Tennessee Department of Health Reinforces Naloxone Importance Amid Cychlorphine Fatalities

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Published March 18th, 2026

Detected March 18th, 2026

Summary

The Tennessee Department of Health issued a notice reinforcing the importance of naloxone due to over 30 fatal overdoses linked to cychlorphine since October 2025. The notice provides information on recognizing opioid overdoses and administering naloxone, which is effective but may require repeat dosing.

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What changed

The Tennessee Department of Health (TDH) has issued a public health notice highlighting the critical role of naloxone in response to a rise in fatal overdoses associated with cychlorphine, a potent synthetic opioid. Since October 2025, over 30 overdose deaths in Tennessee have been linked to cychlorphine, which is reportedly 10 times more potent than fentanyl. The TDH is providing guidance on recognizing overdose symptoms, such as slowed or stopped breathing and unresponsiveness, and emphasizes that naloxone, while effective, may necessitate repeated administration.

Regulated entities and healthcare providers should be aware of this advisory and ensure appropriate protocols are in place for overdose response. The notice encourages individuals who use opioids, or are in contact with them, to carry naloxone. It also directs individuals to resources for obtaining naloxone and seeking substance use treatment. While this is a notice and not a binding regulation, it signals a heightened public health concern and underscores the importance of preparedness and access to overdose reversal medications within healthcare settings and communities.

What to do next

Review internal protocols for opioid overdose response.
Ensure availability and accessibility of naloxone where appropriate.
Educate staff on recognizing overdose symptoms and administering naloxone.

Source document (simplified)

TDH Reinforces Importance of Naloxone with Rise in Cychlorphine Fatalities

Wednesday, March 18, 2026 | 03:20pm NASHVILLE – The Tennessee Department of Health (TDH) is providing statewide information following more than 30 fatal overdoses statewide, since October 2025, associated with a newly identified opioid known as cychlorphine.

Cychlorphine is a synthetic opioid, 10 times more potent than fentanyl and associated with more than 1,633 fatal overdoses (TDH provisional data) in Tennessee in 2024.

Opioid overdoses should be suspected in situations when a person’s breathing slows or stops, they are unresponsive, or they have blue or purple fingernails and lips.

Naloxone, commonly known as the brand Narcan, is a medication that reverses opioid overdoses by restoring breathing. Naloxone is effective with cychlorphine, though it may require repeat dosing.

If an overdose is suspected:
• Call 911 immediately.
• Administer naloxone. Naloxone restores breathing. If the person resumes normal breathing, additional naloxone is not needed but continue to monitor.
• Provide rescue breaths. Supporting breathing is essential while naloxone takes effect. Rescue breathing provides immediate oxygen and can save a life.
• Repeat naloxone if needed. If the person does not respond or breathing slows again, administer another dose.

Carrying naloxone can be lifesaving. People who use opioids, have close friends or family members who do, or are likely to be in contact with someone who uses opioids, should consider carrying it. Naloxone can be obtained from Regional Prevention Specialists with the Tennessee Department of Mental Health and Substance Abuse Services or contacting one of Tennessee’s Local Health Departments.

If you or someone you know uses opioids or needs treatment for substance use, visit the Find Help Now website or call the l TN Redline at 1-800-889-9789. Contact Safe Spot at 800-972-0590, for 24/7 live support in an overdose crisis.

Learn more about TDH services and programs at tn.gov/health.