Medetomidine, a synthetic alpha-2 adrenoreceptor agonist, is a new drug adulterant that was detected in 72% of illegal opioid samples tested in Philadelphia, Pennsylvania, during the last 4 months of 2024.During the same period, detection of xylazine (previously the most common adulterant) decreased from 98% to 31% of samples (1), and health care providers at hospitals in Philadelphia noticed an increasing number of hospitalized patients with a severe drug withdrawal syndrome distinct from fentanyl and xylazine withdrawal, characterized by profound autonomic dysfunction, such as severe hypertension and tachycardia.This report aims to increase awareness of the presence of medetomidine in the illegal opioid supply, characterize the emerging medetomidine withdrawal syndrome, and describe measures to provide effective patient care for this life-threatening syndrome.
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Huo et al. (2025) studied this question.
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