What to know
- Presentation Day/Time: Thursday, April 24, 9:00–10:25 am
- Presenter: Amy Nham, PharmD, MPH, EIS officer assigned to the Chicago Department of Public Health
What did we do?
- On May 11, 2024, the Chicago Department of Public Health (CDPH) was notified of a spike in emergency medical services (EMS) responses for opioid-involved overdoses with atypical symptoms.
- Toxicology results showed medetomidine mixed with opioids, marking the first time medetomidine was detected in Chicago.
- Investigators collected blood and drug sample testing results from the Drug Enforcement Administration's Toxicology Testing Program and the Center for Forensic Science Research and Education, EMS records from the Chicago Fire Department, and medical records from 3 emergency departments receiving the most opioid-involved overdose EMS transports during May 11–17, 2024.
- We investigated to characterize demographic and clinical characteristics of overdose cases involving medetomidine.
What did we find?
- CDPH identified 12 confirmed and 26 probable cases.
- Twelve (80%) of 15 blood and 5 (50%) of 10 drug samples contained medetomidine; all contained fentanyl.
- Cases mostly occurred among males, Black persons, and persons aged 45–64 years.
- The most common symptoms were hypertension and bradycardia.
- Sixteen (42.0%) patients were hospitalized; 9 (24.0%) required intensive care unit admission.
- Of 12 confirmed cases, 11 (92.0%) patients had partial or no improvement of symptoms after naloxone administration.
Why does it matter?
- Medetomidine is a potent nonopioid sedative increasingly detected in illegally manufactured opioids.
- This report is the first to characterize a cluster of overdoses involving medetomidine.
- Clinicians should contact their local health department and submit blood and drug samples for testing if they identify unexpected signs or symptoms for suspected opioid-involved overdoses.
Abstract Category: Opioids