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    Medetomidine is a drug used mainly by veterinarians to calm and relieve pain in animals during surgeries and medical procedures. It works by affecting certain chemicals in the brain that help control alertness and pain. Even though medetomidine is made for animals, it can be dangerous if people use it.

    What is medetomidine?

    First detected in the drug supply in 2022, amounts of fentanyl and heroin laced with medetomidine appears to be spreading across the country.  Mass overdose outbreaks have been reported in Philadelphia, Pittsburgh and Chicago, although more recent news reports suggest that the Pittsburgh claims may have been made in error.[1]

    Medetomidine is more potent than xylazine, another veterinary medicine found in the illicit drug supply. When combined with opioids, its effects can last 2-3 hours or longer. Its use can cause:

    • Sedation or sleepiness
    • Pain relief
    • Muscle relaxation
    • Low heartbeat (as low as 20 beats per minute)
    • Low blood pressure
    • Hallucinations (seeing or hearing things that aren’t real)

    Why is it so dangerous?

    Taking too much medetomidine can be very dangerous. An overdose can cause extreme sleepiness, very low blood pressure, slow heart rate, trouble breathing and even coma or death. This is because the drug can severely slow down the body’s central nervous system and heart.

    One major result of medetomidine overdose is respiratory depression, which occurs when breathing slows down too much. This can lead to not getting enough oxygen and potentially stop breathing altogether. The drug can also slow the heart and lower blood pressure so much that vital organs don’t get enough blood and oxygen.

    The longer-term effects of using this drug are largely unknown. Although medetomidine is similar in effect to xylazine, it’s unclear as to whether it can cause the same kinds of wounds experienced with xylazine.

    How can I protect my loved one?

    If someone overdoses on medetomidine, it’s important to get medical help right away and administer naloxone (Narcan). While naloxone will not reverse the effects of medetomidine, it can help with any opioids in a person’s system. Rescue breathing is also needed until breathing is restored at a minimum of one breath every 60 seconds. Medical providers will make sure the person can breathe properly, with the use of oxygen if needed, and help return heart functioning to normal.[2]

    Loved ones who use opioids regularly may not be aware that medetomidine is in the drug supply. Although there are no test strips available to check for the presence of medetomidine, they can take other measures to increase safety. These include using clean, sterile needles, fentanyl and xylazine test strips, and starting with a test shot. If using alone, the Brave app or the Never Use Alone service can help ensure emergency response for an overdose is available if needed.

    It can be terrifying to know that your loved one might be at risk of ingesting substances like medetomidine without knowing it. We’re here to help. If you are concerned about their substance use and aren’t sure what to do next, contact our support services here.