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The Indiana Department of Health (IDOH) has issued an alert about medetomidine, a non-opioid sedative used in veterinary medicine, now being mixed with illicit drugs such as fentanyl and heroin. Medetomidine, approved only for veterinary use since 1996, is similar to xylazine and has been found to be a strong, long-acting sedative. It is not approved for human use, and its effects are mainly known from veterinary research.

Medetomidine first appeared in drug-related incidents in Maryland in July 2022 and has since been linked to overdoses in Philadelphia, Pittsburgh, and Chicago. In Indiana, it has been detected in syringes from Marion County’s Syringe Service Program, often alongside fentanyl. However, toxicology tests in Indiana have not yet confirmed its presence in overdose deaths, and no prescriptions for medetomidine have been recorded in Indiana’s monitoring program from 2013 to 2024.

Medetomidine shares some effects with xylazine, including respiratory depression, dry mouth, vasoconstriction, hypothermia, hypotension, and low heart rate. Unique effects include muscle twitches, hallucinations, and peripheral cyanosis. When combined with opioids, its sedative effects are enhanced, which can lead to greater respiratory depression. Naloxone may not fully reverse a medetomidine-involved overdose, but should still be administered in suspected overdose cases due to the likely presence of opioids.

IDOH offers two grant opportunities for opioid rescue kits, aimed at local health departments and rural first responder agencies. Naloxone is also available over the counter at pharmacies and can be purchased without a prescription in Indiana. Additional resources for obtaining naloxone can be found at OptIN.in.gov and Overdoselifeline.org.

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