Street drugs laced with toxin for mass ODs

People gather outside the Savage Sisters' community outreach storefront in the Kensington neighborhood of Philadelphia. The area is being hit hard by Medetomidine and Xylazine, powerful sedatives most often used by veterinarians that are moving through the illicit drug supply triggering "mass overdose" events and causing gruesome skin wounds (Matt Rourke/AP).

.

Drug dealing gangs mix another deadly sedative into U.S. street drugs causing 'mass overdoses'

The Least of Us on fentanyl and meth

(NPR, May 29, 2024) Public health officials say Mexican cartels and drug gangs inside the U.S. are mixing a dangerous chemical sedative called medetomidine into fentanyl and other drugs sold on the street.

The combination triggered a new wave of overdoses that began in late April 2024 and have accelerated in May.

"The numbers reported out of Philadelphia were 160 hospitalizations over a 3 or 4-day period," said Alex Krotulski, who heads an organization called NPS Discovery that studies illicit drugs sold in the U.S.

Medetomidine, most often used by veterinarians as an animal tranquilizer, but also formulated for use in human patients, has also been linked to recent “mass overdose outbreaks” in Chicago and Pittsburgh.

Experts say the chemical, mixed into counterfeit pills and powders sold on the street, slows the human heart rate to dangerous levels. It's impossible for drug users to detect.

Public health advisories have been issued in Illinois and Pennsylvania. Dr. Brendan Hart at Temple University in Philadelphia says they first began hearing reports of street drug users exposed to the fentanyl-medetomidine mix in April 2024.

Sam Quinones

"Some of our emergency medicine doctors started stopping me in the hallway," Dr. Hart told NPR. "They said, 'Something funny is going on with the overdoses.'

"Patients were coming in with very low heart rates, as low as in the 20s. A normal heartrate is 60 to 100 [beats per minute], so 20s is extremely low."

Laboratory tests of street drug samples came back positive for the powerful sedative, which is used in some formulations by doctors with human patients, but only in carefully controlled medical settings.

Medetomidine was previously detected in the illicit drug supply as early as 2022 but only rarely and in small amounts. This time experts say it appears to be spreading rapidly, with large-scale overdose events also reported earlier this year in Toronto, Canada.

U.S. drug supply grows more toxic

Last year the Biden administration issued a warning that street fentanyl was being mixed with another tranquilizer used by veterinarians called xylazine.

That mix of drugs led to more overdoses and many users also experience terrible flesh wounds that can linger for months or years. Medetomidine is even more powerful than xylazine, experts told NPR.

As it spreads, Krotulski said no one knows what long-term health effects this new cocktail of chemicals will cause in the human body.

"Patients are being cared for as we speak in emergency rooms," he said. "These are very complex drug products. You’ve got fentanyl adulterated with xylazine that now also contains medetomidine." More: Warnings of new deadly chemical in street drug supply

• Eight students accused of carrying out planned attack on middle school classmate (LA Times)
• Brian Mann, Morning Edition, NPR, May 29, 2024; CC Liu, Seth Auberon (eds.), Wisdom Quarterly