Nitazines & Medetomidine
You’ve heard of fentanyl, the most prominent opioid in the North American drug supply for over a decade. And by now, you’ve likely heard about xylazine (aka tranq), a tranquilizer that has become a common cut in street drugs in the US in the past five years. But have you heard yet about nitazenes or medetomidine? Both are becoming increasingly common in the drug supply, so here’s some basic info you might like to know!
Nitazines
Nitazines are synthetic opioids that were first created in the 1950s as an alternative to morphine, but were never approved for medical use. Later, they first appeared in the street drug supply in 2019, and have become increasingly common in 2025.
As is true for most street drugs the potency of nitazines can vary, but samples have suggested that nitazines can be up to 10x the potency of fentanyl. The effects of nitazines are similar to other opioids including euphoria, relaxation, drowsiness, pain & stress relief, itchiness, nausea, fever, slowed breathing and slowed heart rate. A notable difference from fentanyl is that folks who use nitazines are often found heavily sedated and less responsive when you try to wake them.
Nitazines: Overdose Response
The signs of an overdose like with any opioid are shallow breathing, blue/grey lips & finger tips, and loss of consciousness. Nitazines are often found cut with fentanyl and the overdose response for both drugs is the same, use naloxone! Because both drugs are opioids, naloxone is highly effective for overdose reversal. Just follow the usual steps of performing rescue breathing and administering naloxone (either nasal spray or intramuscular injection) as often as every 2 to 3 minutes as needed.
Nitazines: Withdrawal
Nitazine is an opioid, so the withdrawal symptoms mirror those for heroin or fentanyl, however due to its potency the following symptoms may be more severe:
• Excessive sweating
• Restless legs
• Fever
• Dizziness
• Flu-like symptoms
• Blackouts
• Severe anxiety & panic attacks
When experiencing severe withdrawal symptoms due to a pausing or stopping drug use, you may consider seeking hospitalization or outpatient treatment to manage symptoms.
Medetomidine
Medetomidine is a tranquilizer that was initially developed for veterinary use. In 2022, this tranquilizer was first found in the US street drug supply in a sample from Maryland that was tested by a Street Drug Analysis Lab. It has now become increasingly prevalent in 2025. Samples have been found in the drug supply across the country including in California, Colorado, Illinois, Kentucky, Pennsylvania, New York and Missouri. Medetomidine has likely reached the drug supply in other states as well but has not yet been documented.
In comparison to xylazine, medetomidine is estimated to be approximately 100x more potent. The effects of the tranquilizer include euphoria, but also confusion, muscle twitching and heavy longlasting sedation. In some cases, medetomidine can also cause hallucinations. Like with tranq, when using drugs cut with medetomidine people can experience slowed heart rate & breathing, and sedation resulting in unresponsiveness. In severe cases, this can lead to losing consciousness, vomiting, bloody diarrhea, hypotension, and be life threatening. If someone is experiencing severe symptoms from medetomidine, immediate medical care is required.
Medetomidine: Overdose Response
When responding to an overdose that may have involved medetomidine, be sure to administer rescue breaths to get the person oxygen as quickly as possible in addition to using naloxone. Because medetomidine is typically a cut for fentanyl, naloxone should be administered to reverse the effects of opioid overdose. However, keep in mind that naloxone will NOT reverse the effects of medetomidine. We recommend keeping an eye on the person who overdosed after they have responded to the naloxone, in case of any continued severe symptoms from medetomidine. Continued symptoms that are not alleviated from the naloxone may require medical attention.
Medetomidine: Withdrawal
When regularly using drugs cut with medetomidine, symptoms of withdrawal when pausing or stopping use are more severe than with fentanyl alone or fentanyl with tranq. These symptoms include the following:
• Fast heart rate (>100 beats per minute)
• Dangerously high blood pressure (>180/100)
• Uncontrollable nausea and vomiting
• Tremor
• Excessive sweating
• Changing levels of alertness
• Severe anxiety
If you or someone you know is experiencing these severe withdrawal symptoms it is highly encouraged to seek hospitalization. Medetomidine withdrawal often requires intensive care in a hospital setting to manage the uncomfortable and potentially life threatening symptoms.
Medetomidine:
Wound Care
Notably, unlike xylazine, medetomidine has not been documented to lead to severe wounds. However usage of the tranquilizer causes veins to constrict, which can in turn lead to injection site wounds taking longer to heal. If you suspect medetomidine in your supply, take extra care to clean your injection sites and treat any existing wounds.