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Emerging Drugs in Maryland

The drug supply in Maryland is constantly changing. If you use drugs, even occasionally, you could be exposed to harmful substances, and you may not even know it. These substances, like veterinary sedatives, can have dangerous side effects in humans.

An image of a fentanyl test strip and it's packaging.

If you are using drugs, remember to:

Medetomidine

Medetomidine is a veterinary sedative that is frequently mixed with opioids. Medetomidine is increasingly being detected in drug samples in Maryland.

When in the body, medetomidine can cause deep sleep, or sedation. Individuals exposed to medetomidine may not be able to be aroused for long periods of time. Other symptoms can include shallow or stopped breathing and low blood pressure and heart rate.​ Medetomidine can cause someone to remain unresponsive even after naloxone has been administered. Naloxone does not reverse the effects of medetomidine.

Naloxone should still be administered in response to any suspected overdose. The presence of these sedatives in the drug supply makes it important for rescue breathing to be administered alongside naloxone when you are responding to a suspected overdose. 

Learn how to recognize the signs of an overdose and how to respond on ou Naloxone Page.

Medetomidine Withdrawal

Medetomidine withdrawal can start quickly and be very serious. Sometimes people need to go to the hospital.

Medetomidine withdrawal can cause:

  • a very fast heartbeat
  • very high blood pressure
  • going in and out of responding or being aware even while awake
  • heavy sweating
  • shaking or twitching
  • anxiety and restlessness

Signs to go to the hospital: 

  • can’t stop throwing up
  • have chest pain
  • going in and out of responding or being aware, even while awake
  • otherwise experiencing more severe withdrawal symptoms than usual

Xylazine

Similar to medetomidine, xylazine is a veterinary sedative, sometimes known as “tranq.” Xylazine can cause heavy sedation. Other symptoms when mixed with fentanyl can include blue/grayish skin and slowed breathing and heart rate. Xylazine is not an opioid, but is often found mixed with opioids, therefore naloxone should be given to a person experiencing an overdose involving xylazine.

An image of a bandage being applied to someone's arm.

Xylazine is associated with severe wounds that spread and worsen quickly. The wounds occur regardless of how people use: smoking, snorting, or injecting. People should seek urgent medical attention if they exhibit extreme pain, fever or chills, if the wound turns black, if there is a foul odor, or if they experience bone and/or tissue tenderness or damage.

People who use xylazine heavily and frequently are at risk of withdrawal. Xylazine withdrawal is often marked by irritability, anxiety and a feeling of unease.

Additional Resources

Xylazine in Maryland Report

To respond to the potential threat of xylazine, the Maryland Department of Health’s Overdose Data to Action team developed the Maryland Xylazine Workgroup to address questions, share data, and make recommendations for practice, surveillance, and policy development. Their report summarizes the efforts of the Workgroup and presents critical information about xylazine in Maryland.

Rapid Analysis of Drugs (RAD)

RAD is a statewide drug-checking program overseen by the Maryland Department of Health’s Center for Harm Reduction Services. RAD tests paraphernalia samples voluntarily submitted by participants of syringe services programs in Maryland and provides information on drug composition in near real-time.

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