Using any street drug is now a game of Russian Roulette, according to a police chief in a city grappling with a new cutting agent dubbed ‘rhino tranq’.

Since first wrote about the drug, formally known as medetomidine, more cities are reporting waves of overdoses that medicine cannot reverse.

The sedative is 100 to 200 times more potent than xylazine, an animal tranquilizer being used to boost the potency of everything from cocaine to heroin and fentanyl.

It doesn’t show on test strips and cannot be treated with Narcan, making it a silent killer that neither police or users can keep up with.

Rick Lorah, deputy chief of criminal investigations in Erie, Pennsylvania, not far from Philadelphia where over 160 overdoses involving rhino tranq occurred in just four days last month.

He said ‘So if it’s happening in Philadelphia, it’s happening in New York, it’s happening in Pittsburgh, it will happen here.’

Drugs are openly used and passed around in the Kensington neighborhood in Philadelphia, with many bent over in a trance like state

Drugs are openly used and passed around in the Kensington neighborhood in Philadelphia, with many bent over in a trance like state

He said that the new drug adulterants are ‘all cheaper than the drug being sold. Each one seems to be more deadly.’

Michigan has lost three residents to the drugs laced with the tranquilizer, which is approved as a drug for cats and dogs, since March.

And officials in Chicago saw ‘mass overdose outbreaks’ over just a few days in mid-May. It was the first time the drug was ever found in the illicit drug supply.

But it’s such a new addition to the drug supply that most states have been caught off guard and are still struggling to keep track of how widespread it is. 

Overdoses have escalated throughout May and early June, and the drug has also been detected in San Francisco, Indianapolis, Toronto, Canada, Maryland, and more.

The drug acts on the brain differently than an opioid like fentanyl, which binds to specific receptors in the brain. 

When a person is experiencing an overdose of fentanyl or heroin, paramedics can administer the reversal drug Narcan, buying the person life-saving time to seek additional medical care.

But medetomidine, as well as xylazine, are alpha-2 agonists, which are not affected by Narcan at all. They are often referred to as ‘zombie drugs.’ People taking them often nod off, even while standing up, or slump over on the street in a daze.

As law enforcement has been trying to crack down on xylazine- and fentanyl-laced drugs, cartels and drug suppliers have seen a new opportunity in medetomidine. 

The drug is impossible to detect with standard test strips used to screen heroin and cocaine for deadly fentanyl.

It causes a drastic drop in heart rate, lowers blood pressure, and decreases activity in the brain, raising the odds that the user will go into cardiac arrest. 

These risks are greatly compounded when the drug is paired with another sedative like xylazine in addition to fentanyl.

Dr Daniel Ciccarone, who has studied the effects of drug use for decades at the University of California, San Francisco, said: ‘The concern is that because it’s sedating, that could go in the wrong direction when you’re already on a sedating opioid like fentanyl.

‘Now you have two sedating drugs, which are sort of a double downer combination, we could call it, and that would raise the risk for overdose.’

Officials in Philadelphia, where the Kensington neighborhood has devolved into an open-air drug market, issued a health alert about medetomidine last month that said: ‘To date, all samples that contained medetomidine also contained xylazine and fentanyl.’

Neither medetomidine nor xylazine is approved for human use; neither are their two antidotes, which could have potentially disastrous consequences to the human body. 

Those antidotes would cause extremely high blood pressure and an accelerated heart rate and thus, ‘should not be used to reverse adverse effects of medetomidine,’ according to Philly officials.

Daniel Teixeira da Silva, who heads the Philly Health Department’s Division of Substance Use Prevention and Harm Reduction, said that because the drug is so new in the illicit supply: ‘We don’t really know the effect on humans.’

Xylazine, which got on health officials’ radars in 2018, is known to restrict blood vessels, cutting off oxygen-rich blood flow to skin tissues. When tissue is deprived of oxygen, it can die, leading to ever-worsening skin ulcers that can require amputation.

It’s not clear whether medetomidine would have that same flesh-rotting effect, but it is known to cause blood vessel constriction, which raises that risk.


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In addition to the 160 overdoses in Philadelphia over just four days, three people in Michigan have died with the drug in their systems.

Meanwhile, Chicago officials saw ‘mass overdose outbreaks’ over just a few days around the same time in May that Philadelphia was experiencing a surge. 

Meanwhile, Toronto’s drug-checking service first identified it in the city’s drug supply in late December.

Hayley Thompson, manager of the drug checking program, said: ‘Since then, we’ve seen [medetomidine and its analog] present in 11 percent of the expected fentanyl samples that we check, and that’s worth noting.

‘And right now, we don’t think many people know that this drug is circulating in the unregulated drug supply, which is why we’ve trying to get this communication out so quickly.’

Drug cartels in Mexico, specifically the Jalisco and Sinaloa cartels, have flooded the US with fentanyl and other illegal, highly addictive drugs. 

But at some point in the supply chain, possibly at the start in clandestine Mexican labs, or possibly once the drugs have entered the US, they are cut and adulterated with cheap, poorly regulated additives that enhance an opioid high. 

Indiana’s Drug Enforcement Administration chief said: ‘I try to tell people when drugs get here to Indianapolis… it could exchange hands six, seven, eight times before a drug dealer sells it to somebody here.

‘So every time that exchanges hands, anybody can put whatever they want in it.’   

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