Withdrawal From Medetomidine Increasingly Seen in ICUs

Simultaneously, the number of opioid use disorder-related hospitalizations requiring dexmedetomidine administration rose fivefold
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THURSDAY, Oct. 8, 2026 (HealthDay News) -- Opioid use disorder (OUD)-related hospitalizations involving dexmedetomidine administration rose markedly with the infiltration of the veterinary sedative medetomidine into the street supply of fentanyl, according to a research letter published online Sept. 28 in JAMA Internal Medicine.

Tyler G. Boyce, M.D., from University of Pennsylvania in Philadelphia, and colleagues examined trends in dexmedetomidine receipt and intensive care unit (ICU) admissions among hospitalized patients with OUD. The analysis included electronic health records from 11,846 OUD-related hospital admissions at two large, academic hospitals (7,606 unique patients from Jan. 1, 2020, through Sept. 30, 2025).

The researchers found that from 2020 to quarter 2 of 2024, 5.8 percent of admissions received dexmedetomidine versus 19.8 percent during the medetomidine period (quarter 2 of 2024 to quarter 3 of 2025), rising to 31.7 percent by quarter 3 of 2025. Across the study period, 99.5 percent of admissions involving dexmedetomidine receipt involved the ICU. In the medetomidine period, admissions with dexmedetomidine administration were greater among patients who were descriptively younger (mean age, 42.6 versus 48.1 years without dexmedetomidine), as well as those with Medicaid coverage (77.6 versus 59.3 percent). For admissions with dexmedetomidine administration, fentanyl was more often detected on urine drug testing (90.7 versus 76.1 percent), primary admission diagnosis was more often related to OUD or overdose (61.1 versus 19.8 percent), ICU length of stay was longer (median, 63.5 versus 48.0 hours), and a higher proportion of patients were discharged before medically advised (27.8 versus 16.6 percent). Patients receiving dexmedetomidine were also more likely to receive methadone (78.8 versus 50.1 percent), buprenorphine (36.4 versus 26.2 percent), short-acting opioids (96.8 versus 86.5 percent) at higher doses, and clonidine (80.6 versus 46.1 percent).

"Patients are coming to us very sick, and we have had to rapidly adapt our treatments to serve the patients in front of us," senior author Margaret Lowenstein, M.D., also from University of Pennsylvania, said in a statement. "Understanding the impact of this new adulterant and helping clinicians and hospitals prepare to care for affected patients is critical."

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