New York drug overdose deaths and death rates are on the decline, but with significant disparities and the current, toxic drug supply is partially to blame. Harmful additives like fentanyl analogues, xylazine and medetomidine, among others, have been found in cocaine, heroin, MDMA and pressed into pills. Additives are undetectable by sight, taste and smell which increases the risk of overdose for people who use and may not be aware of what’s in their drug supply. This episode features Drs. Sharon Stancliff and Jennifer Love discussing additives commonly found in the New York State supply, including BTMPS, fentanyl analogues, medetomidine, nitazenes and an updates on xylazine. Related Content:  New York State Department of Health AIDS Institute Clinical Guidelines Program for Substance Use Care: https://www.suguidelinesnys.org/ New York State Department of Health Drug Checking Program: https://www.health.ny.gov/diseases/aids/consumers/prevention/oduh/drug_checking.htm New York City Department of Health Drug Checking Program: https://www.nyc.gov/site/doh/health/health-topics/alcohol-and-drug-use-services.page New York City Department of Health. Setting Up a Drug-checking Program: A Comprehensive Guide to Implementation. https://www.nyc.gov/assets/doh/downloads/pdf/basas/drug-checking-program-implementation-guide.pdf https://legislativeanalysis.org/wp-content/uploads/2025/03/BTMPS-Fact-Sheet-FINAL.pdf Friedman, JR, et al. (2025) The detection of xylazine in Tijuana, Mexico: Triangulating drug checking and clinical urine testing data. J Addict Med. doi: 10.1097/ADM.0000000000001474 Krotulski, AJ, et al. (2024) Medetomidine Rapidly Proliferating Across USA — Implicated In Recreational Opioid Drug Supply & Causing Overdose Outbreaks, Center for Forensic Science Research and Education, United States. Available from https://www.cfsre.org/images/content/reports/public_alerts/Public_Alert_Medetomidine_052024.pdf New York Medication for Addiction Treatment and Electronic Referrals (MATTERS) Program. Request test strips (for xylazine and fentanyl). Available from: https://mattersnetwork.org/request-test-strips/ New York State Office of Addiction Services and Supports (OASAS). Harm Reduction Delivered (online order for xylazine and fentanyl test strips). Available from: https://oasas.ny.gov/harm-reduction-delivered NEXT Distro. Ordering Supplies (for safer drug use). Available from: https://docs.google.com/forms/d/e/1FAIpQLSe-q8tfEZXfdhbIF9DPpN9--BeEYoYdxU1Iw0x4BZBLIktGqQ/viewform CEI Clinical Consultation Line 1-866-637-2342 A toll-free service for NYS clinicians offering real-time clinical consultations with specialists on HIV, sexual health, hepatitis C, and drug user health. ceitraining.org