The Centers for Disease Control and Prevention (CDC), in conjunction with the White House Office of National Drug Control Policy (ONDCP), is issuing this Health Advisory to notify public health professionals, clinicians, laboratorians, and people at risk for overdose about increasing reports from U.S. jurisdictions detecting medetomidine in the illegal drug supply and a severe withdrawal syndrome due to medetomidine exposure. Medetomidine (also known as ‘rhino tranq,’ ‘mede,’ or ‘dex’) is not approved for human use but is approved for sedation and analgesia in dogs. Its dextro-isomer, dexmedetomidine, is approved for procedural sedation in humans. Medetomidine has been increasingly detected in law enforcement drug seizures, drug product and paraphernalia samples, and in wastewater samples, with the highest concentrations in the Northeast region. Testing of illegal drug samples and clinical specimens has identified racemic mixtures of levomedetomidine and dexmedetomidine isomers without the preservatives commonly found in medical or veterinary formulations, making diversion of pharmaceutical products unlikely. Since pharmaceutical-grade products contain only dexmedetomidine, these findings suggest medetomidine is being synthesized in clandestine laboratories.

Advisory:
Medetomidine in the U.S. Illegal Fentanyl Supply Increasing Risk for Overdose and Severe Withdrawal Syndrome