Profound Opioid and Medetomidine Withdrawal: A Case Series and Narrative Review of Available Literature
Medetomidine, a potent central acting α2 agonist, has emerged as a fentanyl adulterant in the non-medical opioid supply. Its use has been linked to a novel withdrawal syndrome that is often resistant to conventional treatment protocols. Four cases are presented exemplifying extreme, but increasingly common forms of this withdrawal syndrome. A literature review is provided demonstrating both the paucity of available literature as well as potential avenues for treatment and future research. As adulterants continue to proliferate in the illicit drug supply, clinicians should anticipate atypical withdrawal phenotypes and consider early intervention.
Authors
- G. O. Fitzpatrick
- Kory London (ORCID: https://orcid.org/0000-0002-0453-5171)
- Jennifer L. White (ORCID: https://orcid.org/0000-0003-1857-6764)
- Drew Lockstein
- Oluwarotimi Vaughan-Ogunlusi
- M.C. Montesi (ORCID: https://orcid.org/0000-0001-6173-0945)
- Karen Alexander (ORCID: https://orcid.org/0000-0002-3941-947X)
- Phil Durney
- Christopher Martin (ORCID: https://orcid.org/0009-0000-7070-4714)
- TaReva Warrick-Stone
- Dennis Goodstein
- Elise Paquin
- Kelly Goodsell
- Keira Chism
- Jamal Rashid
- Paul Goebel
- Sejal H. Patel-Francis
Institutions
- Thomas Jefferson University (US)
- Friends Research Institute (US)
Publication Details
- Journal
- Psychoactives
- Published
- 2025-10-23
- DOI
- https://doi.org/10.3390/psychoactives4040037
- Primary Topic
- Pain Management and Opioid Use
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- University of Pennsylvania
- Temple University