The Centers for Disease Control and Prevention (CDC) and the Office of National Drug Control Policy (ONDCP) issued a Health Advisory to notify public health professionals, clinicians, laboratorians, and people at risk for overdose about increasing reports of medetomidine in the illegal drug supply and a severe withdrawal syndrome due to medetomidine exposure.

The details:

• Medetomidine (aka rhino tranq, mede, or dex) has been increasingly detected in law enforcement drug seizures, drug product and paraphernalia samples, and in wastewater samples, with the highest concentrations in the Northeast.
• Testing suggests that the medetomidine found in the illicit drug supply is synthesized in clandestine labs (as opposed to diverted from medical or veterinary supplies).
• Fentanyl is involved in most overdoses involving medetomidine.

Why it’s important:

• Medetomidine can cause profound sedation, bradycardia, and hypotension.
• Stopping medetomidine following regular use may lead to severe withdrawal, similar to clonidine withdrawal, with symptoms including hypertension, anxiety, nausea, vomiting, and fluctuating alertness, that can require emergency or intensive care.

Next steps: Clinicians and public health and public safety agencies should monitor/track the drug supply and medetomidine-related intoxication and withdrawal symptoms.