Preventing Medetomidine Overdose: A Public Health Concern

A new drug has recently surfaced in the illicit drug market in the United States, contributing to a rise in fatal overdoses alongside fentanyl and other substances. The Center for Forensic Science Research and Education has reported that recent mass overdose incidents in cities like Philadelphia and Chicago are linked to fentanyl or heroin products that contain medetomidine, a synthetic alpha-2 agonist primarily used as a sedative in veterinary practices. This substance is part of the same drug class as xylazine but is 200 times more potent and has a longer-lasting effect. Medetomidine overdose can include prolonged sedation, low blood pressure, dangerously low heart rate, and respiratory depression, particularly when mixed with opioids like fentanyl.

Overdose of medetomidine is particularly concerning because it cannot be reversed with naloxone, a medication used to reverse opioid overdoses. First responders and medical professionals often face challenges in identifying the specific drugs involved in an overdose, as many illicit substances are mixed with various other drugs. Furthermore, individuals using heroin or fentanyl may be unaware that their drugs have been adulterated with medetomidine, and there are currently no available test strips to detect it, unlike those for fentanyl and xylazine. Medetomidine affects the central nervous system and poses significant risks when used in conjunction with other sedatives. The origin of medetomidine’s presence in the illegal drug supply remains unclear, making it essential to raise awareness and educate the public about the emerging risks associated with overdoses of medetomidine.

 

 

Does Medetomidine Provide Pain Relief?

Medetomidine is a commonly used sedative and analgesic in veterinary medicine, especially in procedures involving animals like cats, dogs, and other mammals It is primarily used to induce sedation and facilitate anesthesia during surgeries but can also provide pain relief. It is a mixture of dexmedetomidine and levomedetomidine in equal portions. The drug has pain-relieving properties that can slow an animal’s heart rate down keeping them comfortable, calm, and still. However, the degree of pain relief alone is not enough for major surgical procedures. Medetomidine is administered in dogs undergoing teeth cleanings, removal of skin lesions, in-depth examinations, and other routine procedures. It produces analgesia by inhibiting the release of norepinephrine in the spinal cord and brain, dampening pain signals.

Like other veterinary drugs, medetomidine poses serious health threats in humans using opioids and other illicit substances. Due to its powerful effects, medetomidine intoxication could be responsible for recent spikes in drug overdoses seen across the United States. It can lead to excessive CNS depression resulting in unresponsiveness or coma.

How Does Medetomidine Affect the Heart?

Research on medetomidine has mainly focused on its effects in animals. As a central nervous system depressant, it notably diminishes various bodily functions controlled by the brain, leading to a slower heart rate, decreased blood pressure, reduced body temperature, and impaired respiratory function. A study featured in the National Library of Medicine examined how medetomidine impacts the heart and lungs of beagles, revealing that it initially induced high blood pressure, which was later followed by a drop in blood pressure. The drug also resulted in a slower heart rate, heart block, and decreased breathing rates.

The effects of medetomidine on the heart can be particularly dangerous if the drug is used outside a medical setting or combined with other central nervous system depressants like opioids or alcohol. Such combinations can trigger severe and potentially fatal conditions, including drastic drops in blood pressure, respiratory failure, coma, or even death. Long-term use of medetomidine may elevate the risk of cardiovascular issues, as its sedative properties can lead to bradycardia, putting additional strain on the heart. Furthermore, sustained low blood pressure can diminish blood flow to essential organs, including the heart, gradually compromising cardiovascular health.

Is Dexmedetomidine Stronger Than Medetomidine?

Dexmedetomidine is a derivative of medetomidine utilized in human medicine to sedate patients before or during surgical procedures and during intubation and mechanical ventilation. This medication is a refined dex-enantiomer, recognized as the more pharmacologically active form of medetomidine. As noted by ScienceDirect, dexmedetomidine exhibits greater potency than medetomidine, attributed to its stronger affinity for alpha-2 adrenergic receptors. In fact, it is roughly eight times more potent, allowing for more significant sedative effects at reduced dosages.

What Are CNS Depressant Medications?

CNS depressants, or central nervous system depressants, are a category of drugs that reduce brain activity, leading to feelings of relaxation and tranquility. This group encompasses various medications such as sedatives, tranquilizers, and hypnotics, each serving different medical purposes. While these drugs operate through distinct mechanisms, they all share the common effect of diminishing central nervous system activity and lowering brain awareness. They primarily enhance the production of the neurotransmitter gamma-aminobutyric acid (GABA), which induces drowsiness and a sense of calm.

Although CNS depressants can effectively address a range of conditions, including insomnia, anxiety, panic attacks, pain, and seizures, they also carry risks of misuse, dependence, and addiction. Individuals who become dependent may face withdrawal symptoms when they try to stop using prescription drugs, which can lead to a cycle of addiction. Furthermore, these depressants can significantly decrease heart and respiratory rates, increasing the risk of overdose, particularly in those who have developed a tolerance and require higher doses to achieve the same effects.

Medetomidine is one such CNS depressant that poses a risk of overdose. Signs of medetomidine overdose may include:

• Loss of coordination
• Extreme sedation or lack of responsiveness
• Bradycardia (slowed heart rate)
• Hypotension (low blood pressure)
• Respiratory depression
• Respiratory failure
• Vomiting
• Pale gums, lips, or extremities
• Low body temperature

In veterinary medicine, veterinarians can administer atipamezole, a reversal agent, to counteract a medetomidine overdose effectively. However, in humans who overdose on medetomidine through contaminated illicit drugs, medical professionals cannot use reversal agents, as they do not conduct tests to identify medetomidine. In instances of fatal overdoses, the drug is often only detected post-mortem during an autopsy.

How WhiteSands Can Help You Prevent a Medetomidine Overdose

Medetomidine has consistently been found in street drugs alongside fentanyl, heroin, and xylazine in a recent outbreak of overdoses. Users are unaware they are ingesting potentially fatal doses of these drugs and currently, there are no test strips available to detect their presence in drugs. The only way to prevent a medetomidine overdose is to stop using illicit substances like heroin and fentanyl which may contain the drug. However, for those who have developed an addiction to street drugs like heroin or fentanyl, stopping use on their own can feel impossible. Thankfully, comprehensive treatment programs at WhiteSands Treatment are designed to assist anyone in overcoming substance use disorders and preventing overdoses.

At WhiteSands Treatment, our addiction specialists possess the expertise and resources to address a variety of substance use disorders, including opioid, meth, and cocaine addictions. Our personalized treatment plans incorporate a range of evidence-based therapies, medication management, and holistic methods to tackle the root causes of addiction while equipping patients with relapse prevention strategies for sustained recovery. We offer flexible lengths of stay and levels of care, including medical detox, to help individuals navigate withdrawal symptoms safely and effectively.

If you’re interested in exploring your addiction treatment options at WhiteSands Treatment, reach out to us today at 877-855-3470.

External Sources

• The Center for Forensic Science Research and Education – Medetomidine Rapidly Proliferating Across USA
• National Library of Medicine – Cardiovascular and Respiratory Effects of Medetomidine in Dogs and Influence of Anticholinergics
• ScienceDirect – Medetomidine

 

If you or a loved one needs help with abuse and/or treatment, please call the WhiteSands Treatment at (877) 855-3470. Our addiction specialists can assess your recovery needs and help you get the addiction treatment that provides the best chance for your long-term recovery.