Medetomidine, a highly potent veterinary alpha-2 adrenergic agonist, has recently emerged as a significant adulterant within the U.S. illicit opioid supply. This presentation entitled will review the introduction of medetomidine in the U.S. drug supply, the pharmacology and clinical effects of medetomidine, and the distinguishing features of medetomidine toxicity and withdrawal. We will outline emerging treatment strategies emphasizing early, aggressive alpha-2 agonist therapy; nuanced antiemetic approaches; when and how to escalate to IV dexmedetomidine; and approaches to concurrent opioid withdrawal management. Participants will gain insight into diagnostic challenges, observation and disposition considerations, and strategies for system-level preparedness.
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Funding for this initiative was made possible (in part) by grant no. 1H79TI088037 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.