Hidden Risks on Long Island: Fentanyl in Cocaine & Emerging Adulterants (Nassau & Suffolk)

Benjamin Zohar, NCACIP • November 8, 2025 • Last reviewed: November 8, 2025

Context: Big Busts vs. Real-World Exposure

Multi-agency operations across Long Island have seized significant quantities of fentanyl and other contraband. See media context: CBS New York coverage, ABC7NY report, NBC New York article. For what’s actually driving harm locally, rely on toxicology and public dashboards: NYS OASAS Overdose Death Dashboard, NYSDOH Opioid Data.

Framing note: Phrases like “enough to kill X people” are communication devices, not clinical dose-response guidance. For risk messaging, point to county/state dashboards and CDC toxicology (e.g., CDC SUDORS).

What Seizures Often Miss (But Families See in Autopsies)

Fentanyl in non-opioid supplies (esp. cocaine): Persistent reports show fentanyl turning up in stimulants and counterfeit tablets, driving unexpected opioid exposure among non-opioid users.
Xylazine (“tranq”): Veterinary sedative linked to prolonged sedation, respiratory depression, and difficult wound care; naloxone treats the opioid component but not xylazine itself. See OASAS guidance.
Nitazenes: Ultra-potent synthetic opioids appearing in powders and pressed pills. See the DEA nitazene overview.
Medetomidine: Potent sedative flagged in NY’s illicit supply; see OASAS advisory.

Local Signal Checks (Nassau & Suffolk)

Dashboards & ME abstracts: Use state dashboards (OASAS, NYSDOH) and county medical examiner updates to track substances in fatal/non-fatal overdoses.
Regional advisories: NYC Health Alert Network often posts timely advisories relevant to the metro region: NYC HAN.
Geo scope for outreach: Nassau (Hempstead, North Hempstead, Oyster Bay, Long Beach, Glen Cove) • Suffolk (Brookhaven, Islip, Babylon, Huntington, Smithtown, Riverhead, Southold, Southampton, East Hampton).

Actions for Teams (Harm Reduction, Clinical, Coordination)

Harm Reduction

Scale up naloxone distribution and training; plan for multiple doses with suspected fentanyl exposure.
Where lawful, distribute fentanyl test strips and xylazine testing tools; teach “test-dose,” never using alone, and using with someone who has naloxone.
Issue clear alerts on counterfeit tablets and fentanyl-in-cocaine, citing dashboards for credibility.

Clinical & Treatment

Screen for polysubstance exposure (opioid + sedative + stimulant). Anticipate prolonged sedation when xylazine/medetomidine is suspected.
Ensure rapid access to MOUD (buprenorphine/methadone), ED warm handoffs, and same-day starts; strengthen post-overdose follow-up.
Integrate wound care for xylazine-associated injuries; co-manage with infectious disease and surgical consults as indicated.

Community Coordination

Publish a monthly one-page “Local Drug Supply Snapshot” using OASAS/NYSDOH data; keep language neutral and data-driven.
Refresh resource maps (naloxone pick-up, low-barrier clinics, peer recovery) and share with schools, libraries, shelters, and first responders.

Free Long Island 22-Panel Urine Drug Test (Detects Fentanyl, Xylazine & Tianeptine)

Concerned about fentanyl in cocaine on Long Island? Families, outreach teams, and community partners in Nassau and Suffolk can request a free 22-panel urine drug test cup that screens for high-risk adulterants including fentanyl, xylazine, and tianeptine. Order from InterventionNY — 22-Panel Urine Drug Test Cup.

Long Island alert: Fentanyl-contaminated stimulant supplies (e.g., cocaine) continue to be reported. Home screening can inform when to seek medical care and confirmatory testing.

Key Panels & Cutoffs (approximate detection windows)

Fentanyl: 20 ng/mL (≈2–3 days)
Xylazine: 1000 ng/mL (up to ~96 hours)
Tianeptine: 500 ng/mL (up to ~72 hours)
Plus cocaine, benzodiazepines, oxycodone, methamphetamine, ketamine, kratom, EtG (alcohol), K2/Spice, Delta-8, and more (22 panels total).

Testing note: Windows vary by use pattern, dose, metabolism, hydration, and product specifics. These are immunoassay screening cutoffs. Reactive screens should be confirmed with a lab method (GC/MS or LC/MS). For legal/clinical purposes, follow New York regulations and chain-of-custody procedures.

Service areas: Nassau (Hempstead, North Hempstead, Oyster Bay, Long Beach, Glen Cove) • Suffolk (Brookhaven, Islip, Babylon, Huntington, Smithtown, Riverhead, Southold, Southampton, East Hampton).

Local FAQs

Is fentanyl being found in cocaine on Long Island?

Yes. Toxicology trends and local reports indicate ongoing risk of fentanyl contamination in non-opioid supplies, including cocaine, in Nassau and Suffolk counties. Consider screening and always carry naloxone.

Where can I get a free drug test in NY that detects fentanyl and xylazine?

InterventionNY offers a free 22-panel urine drug test cup that includes fentanyl and xylazine (plus tianeptine). Availability may vary. Request at this link.

Does naloxone work if xylazine is involved?

Naloxone reverses the opioid component (e.g., fentanyl) but not xylazine’s sedation. Still give naloxone, call 911, provide rescue breathing, and monitor for prolonged sedation.

About the Author

Benjamin Zohar, NCACIP — ISSUP member focusing on intervention services and community education.

Disclaimer: Educational content for professionals. Not legal, clinical, or toxicology advice.

Integrated Recovery & Intervention Education Network (IRIEN)