20 May Medetomidine “Rapidly Proliferating Across USA”
On May 20, 2024, the Center for Forensic Science Research & Education (CFSRE), a leading organization within the United States that performs and publishes research related to substance use trends and novel psychoactive substance (NPS) detection, distributed an alert regarding proliferation of medetomidine in multiple parts of the country.
Both medetomidine and xylazine have approved uses in the United States. Xylazine is only approved in veterinary medicine whereas medetomidine is approved in human and veterinary medicine as a sedative and an analgesic. Compared to xylazine, medetomidine is more potent and produces a longer duration of action. Similar to xylazine, it has been detected in highly adulterated drug products and recently has been associated with overdose outbreaks due to the intense effects it has on individuals that encounter it in drugs.
Aegis began testing for medetomidine in Q2-2023 based on reports of identification from other leading national drug surveillance organizations. We first detected medetomidine in a sample received for medically necessary definitive testing in September 2023. Since implementation of testing for this drug, we have detected this substance in 9 unique states, many of which are highlighted in the CFSRE report. Patterns of detection by state can be seen in the charts below.
Similar to the CFSRE report, Aegis has often identified medetomidine in specimens that are indicative of polydrug use and potential exposure to a highly adulterated drug supply. Specimens collected in healthcare settings for testing often also contain other high-risk central nervous system depressants like illicitly-manufactured fentanyl, designer opioids, prescription or designer benzodiazepines, and xylazine. Additionally, co-detection of substances with stimulant effects, such as methamphetamine or cocaine, is very common. The infographic below indicates some of the most frequently co-detected high-risk substances within the group of samples analyzed.
*Co-detection is based on medically necessary orders for testing and detection via Aegis definitive methodology. All samples included in analysis were not tested for all compounds in each classification above. Report dates for samples analyzed ranged from 5/23/23-5/21/24.
As substances within circulation continue to change rapidly, our goal is to remain diligent in updating testing methodologies to reflect drugs that are in use and provide clinicians an opportunity to identify at-risk individuals.
To learn more from a local Aegis representative, please do not hesitate to reach out to our client services team.
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