In recent years, drugs normally used in veterinary applications have begun appearing in illicit street drugs throughout several parts of the United States and Canada. While xylazine, originally developed as a horse tranquilizer, has been making its rounds for several years, a new veterinary drug has appeared more recently: medetomidine.
Like other veterinary drugs, medetomidine poses serious health threats in humans using opioids and other illicit substances. Due to its powerful effects, it could also be responsible for recent and future overdoses.
What is medetomidine?
Medetomidine is commonly used in veterinary medicine as a sedative for dogs undergoing procedures and exams. The drug has pain-relieving properties and can slow a dog’s heart rate to keep them comfortable, calm, and still. Medetomidine for dogs is administered for teeth cleanings, removal of skin lesions, in-depth examinations and other routine procedures. Sold under the brand name Domitor®, medetomidine is a potent alpha-2 agonist, and can amplify the effects of opioids or accelerants.
Medetomidine in recreational drugs
The first reports of medetomidine occurred in 2022, when amounts of fentanyl and heroin were found mixed with the drug. Since then, medetomidine has increasingly appeared throughout the street drug supply throughout the U.S., with numerous hospitalizations taking place during late spring of 2024. Overdose outbreaks have also taken place in Chicago, and public health advisories have been issued in both Pennsylvania and Illinois.
Doctors in the affected areas first began to suspect a change in the formulation of certain street drugs when patients were being hospitalized with extremely low heart rates. Further lab tests confirmed the presence of the veterinary sedative.
Although the first detections of medetomidine were reported in 2022, its appearances were rare and in minimal amounts. Experts now say the drug is spreading rapidly and has been traced to numerous overdose outbreaks, including a recent spike in Toronto.
Why is medetomidine so dangerous?
Like other veterinary drugs, medetomidine isn’t normally intended for human use. The drug is sometimes used for human patients in specific formulations, but only in controlled medical environments and when administered by a trained medical provider.
Experts suspect that the drug may be more powerful than xylazine, also known as “tranq,” which first gained national attention in Philadelphia before spreading throughout the country. The purpose of mixing veterinary sedatives with opioids is to prolong their effects since fentanyl often wears off within several hours.
Medetomidine side effects
The dangers of medetomidine abuse are concerning because research about the drug’s effects on humans is so limited. Medical experts don’t know exactly how dangerous it may be.
Medical providers have narrowed down possible medetomidine side effects, which include:
- Prolonged sedation
- Low blood pressure
- Dangerously low heart rate (as low as 20 beats per minute)
- Hallucinations
- Risks of medetomidine overdoses
Aside from the potentially severe effects of the veterinary drug, medetomidine overdoses are also concerning because they cannot be reversed with naloxone, a medication used to reverse opioid overdoses. Like xylazine, medetomidine isn’t an opioid, so its effects can persist even after administering naloxone.
It’s often difficult for emergency responders and medical providers to determine the types of drugs that have been taken in an overdose incident. Many illicit drugs sold on the street are made with mixtures of various substances. Since most labs in hospitals don’t test for medetomidine in house, medical examiners often test for the drug postmortem when an opioid-suspected death occurs.
There is currently no approved antidote for medetomidine. Serious side effects may include:
- Suppressed breathing
- Coma
- Death (due to significant suppression of the central nervous system)
If a person survives a medetomidine overdose, the long-term effects remain largely unknown. Since the medication is similar to xylazine, it could bear similar effects, which include skin wounds and infections when injected. Medetomidine could also leave users more susceptible to abscesses, rashes, necrosis, and other serious skin issues like those seen in xylazine cases.
Addressing the risks of medetomidine
Another reason medetomidine is so dangerous is that people using other drugs, like heroin or fentanyl, don’t know the drugs have been laced with it. There are currently no test strips available to detect the presence of medetomidine.
However, people who use opioids can still minimize potential dangers in other ways, including using clean needles. Loved ones are also encouraged to help people using opioids by knowing where they can get help if needed and carrying naloxone to administer in the event of a suspected overdose. While it won’t reverse the effects of medetomidine or other veterinary drugs, experts still recommend providing overdose reversal medication.
Efforts to crack down on xylazine have already begun by law enforcement officials, but medetomidine remains a novel challenge. Although use and prescription of veterinary medications with the potential for misuse are overseen by the Drug Enforcement Agency and state controlled substance authorities, such drugs still make their way onto the streets due to issues like unethical practices by veterinary staff and illegitimate claims of animal illness by pet owners.
Addressing dependency on medetomidine
Regardless of their source or what they’re laced with, illicit drugs are dangerous and addictive. Help is available on your terms, free of judgment. Ophelia’s medication-assisted treatment (MAT) program helps manage cravings and prevent overdoses in people with opioid use disorder by providing access to Suboxone® and other buprenorphine-naloxone medications (important safety information). Our telehealth services are available in a growing number of states, and treatment is covered by many insurers, including Medicaid, as well as private pay options.
Not only does our clinical team provide direct care, but they also contribute to ongoing research that increases public awareness of modern opioid treatment options and the challenges that still exist among individuals seeking care.
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