Worcester health officials say at least two recent blood tests of people who overdosed have found traces of an animal sedative mixed with fentanyl, but they don’t yet know if the mixture is the cause of the current surge in overdoses.
The sedative medetomidine, which dangerously slows a person’s heart rate and breathing, has not been mixed with opioids elsewhere in Massachusetts, but the drug has been linked to overdose outbreaks in other cities, including Chicago and Philadelphia.
In Worcester, overdoses are now up 75% compared to this time last year, according to Health and Human Services Director Matilde Castiel. More testing is needed to determine whether medetomidine is causing the increased overdose rates, but users have no way of testing their own medications for the animal sedative.
“Hopefully it’s just a coincidence,” Castiel said, adding that the medetomidine could have come from a “faulty” opioid. “We’re going to continue to work on that. We’re always looking at how we can get people into treatment, how we can track them, how we can get them into housing.”
Staff at Massachusetts Memorial Medical Center discovered the presence of medetomidine after noticing unusual symptoms in people who had overdosed. Patients typically experience increased heart rate and blood pressure when given the opioid antagonist naloxone, better known by the brand name Narcan. But in several recent cases, medical workers saw patients with significantly lower vital signs who needed additional treatment to raise their blood pressure.
Medetomidine is similar to the animal tranquilizer xylazine, which has been found in drugs across Massachusetts, but Brandeis University epidemiologist Tracy Green says it’s 200 to 300 times more potent than xylazine, meaning even a small amount may be enough to sedate a person for a while.
“Because of the sedation, they may be able to hear but not move around much, so it may appear they’ve overdosed,” Green says. “It’s really important to check their breathing.”
Inadequate breathing can prevent the brain from getting the oxygen it needs, which can lead to death or injury, she said.
Green added that Narcan should still be used to treat a medetomidine overdose, but medical personnel must be careful not to mistake the sedative for an overdose, or they may administer too much Narcan, which can cause distress to the patient, who may then need to be hospitalized to treat a slowing heart rate.
Medetomidine is [drug] “The supply is going to be more unpredictable, more toxic and more harmful,” Green said. “This is a headache that no hospital system, no human being, no community should have to deal with in the long term.”
