Medetomidine, a highly potent veterinary alpha-2 adrenergic agonist, has recently emerged as a significant adulterant within the U.S. illicit opioid supply. This presentation entitled will review the introduction of medetomidine in the U.S. drug supply, the pharmacology and clinical effects of medetomidine, and the distinguishing features of medetomidine toxicity and withdrawal. We will outline emerging treatment strategies emphasizing early, aggressive alpha-2 agonist therapy; nuanced antiemetic approaches; when and how to escalate to IV dexmedetomidine; and approaches to concurrent opioid withdrawal management. Participants will gain insight into diagnostic challenges, observation and disposition considerations, and strategies for system-level preparedness.
Dr. Michael Lynch is an associate professor of Emergency Medicine, Toxicology, and Addiction Medicine at the University of Pittsburgh where he works clinically in several UPMC hospitals. He is currently Senior Medical Director for Quality and Substance Use Disorder Services at UPMC Health Plan. He previously served as the first Medical Director of the PA Department of Drug and Alcohol Programs and was Medical Director of the Pittsburgh Poison Center for 10 years. Dr. Lynch is the founder and director of the UPMC Medical Toxicology Telemedicine Bridge Clinic.