Xylazine, medetomidine and nitazines are substances that are emerging as key contributors in the latest wave of the Opioid Overdose Epidemic. Xylazine is an adulterant that increases the duration of a user’s fentanyl high and delays withdrawal to some extent. Medetomidine is another adulterant that belongs to the same family of drugs as xylazine, but its duration is relatively longer. Nitazenes make up a class of synthetic opioids estimated to be significantly more potent than fentanyl. The degree of potency ranges, with reported estimates between 10 to as high as 43 times more potent than fentanyl.
Many entities come to the Opioid Response Networking (ORN) seeking the best and most current information on emerging threats to their communities. In September 2024, the ORN received a request from the Hancock County Board of Alcohol, Drug Addiction and Mental Health Services in Ohio. Their task force was looking for resources to educate themselves further on xylazine, nitazines and medetomidine.
Jess Draws, the ORN Technology Transfer Specialist for Ohio and the Regional Coordinator for Region 5 received the case and got to work. ORN already has a sizable amount of information on xylazine, as it has been impacting more communities across the US in recent years. This information was easily found and shared. Nitazines and medetomidine would be a different story.
Recently, ORN partners at RTI International created several data briefs on new and emerging trends. One of the substances RTI International created a data brief for is nitazines. Draws was also able to find an Ohio news article and additional brief from the US Department of Justice Drug Enforcement Administration.
For medetomidine, she was able to find an announcement and an alert from The Center for Forensic Science Research & Education that pointed to additional information. Jess also reviewed ORN’s internal repository and the public catalogs of Providers Clinical Support System (PCSS) and the ATTC.
Jess was hopeful the ORN team listserv would have even more information to add to this list. She wanted to make sure this requester and their task force had as much current information on these emerging topics as possible. She sent an email request to all Technology Transfer Specialists asking for more resources and potential consultants to work with. Responses poured in from across the US, with different regions sharing webinars and research they had come across in addition to consultants they had worked with. After a week, Jess compiled these resources into a single email and sent it back out to the listserv for easy access. Below are the resources on nitazine and medetomidine the team was able to crowdsource from our shared knowledge base.
ORN hope this information will be helpful for anyone seeking education on these substances in the future.
The opinions expressed herein are the views of the authors and do not reflect the official position of the Department of Health and Human Services (DHHS), SAMHSA, CSAT or the ATTC Network. No official support or endorsement of DHHS, SAMHSA, or CSAT for the opinions of authors presented in this e-publication is intended or should be inferred.