Joseph J Palamar, Joshua S DeBord, Alex J Krotulski, Bruce A Goldberger
JAMA PsychiatryAbstract
The opioid crisis, currently driven by synthetic opioids, such as illicitly manufactured fentanyl (IMF), continues to become increasingly complex. Adulteration of IMF with veterinary sedatives, such as xylazine and now medetomidine, has become commonplace across the US, leading to prolonged sedation that cannot be reversed with naloxone.1 Clinicians, harm reduction experts, and others continue adapting to such changes in the drug supply (eg, testing drug products with test strips and the increased use of oxygen when treating overdoses). In recent months, we have identified a worrisome trend related to the increased identification of local anesthetics (or “-caines”) in IMF and biospecimens obtained from patients.
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