Deadly Pills, Hidden Danger

Christina Lacourte kept two doses of Narcan in her kitchen, prepared for an emergency she desperately hoped would never come. On April 7, she found her 16-year-old son, Dante, unresponsive in his San Francisco bedroom. She administered the overdose-reversal medication, but he could not be revived, according to her account in The New York Times.

“It just takes one pill,” she told the newspaper she had repeatedly warned him.

Dante’s death has brought a troubling name into public view: cychlorphine, an emerging synthetic opioid detected in counterfeit medications. According to San Francisco police, the medical examiner determined that he died from a combination of drugs that included cychlorphine.

The investigation led officers to three San Francisco residences on September 8 and 9. Four suspects were arrested, and police reported seizing more than 20,000 pills, other drugs and firearms, including a semiautomatic assault rifle.

One crucial question remained unanswered in the department’s September 14 announcement: whether the pills seized during those raids contained cychlorphine. Testing was underway with federal assistance. Counterfeit pills from earlier investigations had tested positive. The arrests also did not establish who supplied the drugs responsible for Dante’s death.

For families, the danger lies in the gap between what a pill appears to be and what it contains.

The United Nations Office on Drugs and Crime reports that cychlorphine has appeared in counterfeit products resembling Xanax, Percocet and other prescription medications. Laboratory and animal research indicates potency exceeding fentanyl, with potentially profound suppression of breathing. Claims that it is “10 to 100 times stronger,” however, should not be treated as an established measure of its effects in people.

Ordinary fentanyl test strips are not expected to detect cychlorphine. A negative result therefore cannot establish that a pill is safe.

The threat also extends beyond San Francisco. By May, the U.N. agency reported detections in 10 countries and 78 fatal overdose cases involving the substance, often alongside other drugs. Those figures describe reported cases, not a complete worldwide death toll.

San Francisco District Attorney Brooke Jenkins has urged California lawmakers to explicitly add cychlorphine to the state’s controlled-substance list. The four suspects nevertheless face narcotics and firearms charges arising from the investigation. The allegations remain subject to court proceedings.

Prevention starts with a clear conversation: pills purchased from dealers or through social media cannot be trusted to contain the advertised medication. Families can keep naloxone accessible, learn to use it and seek professional help when a young person is struggling with substance use, anxiety or depression.

A young person seeking relief needs somewhere safe to turn. Parents can start by listening without judgment and arranging an assessment with a qualified health professional.

Recognizing an overdose is equally urgent. An inability to wake someone, slow or absent breathing, choking or gurgling sounds, and discolored lips or nails can signal an opioid overdose. Call 911 immediately and give naloxone if available. Do not assume the person can sleep it off.

For Narcan nasal spray, administer another dose with a new device every two to three minutes if the person does not respond or symptoms return. Follow the dispatcher’s instructions for rescue breathing or CPR. Once the person is breathing normally, place them on their side to help prevent choking.

Stay until emergency personnel arrives—even if the person wakes up. Overdose symptoms can return after naloxone wears off. The medication remains a potentially lifesaving response; needing repeated doses is not a reason to withhold it.

For Coachella Valley families, Riverside University Health System’s CARES Line, 800-499-3008, provides access to behavioral health services, including substance use services. A parent or teenager can ask for an assessment and guidance before an emergency occurs.

CDC emergency guidance