By Kevin Shanks, D-ABFT-FT
Medetomidine, an alpha-2-adrenergic receptor agonist, similar to the prescription medications clonidine and tizanadine and the veterinary medicine xylazine, is approved for use in human and veterinary medicine and has found its way into the illicit drug supply. The adverse effects of medetomidine use are consistent with central nervous system depression and include analgesia, sedation, muscle relaxation, hypotension, bradycardia, and hyperglycemia. It is thought that adding this substance as an adulterant to the current illicit opioid drug supply (e.g. fentanyl) increases potential bradycardia, sedation, and respiratory depression. Medetomidine is not currently a controlled substance in the United States.
Chemical Structure of Dexmedetomidine, the d-isomer of medetomidine Kevin G. Shanks (2024)
The substance was first detected in the United States in Maryland in mid-to-late 2022 and was also sporadically detected in various states, such as California, Colorado, Missouri, and Pennsylvania, into 2023. Reports of the substance spread to Canada in early 2024 when alerts regarding its detection in the drug supply were published out of Toronto, Ontario and Vancouver, British Columbia. In 2024, medetomidine has also been observed in additional states including Florida, Illinois, North Carolina, and Ohio.
Axis Forensic Toxicology has monitored for this substance in Analyte Assurance™ as part of the Comprehensive Panel testing (order code 70510) since January 2024. Over the last 6 months, the laboratory has not detected medetomidine in casework, but we remain vigilant in surveillance for this drug and other newly emerging substances.
If you have any questions or concerns regarding the role of medetomidine or any other newly emerged substance in your toxicology case, please reach out to our Axis Forensic Toxicology subject matter experts at [email protected]. To stay current with the scope of testing for all services offered by Axis, please consult the online catalog.
References
Randall C. Baselt (2020). Dexmedetomidine. Disposition of Toxic Drugs and Chemicals in Man, 12th Edition. Biomedical Publications. Pages 600-601.
The Center for Forensic Science Research and Education, NPS Discovery (2024) Medetomidine Rapidly Proliferating Across USA – Implicated in Recreational Opioid Drug Supply And Causing Overdose Outbreaks. https://www.cfsre.org/nps-discovery/public-alerts/medetomidine-rapidly-proliferating-across-usa-implicated-in-recreational-opioid-drug-supply-causing-overdose-outbreaks?emci=c7a462cb-8617-ef11-86d0-6045bdd9e096&emdi=086973c5-5c18-ef11-86d0-6045bdd9e096&ceid=10243135
National Public Radio (2024) Gangs Mix Another Potent Sedative Into US Street Drugs Causing “Mass Overdoses”. https://www.npr.org/2024/05/31/nx-s1-4974959/medetomidine-overdose-fentanyl-sedative