New York State Department of Health Warns of Highly Potent Synthetic Sedative More Powerful Than Xylazine Emerging in Drug Checking Samples

Department Issues Updated Health Alert for Medetomidine Increasingly Detected in Unregulated Drug Supply

Medetomidine was Detected in 37 Percent of Opioid Samples in 2025, Compared to 4 Percent in May 2024

Medetomidine is a Highly Potent Synthetic Sedative Used in Veterinary Medicine

Severe Withdrawal Symptoms are Associated with Medetomidine

Department is Purchasing Medetomidine Testing Strips to Support Community Drug Checking Program Partners

ALBANY, N.Y. (December 19, 2025) – The New York State Department of Health today issued an updated Public Health Alert after the Department's Community Drug Checking Program has detected an increase in the presence of medetomidine in the unregulated drug supply.

Medetomidine is not an opioid, rather it is a highly potent synthetic veterinary sedative not approved for human use that is similar to, but more powerful than, xylazine. While the full clinical impact of medetomidine is still being explored, medetomidine is associated with longer, heavier sedation than opioids and with severe withdrawal symptoms beyond those with opioids.

"Medetomidine impacts the central nervous system and can lead to extreme vomiting and high blood pressure potentially requiring ICU care. Clinicians should be aware of this clinical syndrome," State Health Commissioner Dr. James McDonald said. "The State Health Department and its Drug Checking Program remain committed to preventing overdoses, ensuring access to needed medical and social services and protecting the safety of New Yorkers."

The Department's Community Drug Checking Program has been monitoring the presence of medetomidine since it first appears in the drug supply and the presence of medetomidine has increased substantially compared to prior years. Data shows that medetomidine was detected in 37 percent of opioid samples in the month of October 2025 (xylazine was detected in 40 percent of opioid samples), compared to 4 percent containing medetomidine in May 2024. More information on medetomidine, xylazine and fentanyl trends in opioid samples over time can be found in the Public Health Alert.

In response to this increase, and in addition to issuing the updated health alert, the State Department of Health is purchasing medetomidine drug checking test strips to support the Community Drug Checking Program partners, helping to ensure timely access to reliable tools that identify the presence of medetomidine in the drug supply.

In New York State, medetomidine is most often found combined with fentanyl and other opioid substances. While medetomidine is in New York, at this time there are few reports of severe withdrawal. Both medetomidine and xylazine are added to fentanyl to extend the effect of the drug. The effect from fentanyl lasts half the time of heroin.

While medetomidine is not an opioid, naloxone should be administered to a person suspected of experiencing an overdose to reverse the effects of fentanyl and restore breathing – even if the individual doesn't regain consciousness. As always, if a drug overdose is suspected, it is critical to seek help by calling 911.

The State Department of Health's Community Drug Checking Program remains a vital component to identifying potentially harmful substances in the unregulated drug supply.

Drug checking programs and the dedicated local participating partner organizations are critical harm reduction resources and public health tools that allow for the rapid identification of emergent substances that in the past would only have been identified in post-mortem toxicology testing. These programs also serve as an important resource offering fentanyl, xylazine and medetomidine test strips for client use and are an important referral pathway to other needed medical and social services.

More information on the State Department of Health Drug Checking Program and how to access drug checking services can be found here.

ADDITIONAL INFORMATIONAL RESOURCES FOR PROVIDERS

As the human use of medetomidine (especially in the presence of fentanyl) is a relatively recent development, the clinical guidelines for care are still evolving. However, useful informational resources for providers include the following: