A new sedative used in veterinary medicine is showing up in street drugs, leading to severe health complications and frequent intensive care unit admissions, local emergency physicians warn.
Medetomidine is the latest drug to be found mixed into opioids sold on the street.
“Almost never would we have to admit or hospitalize someone for the treatment of opioid withdrawal prior to October 2024,” said Dr. Simon Ostrowski, an emergency medicine physician with UPMC. “Since then, we are regularly hospitalizing people for opioid withdrawal treatment — and not just hospitalizing them, but in the intensive care unit.”
UPMC is currently admitting multiple patients to the ICU daily as a result of withdrawal symptoms. Physicians note that Narcan, a common opioid overdose reversal medication, is largely ineffective against the sedative — similar to the challenges faced with xylazine.
“It’s very difficult to reverse,” said Dr. Brent Rau, ER medical director at Allegheny General Hospital. “Like in the case of xylazine there were severe skin reactions, severe wounds that can develop, that can cause amputations and other issues. It does feel like every year it’s something new.”
There is currently no rapid test available in hospitals to detect medetomidine, which makes diagnosis and treatment more challenging. Healthcare providers are relying on clinical symptoms to identify patients exposed to the drug.
The effects of medetomidine withdrawal can be life-threatening.
“We had at least one person in the number of patients in our study who experienced cardiac arrest and briefly died because of this withdrawal,” Ostrowski said. “A lot of people are showing damage to their heart based on bloodwork.”
Doctors emphasize the importance of early intervention and medical care. In some cases, a related compound used in critical care settings is being administered to help manage withdrawal symptoms.
Rau said the reality for people using street drugs is dire.
“All of these drugs taken recreationally are extremely concerning,” he said. “At the end of the day, they are all going to affect your ability to breathe effectively. Patients that are buying illegal drugs on the street aren’t realizing they are mixed in with numerous other things — and there may be someone thinking they are taking heroin, and it’s heroin, fentanyl, xylazine, and medetomidine.”
Physicians are urging people who use illegal drugs to ask questions, understand the risks, and seek immediate medical attention if they feel unwell.
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