WHY NOT? –
Nov. 19, 2025 – We Can’t Fix the Opioid Crisis If We Don’t Know What’s Killing People. Much of our country still relies on toxicology panels built for yesterday’s drug supply. These panels can reliably identify heroin, oxycodone, and fentanyl, but fail to catch nitazenes, brorphine, or other new synthetic analogs. This gap means that policymakers and public health professionals chase outdated trends. Meanwhile, drug manufacturers exploit loopholes, evading detection and remaining a step ahead. This is exactly what happened with the rise of xylazine, the veterinarian tranquilizer that doesn’t respond to Narcan, which has significantly complicated overdose responses across the country. It took years, and too many deaths, before xylazine testing became a relatively common practice.
Our statistics may look highly granular—broken down by county, substance, and year—yet they’re still vulnerable to major blind spots. A person who dies with both cocaine and a nitazene in their system might still be coded as a “cocaine death” if the nitazene wasn’t recognized or confirmed. As fentanyl deaths steeply decline, national figures make cocaine seem responsible for a growing share of overdoses—but that’s misleading if many of those cases actually involve cocaine combined with nitazenes or other synthetic opioids that weren’t detected.
