In Tennessee, data pins Knox County as the hotspot for emerging synthetic opioids known as nitazenes —compounds estimated to be 10 to 40 times stronger than fentanyl , now appearing in the illicit drug supply across the United States.

Yet, according to Chris Thomas, Chief Administrative Officer at the Knox County Regional Forensic Center, Tennessee’s overdose map is more reflective of where testing is happening, not necessarily where people are dying. “It’s not that Knox County is definitely the hardest-hit spot of the epidemic,” he explains. “Other counties simply don’t have the resources to test for drugs like nitazenes or other novel synthetics. They only have the funding to run basic panels.”

That chilling insight exposes a national blind spot. Across the country, medical examine

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