05/22/2026
Everyone wants to know about "that one that starts with an M" - that's MEDETOMIDINE, and it seems to be popping up in the local drug supply in East Tennessee.
Like xylazine, medetomidine is a sedative drug normally used as a tranquilizer for animals. Medetomidine is not an opioid, but it is almost always mixed with fentanyl in the street drug supply. It will can make people very sleepy and sometimes puts people to sleep for long periods of time. It also lowers blood pressure and heart rate.
Since medetomidine is usually mixed with fentanyl, if you suspect someone is overdosing, still use naloxone! Naloxone will still help reverse the effects of fentanyl in the overdose. Naloxone only works on opiates, so the person overdosing may still be drowsy or seem sedated. You want to focus on BREATHING more than responsiveness if medetomidine is involved -- make sure the person's breathing is restored to a normal rate.
The big risk with medetomidine is withdrawal when used regularly. Since medetomidine is decreasing heart rate and blood pressure, stopping after using regularly will cause a spike in both. People will sometimes need to go to the hospital for medetomidine withdrawal, as it can be potentially deadly. If you think you're experiencing medetomidine withdrawal symptoms and you can't stop throwing up, have chest pain, are going in and out of responding (even while being awake), or are noticing your symptoms are much more severe than they've been before, you should go to the hospital.
If you have more questions, Hellbender Harm Reduction is here to for you! Stop by on Thursdays when our drop-in is open to chat and learn more.
Thanks to Substance Use Philly for the information, you can find more by visiting their website here: www.substanceusephilly.com/medetomidine