Opioid Overdose Cases Show Presence of Medetomidine, Veterinary Medicine Similar to Xylazine, According to Recent Study by the Toxicology Investigators Consortium
01 Agosto 2024 - 1:16PM
Data gathered by the Toxicology Investigators Consortium (ToxIC)
Fentalog Study was reported in the CDC’s August 1, 2024 Morbidity
and Mortality Weekly Report (MMWR) “Notes from the Field:
Medetomidine, a clinical and veterinary medication similar to
xylazine, detected in patients presenting to the emergency
department following suspected opioid overdoses - Missouri,
Colorado, and Pennsylvania, September 2020-December 2023.”
This publication presents a detailed evaluation of 5 confirmed
opioid overdoses in which medetomidine was detected. Medetomidine
is a veterinary agent used for its anesthetic and analgesic
properties in dogs. It has been reported in illicit drug samples
from Maryland over the last year, but has not previously been
reported in humans after recreational drug use until now. In
addition to medetomidine, comprehensive toxicology blood testing
demonstrated the presence of other concomitant drugs, including
fentanyl in three patients, illicit benzodiazepines in three,
stimulants in three, xylazine in three, and nitazene opioids in
two. This is the first report demonstrating medetomidine in
the blood of patients after opioid overdose. According to the
report's first author, Evan Schwarz, MD, “Adulterants such as
medetomidine have been found in 3 states, and there is an emerging
concern for exposure in the United States. Concurrent exposure to
both medetomidine and opioids may increase overdose risk in
patients, and can complicate the approach to treatment.”The ToxIC
Fentalog Study collects data from 10 geographically diverse
hospitals in 9 states to identify risk factors and evaluate optimal
treatments for nonfatal overdoses involving fentanyl, fentanyl
analogs (fentalogs), illicit benzodiazepines, and adulterants (such
as xylazine). Now in its 4th year, the study has enrolled over 1800
patients. Data derived from this study are used to characterize
synthetic opioids used, evaluate treatments, and track regional
trends in fentalog overdoses.For more information on the ToxIC
*Fentalog Study and to see quarterly toxicology testing reports
released by Center for Forensic Science Research and Education
(CFSRE), view the ToxIC Fentalog Study webpage. Study findings are
also disseminated through ToxIC partners at the Centers for Disease
Control and Prevention via an interactive data dashboard.
The Toxicology Investigators Consortium (ToxIC) is a multicenter
toxicosurveillance and research network that detects new drugs of
abuse, monitors adverse effects of post-marketing medications, and
identifies emerging toxicological threats. Led by medical
toxicology physicians and registry experts, our projects involve
case registry design and maintenance.The American College of
Medical Toxicology (ACMT) is a professional, nonprofit association
of physicians board certification in medical toxicology and other
professionals with expertise in this area. ACMT members specialize
in the prevention, evaluation, treatment, and monitoring of injury
and illness from exposures to drugs and chemicals, as well as
biological and radiological agentsm and work in clinical, academic,
governmental, and public health settings, and provide poison
control center leadership. *FundingResearch reported in this
publication was supported by the National Institute on Drug Abuse
of the National Institutes of Health under Award Number R01DA048009
(PI: Alex Manini). Supplemental funding is provided by the Centers
for Disease Control and Prevention (Award Number 3R01DA048009-04S1)
to increase the project’s testing capacity.
Jessica Irving
American College of Medical Toxicology
(844) 226-8333
communications@acmt.net
Kim Aldy
Toxicology Investigators Consortium (ToxIC)
toxic@acmt.net