In the six months since a cychlorphine death in Oct. 2025 in South Knoxville, at least 50 fatal overdoses involving cychlorphine have been confirmed in the greater Knoxville area. The largely unknown compound is on track to be the third-most-common drug involved in the region’s fatal overdoses this year, after fentanyl and methamphetamine.

Over that period, Knoxville became a national hot spot for cychlorphine. But if it were not for Dr. Mileusnic’s [chief medical examiner for the greater Knoxville area] tenacity, the community would most likely not even know the drug was circulating.