The Fentanyl Crisis in South Jersey

Fentanyl has fundamentally changed the drug supply in South Jersey — and across New Jersey. It is now present in the vast majority of street opioids, is increasingly found mixed into cocaine and counterfeit pills, and is responsible for the majority of overdose deaths in Camden County and statewide. Understanding what fentanyl is, why it is so deadly, and what can be done about it is critical for anyone in South Jersey who is concerned about a loved one or their own substance use.

What Makes Fentanyl Uniquely Deadly

Fentanyl is a synthetic opioid originally developed for cancer pain management and anesthesia. Pharmaceutical fentanyl, used in controlled medical settings, is precisely dosed and carefully monitored. Illicitly manufactured fentanyl — which now dominates the street drug supply in South Jersey — is none of those things.

Extreme Potency

Fentanyl is 50 to 100 times more potent than morphine and approximately 50 times more potent than heroin. A lethal dose is measured in micrograms — thousandths of a milligram. This means a quantity that is visually indistinguishable from a few grains of salt can be fatal.

Rapid Onset

Fentanyl acts extremely quickly — often within minutes of injection or inhalation. When someone overdoses on fentanyl, they may lose consciousness and stop breathing before they can call for help or before anyone nearby has time to respond. This is why "never use alone" is the most critical harm reduction message for anyone at risk.

Invisible Contamination

Most people who have overdosed on fentanyl did not know they were taking fentanyl. Street heroin, pressed counterfeit pills, and even cocaine in South Jersey are routinely found to contain fentanyl — often without the user's knowledge. The person who has used a particular drug safely for months or years may encounter a batch with a lethal fentanyl concentration.

Uneven Mixing ("Hot Spots")

Because fentanyl is so potent, even when it is mixed into another drug, it may not distribute evenly. A batch of pressed pills or powder may contain pockets of higher fentanyl concentration — "hot spots" — that make dosing completely unpredictable even within the same batch.

Fentanyl and Camden County: The Local Picture

Camden County recorded 206 suspected overdose deaths in 2024 — down 37% from 327 in 2023 in a historic reduction. The vast majority of these deaths involved fentanyl. Camden County still ranks second-highest among all 21 NJ counties for overdose deaths, a position driven in large part by fentanyl's penetration of the local drug supply.

The 37% decline is real and significant. It reflects expanded naloxone access, increased MAT uptake, and coordinated harm reduction efforts by Camden County OMHA, Cooper University Health Care's harm reduction network, and local providers including Hope Harbor Addiction Center. But 206 deaths in a single year in a single county is still a crisis — not a success story.

Source: NJ OCSME / Camden County Prosecutor's Office, February 2025. camdencounty.com

Xylazine: The "Tranq" Crisis Within the Fentanyl Crisis

Xylazine is a veterinary sedative — a large-animal tranquilizer — that has found its way into illicit fentanyl in the Northeast United States, including New Jersey. Dealers mix it into fentanyl because it extends the duration of the high and reduces their cost per dose. But it introduces serious new dangers:

• Narcan does not reverse xylazine: Xylazine is not an opioid. Naloxone works on opioid receptors — it has no effect on xylazine's sedative effects. You should still give Narcan to reverse the opioid component of fentanyl/xylazine, but additional doses may be needed and 911 must be called regardless.
• Severe wound formation: Xylazine causes necrotic skin wounds — open, difficult-to-heal sores — at injection sites and sometimes even at non-injection sites due to vasoconstriction. These wounds can become severely infected and require specialized wound care.
• Prolonged sedation: Because xylazine's effects outlast naloxone, a person who appears to revive after Narcan may re-enter sedation. Never leave a person alone after a suspected overdose, even if they appear to be recovering.

New Jersey began distributing xylazine test strips at Harm Reduction Centers in January 2024. Knowing whether your drug supply contains xylazine is now part of harm reduction in South Jersey. For more information, see: Xylazine in the New Jersey Drug Supply.

What You Can Do Right Now

Carry Naloxone (Narcan)

Free Narcan is available at more than 650 New Jersey pharmacies through the Naloxone365 program — no prescription required for those 14 and older. Visit naloxone365.nj.gov to find your nearest pharmacy. Learn how to use it: Free Narcan in NJ — a complete guide.

Use Fentanyl Test Strips

Fentanyl test strips are legal in New Jersey and available at NJ Harm Reduction Centers and some pharmacies. They can detect fentanyl in a drug sample before use. However, no test strip detects all fentanyl analogs — a negative result does not guarantee safety. Learn more: Fentanyl Test Strips in New Jersey.

Never Use Alone

If fentanyl is present, an overdose can render someone unconscious in minutes. Having another person present who knows how to respond — and has Narcan — is the single most protective behavior change available.

Consider Treatment

Medication-Assisted Treatment (MAT) with buprenorphine (Suboxone) dramatically reduces overdose mortality — studies show 50% or greater reduction in overdose risk. If you or someone you love is using opioids in an environment where fentanyl is present, treatment is available and effective. See: Fentanyl addiction treatment in Cherry Hill, NJ and Xylazine addiction treatment in South Jersey.