Drugs cut with Medetomidine

Medetomidine in Illicit Drugs

Public health officials have recently begun to sound the alarm about a new street drug that may be responsible for overdose surges in a few large U.S. cities. This drug, medetomidine, is typically added to fentanyl and other illicit recreational substances during the manufacturing process. This means that many people who are harmed by it may not even know that they’ve taken it.

What is Medetomidine?

Medetomidine is a veterinary sedative and anesthetic. In the U.S., it has earned approval from the Food and Drug Administration (FDA) to sedate dogs for certain procedures. 

The FDA has also approved a version of medetomidine called dexmedetomidine. This is authorized to be used on human patients who need to be sedated while on a mechanical ventilator or prior to surgery. 

Medetomidine can be both safe and beneficial when it is administered by qualified professionals for legitimate medical purposes. Unfortunately, as we will discuss in greater detail later in this post, illicit drug manufacturers have begun to add medetomidine to some recreational substances, particularly opioids.  

A synthetic drug that is classified as an alpha-2 agonist, medetomidine is similar to xylazine, another drug that has recently been linked to a spike in overdose deaths. However, public health officials have emphasized that medetomidine is more potent than xylazine. This increases the risk faced by individuals who intentionally or unintentionally abuse it for recreational purposes.

Illicit Drugs Laced with Medetomidine

Fentanyl and heroin appear to be the two illicit drugs that are most likely to be contaminated with medetomidine. Some sources have also detected medetomidine in samples of cocaine. However, this doesn’t seem to be nearly as common as opioid and medetomidine combos.

When abused on their own, fentanyl, heroin, and cocaine can all put people at risk for serious negative outcomes, including overdose and death. When they are combined with medetomidine, they can become much more dangerous. This danger may be magnified by the fact that most people don’t realize that the drug they’re taking contains this undisclosed ingredient. 

In a June 3, 2024, CBS News segment, an employee of the Philadelphia Department of Health said that the department detected medetomidine in samples of street drugs that also contained fentanyl and xylazine. 

The combination of fentanyl and xylazine is often referred to as “tranq.” According to one source in the CBS News segment, some people are referring to the fentanyl-xylazine-medetomidine combination as “rhino tranq.” However, another experts have said that they had not heard that term.

Regardless of what they are called, the recent surge in illicit street drugs that have been combined with medetomidine suggests that the nation may be on the verge of another devastating increase in overdose deaths.

Dangers of Medetomidine

A June 2, 2024, feature on National Public Radio (NPR) reported that medetomidine was involved in “mass overdose outbreaks” in Chicago and Philadelphia during the previous two months. In Philadelphia, according to the NPR feature, medetomidine-related overdoses caused 160 hospitalizations over a four-day period.

In addition to the risk of overdose, someone who takes medetomidine in a non-medical setting may also be in danger for a variety of other problematic outcomes, including:

  • Slowed heart rate and breathing
  • Low body temperature
  • Dangerously low blood pressure
  • Elevated blood glucose level
  • Excessive urination
  • Vomiting and diarrhea
  • Twitching
  • Easing of anxiety
  • Hallucinations
  • Delusions
  • Paranoia

How to Help Somone Who Is Overdosing on Medetomidine

Common signs of medetomidine overdose include:

  • Constricted (pinpoint) pupils
  • Extremely slow or shallow breathing
  • Faint pulse
  • Disorientation
  • Difficulty remaining awake
  • Loss of consciousness
  • Cool, clammy skin
  • Blue or purple color near lips or fingertips

Anyone who exhibits these signs after using medetomidine or another drug needs immediate medical help. If you are with someone who is in the midst of a medetomidine overdose, take the following steps:

  1. Call 911 or otherwise summon the closest emergency responder in your area.
  2. If you have naltrexone (Narcan), administer it to the person who has overdosed.
  3. If the individual is awake, help them into a seated position in a comfortable chair.
  4. If the individual is unconscious and cannot be awakened, place them on their side. Do not put them on their back (to reduce the risk of choking if they begin to vomit).
  5. Cover the person with a blanket to keep them warm.
  6. Remain with the person until the emergency responders arrive.
  7. Be prepared to tell the emergency responders as much as you know about what substances the person took, how much they took, and what overdose signs they exhibited.

Also, here are a few important notes about naltrexone (Narcan): 

  • Though Narcan can reverse the effects of an opioid overdose if it is administered in time, it cannot reverse the effects of a xylazine or medetomidine overdose.
  • Since people who ingest medetomidine have usually taken it in combination with an opioid, most trusted sources advise giving Narcan to someone who has overdosed. 
  • However, even though the person may appear to be revived and out of danger after receiving Narcan, any medetomidine in their system may still be harmful to them. 
  • This is why you should always call 911 first, even if you have Narcan with you. A person who has overdosed on an opioid combined with medetomidine needs to be thoroughly assessed by a qualified healthcare provider, even if they appear to be OK after receiving Narcan.

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