MCHD urges residents to stay alert as the drug supply changes 4-3-26

April 3, 2026

MCHD urges residents to stay alert as the drug supply changes

MOBILE, Ala. — The Mobile County Health Department is urging residents to be aware that the illegal drug supply continues to change, with synthetic opioids and animal sedatives — such as xylazine and medetomidine — increasing the danger of overdose. Medetomidine is a non-opioid sedative not approved for use in humans, and CDC has documented overdose clusters involving medetomidine mixed with opioids, including fentanyl.

“The drug supply is becoming more unpredictable and more dangerous, and people may not know what is mixed into the substances they are using,” said Dr. Kevin Michaels, Health Officer for Mobile County. “Naloxone can still save a life in an opioid overdose, but when other sedatives like xylazine or medetomidine are involved, that person still needs immediate emergency medical care.”

If you think someone is having an opioid overdose, administer naloxone immediately and call 911. Naloxone does not reverse xylazine or medetomidine themselves, but it can reverse the opioid effects that commonly occur with them, and emergency medical care remains critical because sedation and breathing problems may continue after naloxone is given.

When available, drug test strips can help detect substances such as fentanyl, xylazine, and medetomidine that may be mixed into drugs without a person’s knowledge.

These drug mixtures can also complicate withdrawal and recovery. Public health guidance has warned that medetomidine withdrawal can begin abruptly, worsen within hours, and cause severe symptoms that may require hospital-level care or intensive monitoring.

For clinicians, consider medetomidine intoxication when a patient has prolonged sedation after a suspected opioid overdose, especially when sedation continues after naloxone administration. CDC reported that bradycardia, hypertension, altered mental status, and partial or no response to naloxone were common clinical features in overdoses involving medetomidine mixed with opioids.

Consider medetomidine withdrawal when patients present with tachycardia, severe hypertension, fluctuating alertness, tremor, chest pain, or intractable nausea and vomiting, or when they do not improve after standard opioid withdrawal treatment. Philadelphia public health guidance notes that severe symptoms may require transfer to an emergency department, acute care hospital, or intensive care unit for closer monitoring and treatment.