The era of “tranq” may be ending, but for many drug users in the US, a new danger has emerged: medetomidine, a sedative that’s becoming increasingly common in illicit substances. As cities like Philadelphia and Pittsburgh report cases of medetomidine-involved overdoses, health officials are sounding the alarm.
Medetomidine, an alpha-2 agonist, is being used to treat pain, ADHD, and other conditions, but its presence in the illicit drug supply has raised concerns. Unlike xylazine, which was previously used as a “cutting agent” for fentanyl, medetomidine’s proliferation has made it more accessible to users.
Physicians warn that medetomidine withdrawal symptoms can be severe and life-threatening, with low heart rates and profound sedation. The substance doesn’t respond to naloxone, making overdose treatment more complicated.
While some see a silver lining in the fact that medetomidine hasn’t been linked to deep skin wounds like xylazine, others are sounding the alarm. “Xylazine and dex are inherently different,” said University of North Carolina researcher Dasgupta. “They look almost identical, but they have very different properties.”
As the US overdose epidemic continues to evolve, health officials and researchers are working together to respond to this new threat. A recent online forum brought together experts to discuss treatment strategies for medetomidine withdrawal.
Despite the challenges, some companies have begun offering test strips to detect medetomidine in illicit substances. With its powerful sedative properties, medetomidine poses a significant risk to users, and health officials urge caution as this new substance takes hold in the US drug supply.
Source: https://www.statnews.com/2025/05/01/medetomidine-replacing-xylazine-in-fentanyl-increases-overdose-danger-withdrawal-risks