Public health officials are warning the public about a deadly combination of drugs hitting the streets, leading to a surge in overdoses and fatalities. This lethal formula involves the veterinary tranquilizer medetomidine, which, like xylazine and other contaminants, is now being secretly mixed with substances like fentanyl, heroin, and others, contributing to a growing public health crisis.

The Emergence of Medetomidine

Medetomidine, primarily used as a tranquilizer for animals, has found its way into illicit drug markets, posing significant risks to human health. Despite being approved only for veterinary use, its close chemical relative, dexmedetomidine, is sanctioned for human anesthesia and pain management. The indiscriminate mixing of these compounds, as found in street drugs, presents grave dangers to unsuspecting users.

Dr. Brendan Hart at Temple University in Philadelphia first began hearing reports of street drug users overdosing on fentanyl and medetomidine in April. “Some of our emergency medicine doctors started stopping me in the hallway,” Hart told NPR.

“They said, ‘Something funny is going on with the overdoses.’ Patients were coming in with very low heart rates. As low as in the 20s. A normal heart rate is sixty to a hundred [beats per minute], so 20s is extremely low.”

Reports Across Major U.S. Cities

The crisis has manifested in multiple cities across the United States, with notable incidents reported in Philadelphia, Chicago, and Pittsburgh. In Philadelphia alone, over 160 hospitalizations were recorded within a 3-4 day period, signaling the severity of the issue. Similar patterns emerged in Chicago, where a spike in overdoses was linked to elevated levels of medetomidine in drug samples.

The presence of medetomidine underscores the complexity of the illicit drug supply chain, where substances frequently contain adulterants meant to maximize profits. With no reliable means of identifying these contaminants, users face heightened risks of overdose and other adverse health effects.

The combination of medetomidine with opioids like fentanyl amplifies the potency and lethality of street drugs, exacerbating the crisis.

Symptoms of Medetomidine Use in Humans

Medetomidine, a potent veterinary tranquilizer, poses significant risks when consumed by humans. The symptoms of medetomidine overdose mirror those of opioid toxicity, including dangerously low heart rates and respiratory depression.

Unlike opioids, however, naloxone, the standard antidote for opioid overdoses, is ineffective against medetomidine. The drug poses significant challenges for first responders and healthcare providers, who must rely on CPR and other treatment methods to stabilize an overdose patient.

Although not approved for human use, its presence in illicit drugs can cause dangerous health consequences, including:

  • Low Heart Rate (Bradycardia): Medetomidine slows the heart rate to dangerously low levels, often resulting in bradycardia. Intoxicated people may experience heart rates well below the normal range of 60 to 100 beats per minute, with some cases dropping into the 20s, posing a life-threatening risk.
  • Low Blood Pressure (Hypotension): The sedative effects of medetomidine can also lead to a drop in blood pressure. This exacerbates the risk of cardiovascular complications and organ damage, especially for people with pre-existing cardiovascular conditions.
  • Respiratory Depression: Medetomidine can suppress respiratory function, leading to respiratory depression. This effect is compounded when medetomidine is combined with other sedatives or opioids, increasing the likelihood of respiratory failure and death.
  • Central Nervous System Depression: The tranquilizing properties of medetomidine extend to the central nervous system, resulting in depression of neurological functions. This depression causes drowsiness, lethargy, confusion, and impaired coordination.
  • Pupil Constriction: Similar to opioid intoxication, medetomidine use can cause pupil constriction or miosis. Constricted pupils are a common sign of central nervous system depression and may indicate opioid or sedative ingestion.
  • Other Symptoms: Other symptoms of medetomidine overdose may include nausea, vomiting, dizziness, and disorientation. In severe cases, coma and death may occur due to profound central nervous system depression and cardiovascular collapse.

The effects of medetomidine can vary depending on factors such as dosage, route of administration, concurrent drug use, and underlying health conditions. People on certain medications that affect the central nervous system are at a high risk for overdose.

Prompt medical attention is essential for people experiencing symptoms of medetomidine intoxication to prevent severe complications and fatalities.

Looking Ahead: Urgent Action and Prevention Needed

As public health agencies grapple with the escalating crisis, urgent action is needed to curb the spread of medetomidine-contaminated drugs. Heightened surveillance, targeted interventions, and enhanced public awareness are essential components of a comprehensive response.

Because harm reduction methods such as Naloxone are ineffective, prevention will largely hinge on education efforts. Currently, there are no testing methods or strips for drug users, either.

The emergence of medetomidine in the illicit drug supply represents a grave threat to public health and is just the latest dangerous substance to contaminate street drug supplies. Xylazine, for example, has been circulating among the opioid and illicit fentanyl supply. Before that, fentanyl itself was the culprit. The DEA has said that they find fentanyl in over 40% of the counterfeit pills they seize.