Powerful new drug creates withdrawal crisis in Philly

Philadelphia, which represents ground zero for America’s ever-evolving drug crisis, is currently battling a new threat.

Medetomidine is a 30-year-old veterinary sedative that’s quietly taken over Philly’s fentanyl supply, and triggered an unprecedented surge in hospitalizations.

Some facts: Medetomidine was first detected in the city’s drug supply last spring, and recently found in 91% of tested fentanyl samples across Philadelphia. It’s up to 200x more potent than xylazine, the last tranquilizer to sweep through Philly.

• Medetomidine typically causes instant blackouts, followed hours later by intense withdrawal symptoms: heart rates above 170 bpm, vomiting, hallucinations, and even brain damage.
• Doctors say it’s created a new type of drug crisis, where the biggest danger for users comes not by overdosing on medetomidine, but by withdrawing from it.

Usage has spread in recent years

Philadelphia’s hospitals have recently come under strain from patients who come in with life-threatening medetomidine withdrawal symptoms.

• There were 7,252 ER admissions for withdrawal in Philadelphia over the first nine months of 2025, compared with 2,787 for all of 2023.
• One local hospital system is expected to spend $2 million on medetomidine patient transfers alone this year, with limited options for reimbursement.

Big picture: Outside of Pennsylvania, medetomidine has been reported in nearly a dozen other states, including Colorado, Florida, New Jersey, and Ohio, per the NY Times. And with its low cost and extreme addictiveness, experts warn medetomidine could spread even faster than past drug waves.