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Mass. city officials see increase in overdoses containing veterinary sedative

The presence of medetomidine was found in the systems of those who overdosed

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The entrance to UMass Memorial Medical Center in Worcester.

Noah R. Bombard

By Adam Bass
masslive.com

WORCESTER, Mass. — There was a reported increase in opioid overdoses in Worcester earlier this month, with blood tests finding traces of a sedative used in veterinary anesthesia, according to officials from UMass Memorial Health.

UMass Memorial Health Paramedic Dr. Brian Rettger and Medical Toxicology Chief Director Dr. Kavita Babu told MassLive that the tests discovered the presence of medetomidine in the systems of those who had overdosed. Medetomidine is a sedative mostly used for animals and is not FDA-approved for human use, according to a press release from UMass Memorial. The finding of medetomidine in the patients’ bloodstream suggests it has now entered into the city’s drug supply, officials said.

Rettger, who noticed the uptick in overdoses, said those who have medetomidine in their system show the same signs as those who overdose but their heart rate and blood pressure drop dramatically. These side effects create what Rettger described as “complications” when treating the patient and are likely to cause a need for additional care.

“Ordinarily we expect people to have higher heart rates and generally normal blood pressure, maybe elevated slightly,” Rettger said. “Sometimes with these patients, we have to provide more care of fluid resuscitation and then sometimes medications to support their blood pressure because of these other vital signs that we are seeing in these overdoses.”

Rettger said medetomidine has been reported in Worcester, but not in Boston or Springfield, which was confirmed by a Boston Public Health Commission spokesperson and Springfield Department of Health and Human Services Commissioner Helen R. Caulton-Harris.

Thomas Matthews, a spokesperson for Worcester City Manager Eric Batista, confirmed to MassLive there has been an increase in opioid overdoses and added that there haven’t been any fatalities the city has become aware of. Matthews said the city gets police data on overdose calls and checks data with Worcester Medical Emergency Services and UMass Memorial.

Overdose patients’ blood was drawn at UMass Memorial Hospital then tested at a facility in Philadelphia as part of a study called Setanyl II, funded by the National Institute on Drug Abuse and anticipated to be complete later this year, Babu said. The purpose of the study is to support up-to-date drug testing on blood specimens to gain a better understanding of how the substances involved in overdoses change over time.

“Our biggest challenge is that if you aren’t able to test for it, you can’t find it,” Babu said.

Babu said that medetomidine’s effects include sleepiness, lower heart rate and lower blood pressure — and that the recent patients in Worcester who had it in their blood showed those symptoms. She went on to add that medetomidine comes from the same family as xylazine — a non-opioid central nervous system depressant that has a powerful sedative that has been found across the state and particularly in Western Massachusetts. Babu and Rettger told MassLive xylazine — also known as tranq — has also been found in patients living in Worcester.

“These are kind of like cousins,” she said. “They have similarities of effects: sleepiness, low blood pressure, low heart rate.”

Both Rettger and Babu told MassLive that Naloxone, a medicine that can reverse opioid overdoses, remains effective when overdose patients have medetomidine in their system.

“Medetomidine travels with fentanyl and fentanyl is the culprit,” Babu said. “Fentanyl is still the thing that kills people and these other agents contribute to that. When you get these patients Naloxone, you still get the most important effect which is that you get them to breathe again and the Naloxone does that.”

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