Public Health Alert – Animal tranquilizer in unregulated drugs and increased toxicity events

Situation

The city of Belleville, Ontario has declared a state of emergency due to a substantial increase in unregulated drug toxicity events in a short period of time. This follows an alert this week about a new drug in the Toronto drug supply: medetomidine/dexmedetomidine. This animal tranquilizer has been found in substances also containing opioids, as well as in some cases containing benzodiazepines and xylazine. These substances interact resulting in increased harms.  Medetoximine/dexmedetoximine has a stronger sedative effect than xylazine and is associated with loss of consciousness and may cause cardiac, circulatory system, and respiratory depression.

Issue

Medetoximine/dexmedetoximine can cause a medical emergency and when combined with other drugs such as benzodiazepines, xylazine, and opioids the risk of toxicity from any of the drugs is increased.

Awareness is a key overdose prevention step for anyone using any kind of unregulated drug.

Prevention and harm reduction opportunities

Messaging for patients/clients:

• Unregulated drugs are rarely “pure” and are frequently cut (mixed) with other substances you may not be expecting, including fentanyl and drugs that depress cardiac, circulatory, and respiratory function such as medetoximine/dexmedetoximine, benzodiazepines and xylazine.
• Don’t use alone. Have someone with you, on the phone, or download and use the Lifeguard app or call NORS 1-888-688-NORS (6677).
• If using with a friend, do not use at the same time. Make sure the other person is OK before you use.
• Carry naloxone and know how to use it – although not effective on all drugs, it is effective on opioids.
• Call 911 if you think someone is experiencing a drug poisoning/overdose! The Good Samaritan Drug Overdose Act provides some legal protection to the person calling.
• Counsel on the range of treatment options for opioid use disorder including opioid agonist treatments.

Resources

• Northwestern Health Unit – Naloxone and Opioid Overdose Prevention
• Sign up for information and alerts from Toronto’s Drug Checking Service

Contact:
Donna Stanley
Director, Health Protection
Northwestern Health Unit