January 29, 2026
Thom Carroll/For PhillyVoice
Less fentanyl available in the street drug supply — locally and nationwide — may be the primary cause of the decline in overdose deaths, new research suggests.
A cluster of drug overdoses in Kensington that occurred within minutes of each other earlier this month prompted Philadelphia health officials to alert addiction medicine providers and harm reduction workers.
A handful of drug users went to emergency departments, but there were no reported fatalities. Subsequent testing of the bags of drugs, sold as opioids or "dope," showed "atypically high levels" of the highly-potent veterinarian tranquilizer medetomidine and lidocaine, often used in medical settings as a local anesthetic. Bags also contained the synthetic opioid carfentanil, the tranquilizer xylazine and the anesthetic benzocaine – among other chemicals.
What they didn't contain much of – or at all – was fentanyl, the potent opioid that has replaced heroin and has been the primary cause of fatal drug overdoses in recent years.
"It was really the portions (of other substances) as compared to fentanyl that were shocking to me," said Christopher Moraff, who heads PA Groundhogs, a regional street-to-lab drug checking program that tracks the content of Philadelphia's illicit drug supply in conjunction with the Center for Forensic Science, Research and Education in Horsham. "There was a massive DO (overdose) event in Philadelphia, and there were no fatalities."
A new research paper, published days before the overdose cluster, suggests the precipitous drop in overdose deaths in the United States and Canada since sometime in 2023 is due to a "fentanyl drought" – something Moraff and other people with boots on the ground have been talking about locally for more than a year.
"The amount of fentanyl in a bag has just gone down," Moraff said. "It stands to reason that when you replace a potentially very highly-toxic, potentially fatal substance with a hodgepodge of certainly problematic but less acutely-toxic substances, you'll see a decline in fatal overdoses."
Preliminary data from the Centers for Disease Control and Prevention shows overdose deaths fell 17% nationwide between July 2023 and July 2024, dropping from 113,000 to 94,000 deaths. Pennsylvania's drug overdose deaths decreased by more than 24%, from 5,195 to 3,937. In New Jersey, they fell by just under 24%, from 3,009 to 2,288.
In Philadelphia, the most current statistics from the city's health department show a 7% decline in overdose deaths between 2022 and 2023 – the first drop in five years. They fell from 1,207 to 1,122.
Noting that these numbers are still far too high, Dr. Nora Volkow, of the National Institute on Drug Abuse, and other health authorities have celebrated the drop in deaths and attributed it primarily to increased access to the opioid overdose reversal medication Narcan and to medications for opioid use disorder.
Mayor Cherelle Parker's administration has made a major push to address the drug crisis in Philadelphia, conducting regular sweeps in Kensington, creating a large recovery housing complex and establishing a fast-track court to steer people arrested for low-level drug crimes into treatment.
The housing complex, called the Riverview Wellness Village, has been making inroads, providing people coming out of inpatient treatment with stable housing, medical attention and case management. The "Wellness Court" has had less success, with eight of 87 people arrested between January and May 2025 completing the program, according to Kensington Voice.
The Philadelphia Department of Public Health did not immediately respond to an interview request for this story.
While local and national efforts to increase access to treatment and other services may help account for the drop in overdose deaths, questions have remained. The new paper seeks to answer them by pointing to the 2023 federal crackdown on China's exportation of fentanyl and chemicals needed to produce the synthetic opioid. In turn, fewer precursor chemicals made it hard for Mexican cartels to produce fentanyl, the paper says.
Moraff also suggested the U.S. arrest of two leaders of the Sinaloa cartel, the primary fentanyl trafficker into North America – and the subsequent chaos and violence – has further disrupted the supply chain and contributed to the fentanyl drought and the decline in overdose deaths.
"It's definitely put a new burden on corners here to get that product (fentanyl), which had replaced heroin because of its abundance and because of its ease of trafficking – it's now become somewhat scarce," Moraff said.
Bags of opioids his organization has been checking are made up of less than 1% to 7% of fentanyl, compared to twice that amount two years ago, he said.
In the meantime, the increasingly poly-substance makeup of Philadelphia's drug supply – and the heavy presence of medetomidine – has been challenging for medical providers as people come in with severe withdrawal symptoms.
The question, Moraff said, is what will happen next.
