Warning about powerful tranquilizer in Alberta’s drug supply that negates overdose treatments

A powerful tranquilizer that is turning up in Alberta’s unregulated drug supply cannot be reversed by standard opioid overdose treatment, an Alberta-based researcher and physician warns.

Medetomidine – a strong non-opioid sedative used primarily by veterinarians – is being found more frequently in Alberta’s illicit drug supply, according to Dr. Monty Ghosh, an addiction medicine specialist who works in Edmonton and Calgary.

Red flags about this tranquilizer began to emerge in December when reports emerged of medetomidine becoming more prevalent in other provinces, Ghosh said.

“Since then we’ve really been looking into this and we’re seeing a huge increase in the amount of medetomidine in (Alberta’s) drug supply,” said Ghosh, who is also an associate professor at the University of Alberta and the University of Calgary.

Ghosh said there have been some previous cases of medetomidine entering Alberta’s drug supply, but never to the extent seen in the past few months. He said it is about twice as powerful as some other tranquilizers.

Ghosh said researchers are looking at medetomidine in data ranging from wastewater testing, drug spot testing and police drug seizure data in Calgary.

In Edmonton, the Spectrum drug testing program proposed by the Queer and Trans Health Collective (QTHC) has also detected a significant increase of dangerous sedatives in drug samples.

“People are expecting fentanyl, but upon our analysis, it’s fentanyl, benzodiazepine and medetomidine all in one sample,” said Kayla Holliday, harm reduction manager for QTHC.

Halliday says the primary concern with the increased prevalence of medetomidine is its impact on potential emergency responses to drug toxicity.

“With fentanyl, you give someone Narcan, you wait a few minutes, they’re revived and you can go on your way,” Holliday said.

“With medetomidine in the mix, we’re no longer expecting people to wake up because medetomidine doesn’t react to naloxone.”

Ghosh said it’s still important to try to administer naloxone to deal with the opioid component of an overdose, but “there’s really no antidote for (medetomidine).”

“For the general bystander … if they see an overdose (and) they’ve tried naloxone four or five times and it’s still not working, call for help,” Ghosh said.

A low heart rate of less than 50 beats per minute may indicate that a person who is taking a higher dose has medetomidine in their system, Ghosh said.

In a statement emailed to CBC on Friday, a spokesperson for Alberta’s Ministry of Mental Health and Addictions said the province is “aware that medetomidine is in the illicit drug supply, but there have been zero deaths as a result of this adulteration in Alberta.”

Opioid-related deaths in Alberta have declined by 39 per cent since the peak in 2023, with most communities except Edmonton returning to pre-pandemic levels, a provincial spokesperson said.

change in drug supply

Ghosh said medetomidine is added to the drug supply primarily to enhance the sedative effects of the substance.

“The issue here is that the people who are developing (and) developing these drugs … are always looking for ways to keep someone addicted for longer periods of time,” Ghosh said.

He said that means the mix of drugs in the supply “can change in the blink of an eye.”

“All it takes is one new dealer to set up shop in a certain city … that could change what’s happening with the drug supply.”

According to Ghosh, the continued growth of the illicit drug market means Overdoses – and the methods required to treat them – are moving targets.

“We must have every tool available to deal with this. And that includes not only Narcan, but also places like supervised consumption sites where we can respond to these situations.”

A spokesperson for the Edmonton Police Service said its drug experts have looked at medetomidine in the city, but have seen no increase in tranquilizer-related overdose deaths.