Severe withdrawal cases point to growing medetomidine use
A powerful veterinary sedative, medetomidine, is increasingly appearing in street supplies of the already deadly opioid fentanyl, and the number of patients suffering from medetomidine withdrawal has quadrupled in recent years, according to a new analysis by researchers at the Perelman School of Medicine at the University of Pennsylvania.
Recent research from the Perelman School of Medicine at the University of Pennsylvania reveals a worrying trend of increasing medetomidine use in street fentanyl supplies, leading to a quadrupling of severe medetomidine withdrawal cases. Medetomidine, a powerful veterinary sedative 100-200 times stronger than xylazine, is often mixed with fentanyl, an already deadly opioid.
This combination is causing particularly severe withdrawal symptoms including tachycardia, extreme anxiety, nausea, and vomiting, and in some cases, organ damage. Medical professionals are treating these cases with infused medications like dexmedetomidine, which require intensive care unit (ICU) stays due to the risk of low heart rates and blood pressure.
The study, published in JAMA Internal Medicine, analyzed data from two Philadelphia hospitals from 2020 to September 2025. Before medetomidine appeared in fentanyl supplies around mid-2024, dexmedetomidine was administered to 6% of opioid use disorder patients. After its emergence, this rate jumped to 20% and then to 32% in the final three months of 2025.
The number of patients needing ICU management for medetomidine withdrawal skyrocketed from a small fraction to nearly a third of treated patients in the last quarter of the study.
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