Mexican cartels, U.S. drug gangs mixing another lethal chemical into fentanyl, causing mass overdoses in cities across the U.S.

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Fentanyl, a lethal drug that is already causing an increase in drug overdoses across the country is now being mixed with another dangerous chemical sedative called medetomidine, and according to a report from NPR, the combination has triggered a new wave of overdoses between the months of April and May. 

Public health officials said that Mexican cartels and other gangs that sell drugs are mixing medetomidine into fentanyl and other drugs that are being sold on the street. Alex Krotulski who leads NPS Discovery, an organization that studies illicit drugs sold in the United States said, "The numbers reported out of Philadelphia were 160 hospitalizations over a three-or-four day period."

The dangerous chemical, medetomidine is most often used by veterinarians as an animal tranquilizer. Combining it with fentanyl and other drugs have been linked to mass overdose outbreaks in Chicago and Pittsburgh. Those with expertise about the chemical said that when mixed into counterfeit pills and powders, the drugs will slow the human heart rate to dangerous levels, adding that it's impossible for those using the drugs to detect it.

Since the mass overdoses, public health advisories have been issued in both Illinois and Pennsylvania. Dr. Brendan Hart from Temple University in Philadelphia said that they first began hearing reports of those using street drugs and being exposed to the fentanyl-medetomidine mix in April, adding, "Some of our emergency medicine doctors started stopping me in the hallway. They said, 'Something funny is going on with the overdoses.' Patients were coming in with very low heart rates. As low as in the 20s. A normal heart-rate is 60 to 100 [beats per minute] so 20s is extremely low."

Laboratory tests of the street drug came back as positive for medetomidine, which is sometimes used in some formulations by doctors with human patients, but only in carefully controlled medical settings. Other than that, it is primarily used as a sedative for animals. 

Medetomidine was previously detected in illicit drugs as early as 2022, but rarely and in small amounts. It is nothing like right now, which experts say appears to be spreading at a very fast pace, with large-scale overdose events reported before the ones in Chicago and Pittsburgh, those times in Toronto, Canada. 

In 2023, the Biden administration issued a warning that street fentanyl was being mixed with another highly sedative drug used by veterinarians called xylazine. That combination of drugs led to more overdoses with many users also experiencing terrible flesh wounds that lingered for months or years. 

According to experts who spoke with NPR, medetomidine is more powerful than xylazine and as it spreads, no one really knows what the long-term health effects of this new combination will cause to the human body. Krotulski said, "Patients are being cared for as we speak in emergency rooms. These are very complex drug products. You've got fentanyl adulterated with xylazine that now also contains medetomidine."

These combinations of drugs severely complicates the medical responses to high-risk overdoses. Both xylazine and medetomidine do not respond to Naloxone, the medication used to reverse most fentanyl overdoses. Also, there currently is no way for those using fentanyl to know if the drug is laced with medetomidine. 

Dr. Bertha Madras, a drug researcher at Harvard Medical School and McLean Hospital, said as of now, it is unclear why drug gangs are mixing these new chemicals with fentanyl. She said that first responders and emergency rooms need to be prepared to treat these complicated overdoses and the people using the drugs need to be warned that these drugs are more perilous than ever. She said, "They're playing Russian roulette now with the drug supply."

Madras also said that Mexican cartels and U.S. drug gangs are moving fast to create new combinations of powerful synthetic drugs and will often use chemicals like medetomidine, which are not yet regulated or tightly controlled under U.S. law. She said that it is impossible for law enforcement and public health officials to keep up.

She added, "There is an almost endless supply of new psychoactive substances and there are literally thousands and thousands of drugs that can be made."

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