Philadelphia is in the throes of a tragic public health crisis. The non-opioid veterinary sedative medetomidine, nicknamed “rhino tranq” or “stampstranq,” has circulated into the city’s drug supply. This potent sedative, which has no approved medicinal uses for humans, is causing severe complications for both users and healthcare providers. Given the onset of 2023, medetomidine-adulterated fentanyl has become the norm in the street drug economy. This rapid increase has caused great concern among federal officials and health experts alike.
Currently, medetomidine is used mainly as an anesthetic for dogs. It is used to provide deep sedation for patients in ICUs who are on mechanical ventilators. Its introduction to the illegal drug market has had deadly outcomes. By the beginning of this year, medetomidine was found in nearly seven of ten traced stamped heroin bags in Philadelphia. This deeply troubling trend further compounds a dangerously serious and complex public health crisis around substance abuse and overdose deaths.
Pennsylvania has recently stepped up enforcement against xylazine, as this non-opioid active ingredient was the biggest player in the commonwealth’s local drug crisis. Consequently, the use of medetomidine has increased dramatically in kind. As xylazine came under increased regulation, cartels rapidly looked for new substances to mix with fentanyl. This change directly resulted in the uncontrolled spread of medetomidine. Chris Simpson, a local drug expert, noted, “The cartels figured out a way to make more money this way.”
Medetomidine’s impacts on human users are especially troubling. Medetomidine withdrawal is interesting because it constitutes the only example without a diagnosis code. Reports have indicated that the symptoms of withdrawal from it can be stronger than those of traditional opioids. As the crisis accelerates, this presents an unprecedented challenge for treatment programs and hospitals alike, which are poorly prepared to deal with the devastation.
Roz Pichardo, a healthcare provider in Philadelphia, told lawmakers that medetomidine was harmful to users and medical personnel alike. “It’s made things worse for everyone – not only the people who use it but for the doctors too,” she said. The contrary nature of the drug complicates treatment plans. Even after naloxone successfully reverses a fentanyl overdose, people can continue to be unconscious.
Preventing any future damage to public health Healthcare professionals are starting to raise the alarm about the cost medetomidine could impose on public health. Jeanmarie Perrone, an expert in emergency medicine, stated, “It is always difficult to track the cause of death, partly because hospitals don’t test for medetomidine. I’m not sure that medetomidine is causing more fatalities – it might be – but it’s causing a lot more morbidity.” The complexities introduced by this new substance made it clear to her that what was needed was innovation in how these rehabilitation centers were run and developed.
Local officials are just as attuned to the emerging crisis. Cherelle Parker, a prominent community leader, remarked on the broader context of the issue, stating, “What has been allowed to become the status quo, standard operating procedure for how life is lived in the Kensington area, it didn’t happen in a day.” She acknowledged that while change is necessary, it cannot be achieved overnight: “I know we’re not going to fix it in a day … We know we just can’t police our way out.”
The effects of medetomidine on users go beyond acute health risks, however. Chris Simpson described the altered experience of using heroin mixed with medetomidine, noting, “Heroin used to last all day. This shit only lasts for like four hours. The rush is the same but there’s no euphoria.” This alteration in impact could help lead to higher usage rates as people attempt to recreate experiences from years gone by.
As Philadelphia continues to confront this emerging crisis, the need for comprehensive strategies to combat addiction and support affected individuals has never been more urgent. Healthcare providers and community leaders stress that addressing the complexities introduced by medetomidine requires innovative approaches and resources tailored to meet the evolving needs of users.