Thursday, Jan 22, 2026 • 12 pm to 1 pm

Virtual

Training Sessions

Abstract

Medetomidine, a potent veterinary alpha-2 agonist, has recently emerged as an adulterant in illicit fentanyl products, first identified in Maryland in 2022 and later associated with overdoses and withdrawal cases in multiple U.S. cities. It produces prolonged sedation, bradycardia, and biphasic blood pressure changes unresponsive to naloxone. Withdrawal begins within hours, with severe autonomic instability and limited response to opioids or benzodiazepines. Management centers on dopamine-antagonist antiemetics and alpha-2 agonists such as clonidine, guanfacine, or intravenous dexmedetomidine. Diagnosis remains clinical due to limited testing. The rise of medetomidine parallels xylazine’s emergence and underscores the need for rapid clinician education, multidisciplinary coordination, and harm-reduction collaboration to address this evolving threat.

Objectives

  • Describe the pharmacology and clinical effects of medetomidine and its role as an emerging adulterant in the illicit drug supply.
  • Differentiate medetomidine toxicity and withdrawal syndromes from those associated with opioids and other sedative agents.
  • Identify key diagnostic clues and laboratory findings suggestive of medetomidine exposure in emergency and inpatient settings.
  • Formulate evidence-informed strategies for managing medetomidine toxicity and withdrawal, including appropriate use of alpha-2 agonists.
  • Discuss the public health and healthcare system implications of medetomidine’s emergence and the importance of multidisciplinary collaboration and harm-reduction integration.

Accreditation

PHYSICIAN (CME)

The University of Pittsburgh designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

NURSING (CNE)

A maximum of 1.0 nursing contact hours will be awarded. Participants will be able to claim credit commensurate with the extent of their participation in the program.

SOCIAL WORK

As a Jointly Accredited Organization, University of Pittsburgh is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. University of Pittsburgh maintains responsibility for this course. Social workers completing this course receive 1.0 continuing education credits.

Psychologist (APA)

Continuing Education (CE) credits for psychologists are provided through the co-sponsorship of the American Psychological Association (APA) Office of Continuing Education in Psychology (CEP). The APA CEP Office maintains responsibility for the content of the programs.

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