The Indiana Department of Health (IDOH) is updating physicians about the substance medetomidine, a non-opioid sedative used in veterinary medicine. Medetomidine has been increasingly detected in both national and Indiana data. While it is most commonly detected alongside opioids, like fentanyl and fentanyl analogs, medetomidine has also been identified with other substances, such as stimulants, cannabis and common drug supply adulterants, such as diphenhydramine, lidocaine and xylazine. 

Medetomidine is an alpha-2 agonist intended for veterinary use, similar to but more potent than xylazine. Medetomidine was first approved by the Food and Drug Administration (FDA) in 1996 for veterinary use. Medetomidine is not approved for human use. However, in human medicine, medetomidine is the most closely related to dexmedetomidine, which was approved as a sedative for human patients. Currently, neither medetomidine nor dexmedetomidine is scheduled as a controlled substance by the United States Drug Enforcement Administration.
 
Human use of medetomidine may cause sedation, low heart rate, and low blood pressure. Additionally, stopping medetomidine after regular use can cause severe withdrawal symptoms. 

From November 2023 to February 2026, there have been 2,231 detections of medetomidine in syringes returned to select disposal sites.  Detections have increased annually over that period, with 28 detections in 2023, 713 in 2024, and 1,281 in 2025. Another 209 detections have occurred through February 2026. Common co-detections include cocaine, diphenhydramine, fentanyl (including metabolites and analogues), lidocaine, methamphetamine, quinidine, and xylazine. Fentanyl was found in 99.5% of specimens where medetomidine was detected. From December 2024 to March 2026, there have been 70 total detections of medetomidine in Indiana toxicology data, which is derived from toxicological testing of specimens submitted by Indiana coroners in the event of a suspected overdose death. o Only one detection occurred in 2024, 43 detections occurred in 2025, and 26 detections have as of March of 2026. Detections occurred in 24 Indiana counties, with Marion County accounting for 45.7% (32 total) of all positives. Wayne County has the second-highest percentage, accounting for 7.1% (5 total) of all positives. There have been no records of prescriptions for medetomidine or dexmedetomidine in INSPECT data from 2017 to 2025 for human or nonhuman patients.

To learn more about signs and symptoms or to obtain Naloxone, contact IDOH.