Suspected Medetomidine Withdrawal Syndrome Among Fentanyl-Exposed Patients in Philadelphia, PA

"The syndrome described in this report is similar to that described among ICU patients with days-long exposure to dexmedetomidine, an enantiomer of medetomidine, who experience an autonomic withdrawal syndrome with vomiting and agitation when dexmedetomidine is discontinued (4,5). In the patients described in this report, these signs and symptoms were not resolved by increasing doses of medications previously effective in managing fentanyl and xylazine withdrawal; however, they were responsive to dexmedetomidine, as described in the management of dexmedetomidine withdrawal (4,5). Health care providers and public health agencies need to be aware of this life-threatening withdrawal syndrome because it can require substantial escalations in care compared with the typical opioid and xylazine withdrawal syndromes. Public health agencies should consider testing for medetomidine in their regional drug supplies."