Drug overdoses are a continuing issue in the United States. Many reports show that new substances are being found mixed into street drugs, increasing their risks. One such substance, medetomidine, is extremely potent and has recently been linked to several overdose deaths.
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What is medetomidine?
Medetomidine is a synthetic drug classed as an alpha-2 agonist. It is not approved for human use in the US but is used in veterinary medicine as an animal sedative and analgesic. Derivatives of medetomidine, such as dexmedetomidine, are used in human medicine.[1]
In recent years, medetomidine has become increasingly popular as a street drug, as it reportedly creates a very powerful high. The use of medetomidine as a street drug was first reported in 2022 and has since been increasingly found in the recreational drug supply in nine states across North America.[1][2]
The effects of medetomidine include:
- Sedation
- Muscle relaxation
- Reduced anxiety
- Reduced heart rate
- Pain relief
- Hallucinations
The potent and extreme effects of medetomidine have caused it to become referred to as the new ‘zombie drug’. These effects can be very dangerous and are associated with many overdose deaths.[2][3]
Why is medetomidine dangerous?
Medetomidine has been found in many street drug mixtures associated with overdose and death. It is a very potent sedative, which can cause extreme effects on the central nervous system (CNS) including severe changes in heart and breathing rates.[4]
It is being found mixed with street drugs such as heroin, which also produce similar effects on the CNS. As such, this combination can be particularly dangerous as it increases the risk of overdose. Additionally, people may be unaware that they are taking medetomidine when it is mixed with other substances, making it especially risky.[1][5]
However, unlike fentanyl and heroin, medetomidine is not an opioid and therefore, does not respond to naloxone (Narcan), a drug that reverses the effect of opioid overdose. Currently, there is no antidote to a medetomidine overdose and immediate medical intervention is required. Experts advise that naloxone should be administered when a medetomidine overdose is suspected, as the substance may contain an opioid.[4]
How does it compare to xylazine?
Xylazine is also an alpha-2 agonist not approved for human use but used as an animal sedative. Medetomidine has a chemical structure and action similar to xylazine and clonidine. However, it is reportedly around 200 times more potent, creating a significantly greater sedating effect.[6]
Xylazine is also often mixed with other substances such as opioids to be sold on the street, contributing to the potent effect of these drugs and their potential for overdose. It was first reported in the early 2000s and has since been listed as the cause of many overdose deaths.[7]
Because of their powerful effects, some people seek substances mixed with medetomidine or xylazine, as these substances reportedly enhance the opioid high. These drugs, particularly medetomidine, are long-lasting, and therefore prolong the high, further attracting people to their use.[6][7]
Comparatively, the two drugs are very similar in many regards, with medetomidine being significantly more potent. Reports of xylazine use and overdoses over the last two decades indicate that medetomidine, still a new drug on the streets, is likely to contribute to many more overdose deaths in the coming years.
Signs of medetomidine overdose
As it is extremely potent, the intentional or unintentional use of medetomidine can cause an overdose, which may be fatal. Signs of a medetomidine overdose include:[4]
- Severely reduced heart rate
- Slowed or stopped breathing
- Extreme drowsiness and dizziness
- Chest pain
- Seizure
- Loss of consciousness
If a medetomidine overdose is suspected, administer naloxone if available and call 911 immediately.
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