In Harrisburg, state legislators are moving forward with plans to criminalize the possession of medetomidine, a potent veterinary sedative that has increasingly been detected in fentanyl sold on the streets of Philadelphia.
The initiative, spearheaded by State Sens. Michele Brooks (R-50) and Doug Mastriano (R-33), proposes to classify medetomidine as a controlled substance. This mirrors a similar measure enacted last year targeting xylazine, another veterinary tranquilizer commonly used to dilute illicit drugs.
However, there are growing concerns among critics that such regulations may exacerbate the very issues they aim to resolve. Critics argue that attempts to control substances traded on the street frequently compel traffickers to seek out alternative adulterants, often leading to the introduction of even more dangerous substances.
A joint statement released Tuesday by leaders from PA Groundhogs, a statewide drug-checking initiative, the PA Harm Reduction Network, and The Everywhere Project highlighted the potential fallout from this legislation. They warned that the sudden banning of medetomidine could ignite a medical crisis among users—many of whom have developed a dependency on the sedative in combination with opioids.
The statement outlined alarming scenarios in which users could suddenly find themselves forced to detox from medetomidine, either cold turkey or under the care of unprepared healthcare providers. This predicament could lead to severe withdrawal symptoms, the nature of which many medical professionals are now just beginning to understand.
In May 2024, the Philadelphia Department of Public Health issued a warning regarding the emerging presence of medetomidine in the city’s drug market. The tranquilizer, which is reported to be 200 times more potent than xylazine, poses grave health risks and has shown a worrying trend—overtaking xylazine as the predominant drug adulterant in the area.
A report published last month by the Centers for Disease Control and Prevention noted this troubling shift, which included contributions from medical researchers affiliated with Penn Medicine, Jefferson Health, and Temple Health. It details the life-threatening withdrawal syndrome that users can face after prolonged exposure to medetomidine, necessitating a level of medical care significantly more intensive than what is typically required for opioid or xylazine withdrawal.
The emergency department at Thomas Jefferson University Hospital has recently recorded stark increases in patients exhibiting withdrawal symptoms related to medetomidine. Dr. Phil Durney, who specializes in internal and addiction medicine, reported that patients are experiencing extreme and unprecedented symptoms, such as uncontrollable vomiting, severe cardiac issues, and crippling anxiety.
Teams of clinicians across Jefferson Health, Penn Medicine, and Temple Health have begun collaborative meetings to tackle this burgeoning crisis. They are working not only to understand the complexities of medetomidine withdrawal but also to develop effective treatment protocols.
Dr. Kory London, an emergency medicine physician at Jefferson Health, remarked on the severity of withdrawal for some patients, noting cases where even the highest doses of sedatives would not alleviate their symptoms. Other individuals may enter a catatonic state, complicating efforts to devise care without the capacity for dialogue.
Given the unpredictable nature of drug compositions on the street, many users are unaware of the specific substances they are ingesting, compounding the issue.
Innovative solutions are emerging from Jefferson University, where a team has succeeded in creating a urine test capable of detecting medetomidine metabolites. This breakthrough is being hailed as a key tool to aid in diagnosing and treating those affected by medetomidine exposure, with plans for future publication of this research.
Since its initial detection in street samples of fentanyl in April 2024, medetomidine has surged in prevalence, effectively replacing xylazine as the preferred cutting agent among drug dealers. PA Groundhogs reported that medetomidine was found in 89% of fentanyl samples tested since January.
The statement from PA Groundhogs and its partners concluded with a cautionary note: reactionary approaches to scheduling drugs may lead only to an ongoing cycle of regulation that neglects the complexities of the illicit drug landscape and the needs of individuals involved in substance use—whether they are users themselves or those striving to help them.
image source from：https://www.phillyvoice.com/medetomidine-controlled-substance-pennsylvania-addiction-crisis-philadelphia/
