Health care professionals report increase in adverse withdrawal associated with new drug
Butler health care professionals are reporting an increase in atypical withdrawal symptoms associated with a new veterinary sedative mixed with fentanyl.
Medetomidine, a veterinary sedative similar to xylazine but with more severe reactions, overtook xylazine around July as the most common adulterant found in Philadelphia’s illicit opioid samples, according to Highmark Wholecare.
According to Luke Zigrossi, medical director of Butler Regional Recovery Center, the substance appears to be taking hold in Butler, with physicians reporting an influx of atypical withdrawal symptoms associated with it.
Patients with medetomidine in their system typically experience stronger sedation effects for longer periods, he said. The substance is also used as an antifouling agent to stop marine life from growing on the bottom of boats.
Highmark said medetomidine began appearing more regularly in April 2024. The increase coincides with Pennsylvania classifying xylazine as a Schedule III substance in May 2024.
“Once the news on xylazine was commonplace, use became restricted,” Zigrossi said. “As a result, suppliers replaced it with medetomidine, and now IV drug abuse is even more dangerous.”
Medetomidine is many times stronger than xylazine and is not approved for human use, according to Mark Fuller, medical director of Carelon Health of Pennsylvania.
Zigrossi said there’s no way to confirm the presence of medetomidine during an overdose, so it’s diagnosed based off symptoms of rapid heart rate, severe high blood pressure, nausea, vomiting and violent delirium.
“If the window is missed to take medications by mouth, such as clonidine, an alpha-2 agonist typically used for blood pressure control, then the only effective treatment would be medications only safe to administer intravenously in an ICU,” Zigrossi said.
Narcan and naloxone will not reverse the effects of medetomidine but is still recommended to reverse the fentanyl effects. The patient may remain sedated after Narcan is administered, which is safe as long as the patient is breathing, Highmark said.
Narcan should be administered every three minutes.
