Medetomidine, a central nervous system depressant that national experts have seen being used with fentanyl, has led to overdose outbreaks in major U.S. cities. Local law enforcement has not seen signs of it in Portage County just yet, but anticipate usage since the drug has reached the Cincinnati area.
The Center for Forensic Science Research & Education released a public alert in May 2024 stating the use of medetomidine is rapidly increasing in use as an adulterant in the recreational drug supply.
Alex Krotulski, a director of toxicology and chemistry at the CFSRE, explained medetomidine as an alpha-2 agonist, which are receptors that spread throughout the central and peripheral nervous system. He said it is used in hospitals for sedation, but when taken recreationally, it causes a very low heart rate, or bradycardia, and some people have been sent to the ICU for what he described as “pretty significant withdrawal syndrome.”
The overdose outbreak is occuring from the mixture of active and inactive forms of the drug. The mixture is being partnered with fentanyl, which is where it becomes increasingly dangerous.
Overdose outbreaks in the U.S.
Recent mass overdose outbreaks in Philadelphia, Chicago and elsewhere have all been associated with fentanyl or heroin drug products containing medetomidine, as well as xylazine or other substances, according to the public alert.
Krotulski said the Drug Enforcement Administration classifies an overdose outbreak as anything more than three.
“So, I mean, at this point, it’s been hundreds of people that have been impacted by medetomidine, if not thousands, in Philadelphia and Chicago,” he said.
He said it gets difficult to know the exact number of people who have been impacted by medetomidine when not every patient in the hospital is being tested for the drug. Krotulski said that with medetomidine being in Pennsylvania, Illinois and Toronto, there’s no reason for him to believe that medetomidine would not be in northeastern Ohio.
Detective Ed Kennedy with the Portage County Sheriff’s Office said he checked with the coroner’s office, and they have no reports of medetomidine on their toxicology yet.
“We do know that there are some reported overdoses outside of Portage County and other areas of Ohio, but as of right now, to this date, we have nothing on the toxicology,” he said.
He said there were a couple in Hamilton County around Cincinnati.
Kennedy said people could be accessing medetomidine in several different ways, whether it’s connections to veterinarians, suppliers or getting it off the dark web.
Public concern and safety
Krotulski said the general public does not need to worry; it’s people who are using opioids, specifically the non-regulated recreational opioid supply, who are being affected.
“I would say that the reality of the drug supply today is that fentanyl is what we’ve seen over the last several years, that fentanyl is always going to be accompanied by another drug, essentially fentanyl, and another friend,” he said. “And those are really the scenarios where people will be exposed to medetomidine, when they’re using fentanyl.”
Krotulski said using fentanyl test strips is still a good strategy to stay safe, as well as having naloxone nearby.
Medetomidine by itself does not respond to naloxone. However, Krotulski said that since it is seen alongside fentanyl, it’s good to use naloxone in overdose scenarios to reverse fentanyl as the primary opioid present.
Kennedy said it’s important to spread awareness, knowledge and to educate people. He said the sheriff initiated the Overdose Quick Response Team in 2023, and they’ve transitioned to awareness.
“You know, just the only thing that we say is, don’t use drugs,” Kennedy said. “You don’t know what you’re getting. And if you can’t, if you can’t afford medical coverage, get ahold of Townhall II, or an agency like that, that can help you.”
