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Войти в исследования Forensic science international · 2025
Qualitative medetomidine detection in ante- and post-mortem samples via toxicology surveillance testing, Michigan 2024-2025.
СтатьяНазвание и аннотация: Перевод в очереди
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Vohra Varun, Levitas Matthew P, Thomas Chris S, Jones Prentiss
Аннотация
INTRODUCTION: Medetomidine is a non-opioid sedative with an increasing presence as an adulterant in the North American illicit drug supply. This study's purpose was to characterize the prevalence of medetomidine-positive cases in both ante- and post-mortem samples across Michigan.
METHODS: Post-mortem blood samples were submitted to the Swift Toxicology of Overdose-Related Mortalities (STORM) project between March 1, 2024, and May 16, 2025. Ante-mortem oral fluid samples were submitted to Forensic Fluids Laboratories Inc. between August 6, 2024, and May 27, 2025. All ante- and post-mortem samples were screened for common drugs of abuse. Medetomidine was qualitatively identified in both matrices using liquid chromatography-tandem mass spectrometry.
RESULTS: 4290 post-mortem blood samples were tested with medetomidine detection in 17 (0.4 %) specimens. Fentanyl was co-detected with medetomidine in 16/17 (94.1 %) cases while xylazine was co-detected in 8/17 (47.1 %) cases. Positive co-detection of both xylazine and fentanyl occurred in 8/17 cases (47.1 %) cases. 20,736 ante-mortem oral fluid samples were tested with medetomidine detection occurring in 129 (0.6 %) specimens. Fentanyl was detected in 126/129 (97.7 %) cases while 59/129 (45.7 %) samples involved co-detection of both fentanyl and xylazine.
CONCLUSIONS: Our findings support recent evidence of frequent co-detection of medetomidine in mixtures containing fentanyl and xylazine. Post-mortem blood and ante-mortem oral fluid data may reflect different inflection points related to market saturation of emerging drugs and adulterants. The prevalence of medetomidine in street-level opioids highlights the significance of increasing awareness and education directed to people who use drugs and health information exchange across health sector entities to mitigate morbidity and mortality.
METHODS: Post-mortem blood samples were submitted to the Swift Toxicology of Overdose-Related Mortalities (STORM) project between March 1, 2024, and May 16, 2025. Ante-mortem oral fluid samples were submitted to Forensic Fluids Laboratories Inc. between August 6, 2024, and May 27, 2025. All ante- and post-mortem samples were screened for common drugs of abuse. Medetomidine was qualitatively identified in both matrices using liquid chromatography-tandem mass spectrometry.
RESULTS: 4290 post-mortem blood samples were tested with medetomidine detection in 17 (0.4 %) specimens. Fentanyl was co-detected with medetomidine in 16/17 (94.1 %) cases while xylazine was co-detected in 8/17 (47.1 %) cases. Positive co-detection of both xylazine and fentanyl occurred in 8/17 cases (47.1 %) cases. 20,736 ante-mortem oral fluid samples were tested with medetomidine detection occurring in 129 (0.6 %) specimens. Fentanyl was detected in 126/129 (97.7 %) cases while 59/129 (45.7 %) samples involved co-detection of both fentanyl and xylazine.
CONCLUSIONS: Our findings support recent evidence of frequent co-detection of medetomidine in mixtures containing fentanyl and xylazine. Post-mortem blood and ante-mortem oral fluid data may reflect different inflection points related to market saturation of emerging drugs and adulterants. The prevalence of medetomidine in street-level opioids highlights the significance of increasing awareness and education directed to people who use drugs and health information exchange across health sector entities to mitigate morbidity and mortality.