The US drug supply has been found to contain medetomidine as an adulterant to heroine/fentanyl. It is a potent tranquilizer used in animals. It is an alpha 2 blocker (similar pharmacology to clonidine and xylazine). Exposure to this drug can induce withdrawal symptoms to include anxiety, tremor, diaphoresis, nausea, vomiting, agitation, sympathetic hyperactivity, and delirium. Withdrawal can start within 4-6 hours of last use.
Treatment for withdrawal is outlined in this diagram.
