A powerful veterinary tranquilizer showing up in the street drug supply is putting new pressure on hospitals and treatment centers in Western Pennsylvania, according to local doctors and providers.
Allegheny County health officials say the drug, medetomidine, is a non-opioid sedative similar to xylazine, also known as tranq, but 100 to 200 times more potent.
At UPMC, Dr. Anthony Pizon, chief of medical toxicology, said the drug is creating added strain in emergency departments.
“It is definitely putting a strain on emergency departments,” Pizon said.
Pizon said doctors are seeing more patients overdosing or experiencing severe withdrawal from fentanyl mixed with medetomidine, and many of those cases require intensive care.
“It almost always guarantees an ICU-level admission — so our ICUs are really inundated with these patients, and that makes it challenging to care for other patients who also need that level of care,” he said.
At Pinnacle Treatment Centers, medical director Dr. Christopher Cole said many people using opioids do not realize medetomidine is now part of the drug supply.
“It’s here. Most people who are using opioids don’t even realize it’s part of the drug supply now,” Cole said.
Cole said the drug’s sedative effects can put people at serious risk.
“It makes people extremely sleepy — they can’t keep their eyes open. You try to talk to them, and they immediately fall asleep,” Cole said. “You can pass out outside and develop hypothermia. You can pass out on stairs and suffer serious trauma.”
Cole also said the region’s drug supply has changed dramatically in recent years.
“When I first started doing this, we still saw heroin. Now — it’s all fentanyl. No heroin,” Cole said.
Doctors and treatment providers said medetomidine is stretching an already fragile system, with some patients requiring hospitalization for days, particularly during withdrawal.
“We have people going to the hospital all the time for days because of the withdrawal,” one provider said.
Doctors stressed that Narcan should still be administered during a suspected overdose and 911 should be called immediately, but warned that people may not “wake up” quickly because the tranquilizer’s effects are not reversed by naloxone, and many patients will still require ICU-level care.
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