Clinicians first noticed medetomidine in the Philadelphia drug supply during the spring of 2024. There was a cluster of overdoses one weekend, leaving patients more sedated and with lower heart rates than normal after receiving the reversal medication naloxone.
It raised some red flags, but amid a constantly changing drug supply, not many. None of the patients died, and most went home from the hospital the same day. It wasn’t until autumn, when patients started coming in with excruciating withdrawal symptoms, that doctors knew something had dangerously shifted.
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