The Storm After the Calm: A Case of Medetomidine Withdrawal.
Gustavo D Porto, Kira Galeano, William Binder
✦ AI-curated · Sources linked
Case in brief
A 30-year-old woman with a history of intravenous drug use presented to the emergency department exhibiting nausea, vomiting, agitation, and delirium. She required endotracheal intubation for airway protection and further evaluation. Despite maximum sedation, she developed tachycardia and hypertension. Toxicology screening identified medetomidine, a sedative commonly found in illicit fentanyl mixtures.
What made this case unusual
This case highlights the presence of medetomidine, a veterinary sedative, as an adulterant in illicit fentanyl, which is not commonly reported in Rhode Island.
Diagnostic / clinical pearl
Clinicians should consider the possibility of medetomidine exposure in patients presenting with severe agitation and altered mental status, especially in the context of intravenous drug use.
Why it matters
Understanding the emergence of medetomidine in the illicit drug supply is crucial for appropriate management and awareness of potential complications in emergency settings.