BTMPS has been detected in all regions across the United States, demonstrating vast prevalence. BTMPS has appeared in more than 600 drug materials tested by our laboratory. Tetramethyl-4-piperidinol (TMP) was first detected in August 2024 and since has appeared in more than 20 drug materials. Tetramethyl-4-AP (TM-4-AP) and tetramethylnorfentanyl (TMNF) were first detected in April 2025 and since have appeared in more than ten drug materials, often together. To date, a substance suspected of being tetramethylfentanyl (TMF) has been identified in only small (or trace) amounts alongside these other related substances; however, confirmation of this substance is pending acquisition of standard reference material.
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