an emerging concern.
Nitazenes vs. Fentanyl
Both fentanyl and nitazenes are synthetic opioids, but they are chemically different.
Certain nitazenes may be extremely potent, creating additional uncertainty when they appear in an already unpredictable drug supply.
A person generally cannot determine whether powder or a counterfeit pill contains a nitazene simply by looking at it.
Other Ways People May Encounter Fentanyl
Heroin
Fentanyl can be mixed with or sold as heroin. Someone seeking heroin may therefore receive a product containing fentanyl instead.
Cocaine
Fentanyl has also been identified in stimulant supplies. Someone using cocaine may have little or no opioid tolerance and may not expect opioid effects.
Counterfeit Prescription Pills
Illegal pills may be manufactured to resemble oxycodone, Xanax or other medications while containing fentanyl, bromazolam, synthetic opioids or other unexpected substances. Appearance alone cannot establish what a pill contains.
The New Jersey Drug Supply Is Becoming a Polysubstance Problem
The larger story is not any single additive. It is polysubstance exposure.
Someone may believe they have been using one drug while their body has repeatedly been exposed to several substances with different effects.
This growing complexity can affect overdose response, withdrawal symptoms, medical stabilization and the type of treatment someone may need afterward.
Why Can Withdrawal Be More Complicated?
Withdrawal depends partly on what substances the body has adapted to.
Someone who believes they have developed dependence only on fentanyl could also have experienced repeated exposure to medetomidine, xylazine, benzodiazepine-like substances or other drugs.
This is particularly important with medetomidine because repeated exposure has been associated with severe withdrawal after the drug is stopped.
Important: Withdrawal from today’s illicit opioid supply should not automatically be assumed to be predictable fentanyl-only withdrawal. A medical assessment can help determine the safest level of care.
Can You Tell What Fentanyl Is Mixed With?
Usually not by appearance.
Powders and counterfeit pills can contain substances that cannot reliably be identified by sight, smell or taste.
Fentanyl test strips can identify the presence of fentanyl in many circumstances, but they do not provide a complete chemical analysis of everything contained in a sample.
A negative result for one substance does not establish that an illicit drug is safe.
Signs of a Possible Fentanyl Overdose
A fentanyl or opioid overdose may involve:
- Very slow, shallow or stopped breathing
- Difficulty waking the person
- Extreme sleepiness or unconsciousness
- Pinpoint pupils
- Limpness
- Pale, gray or bluish skin, lips or fingernails
- Choking, snoring or gurgling sounds
- A slow or absent response to stimulation
Treat a suspected overdose as a medical emergency.
Call 911 and administer naloxone when an opioid may be involved. Additional naloxone doses may sometimes be necessary according to product instructions and emergency guidance.
Because substances such as xylazine and medetomidine are not opioids, naloxone may not reverse every effect.
Naloxone Still Matters When Other Drugs Are Present
The emergence of xylazine and medetomidine does not make naloxone ineffective against fentanyl.
Naloxone remains capable of reversing the opioid component of an overdose. What may continue are symptoms caused by non-opioid substances present at the same time.
1
Call 911.
2
Administer naloxone.
3
Follow the naloxone product instructions.
4
Provide rescue breathing or CPR when appropriate and trained to do so.
5
Stay with the person until emergency medical professionals arrive.
New Jersey Is Making Progress, but Fentanyl Remains a Serious Threat
New Jersey has reported encouraging declines in overdose deaths in recent years.
Those improvements matter, but they do not mean the illicit drug supply has become predictable or safe.
Fentanyl remains a major overdose concern, while veterinary sedatives and emerging synthetic substances can make overdose, withdrawal and treatment increasingly complicated.
What Should You Do After Fentanyl Detox?
Detoxification or withdrawal management addresses only one part of opioid addiction.
Once someone is medically stable, continuing treatment can help address cravings, behaviors, emotions, mental health concerns and environmental factors associated with returning to opioid use.
This can be particularly important after fentanyl use because reduced opioid tolerance combined with an unpredictable illicit drug supply can make relapse especially dangerous.
Partial Hospitalization
PHP provides intensive daytime behavioral health support while allowing clients to return home outside treatment hours when clinically appropriate.
Intensive Outpatient Treatment
IOP provides structured therapy, relapse prevention and recovery support while allowing greater flexibility for home and daily responsibilities.
Outpatient Treatment
Outpatient care can support continued therapy, medication management when appropriate and ongoing recovery planning.
Co-Occurring Mental Health Care
Treatment can also address depression, anxiety, trauma, bipolar disorder and other behavioral health concerns that may affect recovery.
Fentanyl Addiction Treatment in New Jersey
At Green Springs Wellness, treatment is designed around the individual rather than simply the substance someone believes they have been using.
That distinction matters because a person seeking help for fentanyl addiction may also have experienced exposure to xylazine, medetomidine, benzodiazepine-like substances, stimulants or other synthetic opioids.
Green Springs Wellness provides structured addiction and behavioral health treatment in New Jersey through levels of care that can include partial hospitalization, intensive outpatient treatment, outpatient treatment and continuing care.
If medical detoxification is necessary, an appropriate detox provider should address stabilization first. Green Springs Wellness can then support the next phase of treatment and recovery.
Getting Help for Fentanyl Addiction in New Jersey
A person does not need to know exactly what was contained in every drug they used before asking for treatment.
If fentanyl, heroin, counterfeit pills or other opioids have become difficult to stop, a professional assessment can help determine the next appropriate step.
Green Springs Wellness provides addiction and mental health treatment for adults in New Jersey.
If you are currently experiencing an overdose or another medical emergency, call 911 immediately.
New Jersey residents can also contact ReachNJ at 844-732-2465 for free, confidential addiction treatment and recovery support information.
Frequently Asked Questions About Fentanyl in New Jersey
What is fentanyl being mixed with in New Jersey?
New Jersey authorities have identified an increasingly complex illicit drug supply involving fentanyl and substances including xylazine, medetomidine and bromazolam. Nitazenes and other emerging synthetic substances are also concerns. Fentanyl itself may also be found in heroin, cocaine and counterfeit prescription pills.
Is medetomidine being mixed with fentanyl?
Yes. CDC surveillance indicates medetomidine is primarily appearing with illegally manufactured fentanyl. Recent surveillance has found especially strong overlap between medetomidine-positive samples and fentanyl.
Is medetomidine the same as xylazine?
No. Both are veterinary sedatives that have appeared in the illicit opioid supply, but they are different drugs. Neither is an opioid, and naloxone does not directly reverse their effects.
What is tranq?
Tranq commonly refers to xylazine when it appears in the illicit drug supply. Xylazine is a veterinary sedative that has increasingly been found with fentanyl.
What is rhino tranq?
Rhino tranq is a street term that has been used for medetomidine, a veterinary sedative increasingly detected with illicit fentanyl.
Can fentanyl be found in cocaine?
Yes. Fentanyl has been identified in stimulant supplies including cocaine. This can be particularly dangerous because someone intending to use a stimulant may not expect opioid exposure.
Can fake Xanax contain fentanyl?
Counterfeit pills sold as Xanax may contain unexpected substances. New Jersey authorities have identified bromazolam in counterfeit Xanax-type pills, while counterfeit pills more broadly may contain fentanyl and other drugs.
Does naloxone work if fentanyl contains xylazine?
Naloxone reverses opioid effects from fentanyl but does not directly reverse xylazine. Naloxone should still be administered whenever opioid overdose is suspected, followed by immediate emergency medical care.
Does naloxone work on medetomidine?
Naloxone does not directly reverse medetomidine because medetomidine is not an opioid. However, medetomidine frequently occurs with fentanyl, so naloxone should still be administered when an opioid overdose is suspected.
Can fentanyl withdrawal be more complicated when other drugs are present?
Yes. Exposure to additional substances can change withdrawal symptoms and medical needs. Repeated medetomidine exposure has specifically been associated with severe withdrawal, making medical assessment important when someone does not know what substances were present.
Where can I get naloxone in New Jersey?
The New Jersey Department of Health provides information about free naloxone access and overdose prevention resources for residents.
Where can I get help for fentanyl addiction in New Jersey?
People who need immediate medical stabilization should seek emergency or appropriate detoxification services. After stabilization, Green Springs Wellness provides structured addiction and mental health treatment in New Jersey through PHP, IOP, outpatient and continuing-care services.
Clinical Sources and Medical Review
This page is educational and does not replace an individualized medical assessment. The illegal drug supply changes rapidly, and a person often cannot know which substances they have been exposed to without laboratory testing.
✓ Medically Reviewed
Dr. Vahid Osman, M.D.
Board-Certified Psychiatrist & Addictionologist
✓ Clinically Reviewed
Josh Sprung, L.C.S.W.
Licensed Clinical Social Worker
Clinical Sources and References
New Jersey State Commission of Investigation.
Evolving Trends and Threats in the Illicit Drug Market: Fentanyl, Veterinary Sedatives, and Other Emerging Synthetic Substances.
New Jersey Department of Health.
Fentanyl, xylazine, overdose prevention and naloxone resources.
New Jersey State Police.
Drug analysis and public safety information involving illicitly manufactured fentanyl and counterfeit pills.
Centers for Disease Control and Prevention.
Medetomidine Situation Summary.
Centers for Disease Control and Prevention.
Medetomidine in the U.S. Illegal Fentanyl Supply Increasing Risk for Overdose and Severe Withdrawal Syndrome.
U.S. Drug Enforcement Administration.
Public Safety Advisory: Heightened Threat: Fentanyl Mixed with Emerging Synthetic Drugs.
Contributors
Medically Reviewed By:
Dr. Vahid Osman, M.D.
Board-Certified Psychiatrist and Addictionologist
Clinically Reviewed By:
Josh Sprung, L.C.S.W.
Board-Certified Clinical Social Worker
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