On July 10, 2025, first responders in Baltimore discovered numerous individuals simultaneously overdosing in the same neighborhood. Twenty-five people ages 25-55 were hospitalized, five in critical condition. There were no deaths. All victims had bought and used a neighborhood street sample of opioids, and testing revealed the drug mixture included fentanyl, N‑methylclonazepam (a benzodiazepine not approved in the United States), acetaminophen, mannitol, quinine, and caffeine. The benzodiazepine caused prolonged unconsciousness, even after naloxone was given.

Baltimore has one of the highest overdose rates of any city in the United States. One reason for this is that illicit drug manufacturers constantly add new substances, prolonging the drug’s effects, making users feel different or more powerful. Adding xylazine or medetomidine created the zombie drug crisis in Philadelphia. But combining opioids with benzodiazepines is dangerous because both drugs cause sedation, making it harder to breathe. In 2021, nearly 14 percent of fatal opioid overdoses in the United States involved benzodiazepines, according to the National Institute on Drug Abuse (NIDA). Most recently, fentanyl has been used with methamphetamine, the synthetic speedball, or cocaine, but more recently, Canadians have reported that their fentanyl has become contaminated with benzodiazepines. This synthetic benzodiazepine-laced opioid concoction is often called "benzodope." It poses amplified risks for people who use fentanyl.

While national overdose fatalities declined in 2024, fentanyl alone or in combination remains a leading cause of preventable death in young people. Over the past decade, drug overdoses among young people have surged, killing 230,000 people under 35 years old. Opioids, particularly fentanyl and other synthetics, are driving the high overdose death rate among adolescents and adults.

Julie Gaither, Ph.D., from the Yale School of Medicine, analyzed Centers for Disease Control and Prevention data on children and teens under 20. She found that 13,861 youths died from opioids from 1999-2021—about 37.5 percent of those deaths involved fentanyl. Teens ages 15-19 years made up 90 percent of the fentanyl deaths. In about 17 percent of cases, the child or

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