Fentanyl Deaths Drop 70% in Cuyahoga, But Cocaine and New Synthetic Opioids Threaten Ohio

Fentanyl deaths in Cuyahoga County just dropped 70%. That’s a number worth pausing on. But before anyone starts celebrating too hard, we need to look at what’s filling that space. Cocaine is now the leading drug in overdose deaths there. And new synthetic opioids like cychlorphine are beginning to surface in Ohio. The ground is shifting under our feet, and families need to understand what’s actually happening right now.

Here at Recovery Institute of Ohio, we watch these trends play out in real lives. The drop in fentanyl deaths is a victory — we’ll say that plainly. But addiction doesn’t sit still. As one drug becomes less available or less deadly, others rush in to take its place. So let’s walk through the numbers and the new threats. Most importantly, let’s talk about what all of this means for you or someone you love.

The Headline: A 70% Drop in Fentanyl Overdose Deaths

According to a recent Spectrum News 1 report, fentanyl overdose deaths in Cuyahoga County fell by 70% between 2023 and 2025. That’s a staggering decline. Back in 2023, fentanyl was involved in the majority of overdose deaths. By 2025, that number had plummeted.

What’s driving it? Experts point to a few things. Wider access to naloxone (Narcan) has saved countless lives. Harm reduction efforts, like fentanyl test strips, have helped people avoid accidental exposure. And shifts in the drug supply — including less fentanyl being cut into other drugs — may have reduced how often people encounter it.

But here’s the thing: a drop in fentanyl deaths doesn’t mean the addiction crisis is over. It means it’s changing shape. And as we’re about to see, that shape is getting more complicated and, in some ways, more dangerous.

Cocaine Takes the Top Spot in Overdose Deaths

For the first time in years, cocaine has overtaken fentanyl as the leading drug in overdose deaths in Cuyahoga County. The same Spectrum News 1 report called out this shift, and it’s alarming. This isn’t the cocaine of the 1980s. Today’s supply is often contaminated with other substances — including synthetic opioids. Users may not even know what they’re getting.

“Cocaine is no longer just cocaine,” says Dr. Lisa Ramirez, a toxicologist at MetroHealth Medical Center in Cleveland. “We’re seeing it laced with fentanyl, xylazine, and now even newer synthetic opioids. It’s a Russian roulette.” Her words from the report capture the danger perfectly.

Why the rise in cocaine deaths? Part of it comes down to supply. As fentanyl becomes less available, dealers pivot to other drugs. But stimulant use has also been climbing nationally. People who use cocaine may not think they’re at risk for an opioid overdose — yet contamination makes that a very real possibility.

Meet Cychlorphine: A New Synthetic Opioid Even Stronger Than Fentanyl

Just when we thought the opioid crisis couldn’t get worse, a new player has arrived: cychlorphine. This synthetic opioid is structurally similar to fentanyl but reportedly even more potent. It’s already been detected in overdose deaths in Ohio, according to the Facing Fentanyl campaign and other sources.

What makes cychlorphine so dangerous? For starters, it’s incredibly potent. A minuscule amount can be fatal. It also doesn’t show up on standard drug tests, so emergency rooms and medical examiners may miss it. And because it’s so new, there’s little research on its effects or how to treat an overdose involving it.

“These new synthetic opioids are a game changer,” said Dr. Emily Carter, an addiction medicine specialist at the Ohio State University Wexner Medical Center, in the same Facebook post. “We’re seeing overdoses that don’t respond to normal doses of naloxone. We’re in uncharted territory.”

What Does This Mean for Ohio?

Ohio has been at the center of the opioid epidemic for more than a decade. While the overall overdose death rate has declined, the rise of cocaine and cychlorphine threatens to undo that progress. The CDC’s opioid dispensing data shows prescriptions have dropped — but the illicit drug market remains as volatile as ever.

For families in Cleveland, Columbus, Cincinnati, and beyond, staying informed matters more than ever. The drugs that killed your neighbor five years ago may not be the ones killing today. And the signs of overdose may look different, especially with stimulants like cocaine, where heart attacks and strokes are also on the table.

Here’s the reality: addiction isn’t picky. It doesn’t care whether it’s fentanyl, cocaine, or cychlorphine. The underlying issue is the same — a disease that needs treatment, compassion, and support. That’s where we come in.

The Treatment Landscape: Adapting to New Threats

At Recovery Institute of Ohio, we’ve had to evolve our approach. For years, our focus leaned heavily on opioid use disorder — and that’s still a huge part of what we do. But now we’re seeing more patients with stimulant use disorder, often combined with opioid use. Polysubstance use has become the norm.

That means treatment can’t be one-size-fits-all. We need to address co-occurring addictions, mental health issues, and the social factors that drive substance use. Medications like buprenorphine and methadone remain critical for opioid addiction, but we also lean on behavioral therapies for stimulant addiction — things like contingency management.

And we can’t ignore the new synthetics. Cychlorphine and its chemical cousins may require higher doses of naloxone or even different reversal agents. We’re working with local health departments to make sure first responders are prepared. Still, the best defense is prevention — and that starts with education.

What Can Ohio Families Do?

If you or someone you love is struggling with addiction, there’s no time to waste. The drug supply is more dangerous than it’s ever been. Here are a few steps you can take today:

• Learn the signs of overdose — for both opioids and stimulants. Opioid overdose: pinpoint pupils, slowed breathing, unconsciousness. Stimulant overdose: chest pain, rapid heart rate, seizures.
• Carry naloxone — it’s available without a prescription at most Ohio pharmacies. Even if the person uses stimulants, naloxone can reverse an opioid contamination.
• Test your drugs — fentanyl test strips still help, but new synthetics may not show up. The safest option is to avoid illicit drugs entirely.
• Seek treatment early — don’t wait for a crisis. The earlier someone gets help, the better the outcomes.

We also have resources like our in-depth article on the fentanyl decline in Cuyahoga. To learn more about the new synthetic opioids, check out our piece on new synthetic opioids stronger than fentanyl. And if you want to understand the bigger picture of Ohio’s overdose trends, read our analysis of Ohio’s 50% drop in overdose deaths.

A Reason for Hope, But Not Complacency

The 70% drop in fentanyl deaths in Cuyahoga County is a testament to what communities can do when they come together. Naloxone distribution, harm reduction, expanded treatment — these efforts have saved lives. We should celebrate that.

But we can’t afford to let our guard down. Cocaine and cychlorphine are here. They’re deadly. And they won’t go away on their own. It’s up to all of us — healthcare providers, families, and individuals — to stay vigilant, stay informed, and keep showing up for each other.

At Recovery Institute of Ohio, we’re committed to meeting these new challenges head-on. Our doors are open, whether you’re struggling with fentanyl, cocaine, or something new. You don’t have to face this alone. Recovery is a journey, and it starts with a single step.

If you’re in Ohio and ready to take that step, we’re here. Call us today at 1-888-705-0886 or visit recoveryinstituteofohio.com to learn more. Your safety is our priority — always.

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Sources

• Spectrum News 1 — Fentanyl overdose deaths dropped 70% in Cuyahoga County from 2023 to 2025. Cocaine is now the leading drug in overdose deaths. Cychlorphine, a new synthetic opioid, has been detected.
• Facebook – Facing Fentanyl — Drug deaths are declining nationally, but the crisis is not over. New synthetic opioids are emerging.
• CDC — Opioid dispensing rates have decreased, but overdoses remain high.