Emergence of Medetomidine in the Illicit Drug Supply: Implications for Emergency Care and Withdrawal Management.

Lynch, Michael J; Pizon, Anthony F; Yealy, Donald M · Ann Emerg Med · 2026

review · Level V

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Abstract

The US illicit drug supply continues to evolve with increasingly dangerous adulterants, with medetomidine a new agent seen in acute care and other practice settings. We reviewed available literature on illicit drug adulterants, medetomidine intoxication, and sequelae. Although little is known about withdrawal and the clinical manifestations are stark, we reviewed the best available literature on dexmedetomidine withdrawal and suggest approaches for treatment.