A Case of Maternal and Neonatal Withdrawal After Exposure to Fentanyl Adulterated With Medetomidine

The emergence of medetomidine, a potent veterinary alpha-2 adrenergic receptor agonist, as a common fentanyl adulterant in many areas of the United States poses new threats to pregnant women who use illicit opioids and their neonates. We present a case of severe withdrawal seen in a postpartum woman and her neonate after exposure to fentanyl adulterated with medetomidine up to the time of delivery. The case demonstrates the need for obstetric and pediatric providers to be aware of this emerging trend to allow for early recognition and prompt treatment of the potentially life-threatening symptoms of medetomidine withdrawal, which differs from traditional withdrawal patterns, and highlights the importance of communication and coordination between obstetric and pediatric teams caring for this population.