Identification of the Veterinary Sedative Medetomidine in Combination with Opioids and Xylazine in Maryland

Abstract

Public health, public safety, and forensic science personnel continue to face the emergence of new compounds into the drug market. While focus is often put on the detection of new analogs of known illicit drugs, monitoring the changes in cutting agents and other compounds can be equally as important. Over the last year, near real-time monitoring of the drug supply in Maryland has been completed through a public health – public safety partnership whereby residue from suspected drug packaging or used paraphernalia is collected and analyzed. Through this project, we have recently detected the presence of the veterinary sedative medetomidine in a small number of samples. The presence of medetomidine has been identified in both public health and law enforcement samples and in the presence of fentanyl and xylazine – another veterinary sedative that has been widely observed over the last year. While the rate at which medetomidine has been detected remains low, it is concerning and worthy of continued monitoring.

Understanding Sensitivity and Cross-Reactivity of Xylazine Lateral Flow Immunoassay Test Strips for Drug Checking Applications

“…12 Care should be taken in using these XTS when lidocaine may be present, as it may yield false positive results. Other α2-agonists found in the illicit drug supply, such as medetomidine, 13 did not cross-react and would not be detected using this approach, potentially creating a false sense of safety for PWUD. This highlights a need for comprehensive drug checking services to identify a range of substances in the illicit supply and better inform consumers about drug contents using point of care technologies (e.g., Fourier-Transform Infrared spectrometry (FTIR)) in combination with confirmatory testing (e.g., DART-MS, GC-MS/MS).…”

Understanding Sensitivity and Cross-Reactivity of Xylazine Lateral Flow Immunoassay Test Strips for Drug Checking Applications

“…22 Care should be taken in using these XTS when lidocaine may be present, as it may yield false positive results. Other α2-agonists found in the illicit drug supply, such as medetomidine, 23 did not cross-react and would not be detected using this approach, potentially creating a false sense of safety for PWUD. This highlights a need for comprehensive drug checking services to identify a range of substances in the illicit supply and better inform consumers about drug contents using point of care technologies (e.g., Fourier-Transform Infrared spectrometry (FTIR)) in combination with confirmatory testing (e.g., DART-MS, GC-MS/MS).…”

Trends and Adverse Outcomes of Xylazine Misuse: A Digital Surveillance Study

“…Human consumption of xylazine was first described in Puerto Rico during the early 2000s, often in combination with opioid use, though it has spread stateside over the past decade [4][5][6]. Case reports and local surveillance data indicate that xylazine is increasingly being used as an adulterant in street supplies of opioids like heroin or fentanyl, heightening overdose risks [7][8][9][10].…”