A substance normally used as a sedative in animals, médétomidine, is increasingly present in illicit drugs in Quebec. Often incorporated into other products without the knowledge of consumers, it illustrates a “worrying” reality, according to doctors: the substances sold illegally contain mixtures now unpredictable.
Médétomidine, whose use is not approved in humans, can cause stunning, significant sedation as well as a drop in heart rate and blood pressure. On the illegal market, it is generally combined with other products, such as fentanyl, a powerful opioid of synthesis, which increases the risks of overdose.
First identified in drugs entered in the United States in 2022, this substance appeared in Quebec about a year later, the National Institute of Public Health of Quebec said in an article published on August 4. Since April 2023, it has been found 21 times in the province, which represents less than 2 % of the detections recorded in Canada.
However, this product seems to gain ground in Montreal, says the Dr Alexandre Larocque, a medical adviser in toxicology for the regional public health department of the metropolis. “She is more present today than a few months ago. »»
At the Montreal Dopamine organization, located in Hochelaga-Maisonneuve, the director general Martin Pagé reports that médétomidine was detected in around 85 % of fentanyl samples analyzed between April and July. “It is certain that we are very circumscribed in a neighborhood, but it is still high. »»
Increasingly unpredictable mixtures
Currently, the greatest danger for consumers lies in the lack of consistency of the products consumed, however, says the Dr Larocque. “Today, we serve a pink powder, but we don’t know exactly what is in it. Then, next week, it may be still different. The final effect is therefore very difficult to predict and it increases the risks of poisoning. »»
There is no antidote in the event of a médétomidine overdose, notes the Dr Carl Whissel, who practices medicine of drug addiction at the University of Montreal hospital center. “What we use to neutralize opioids, naloxone, just has no effect on this substance. »»
In the event of an overdose involving this product, the intervention must therefore be done in the emergency room, where the teams can support the patient’s vital functions until the effects fades, specifies the Dr Larocque.
However, it is recommended to continue to administer naloxone in the event of suspected overdose, as it is often impossible to immediately determine whether the person has consumed an opioid, médétomidine or a mixture of the two, he adds.
Keep people alive
According to Martin Pagé, director general of Dopamine, it is essential that community organizations remain in contact with other regions of Canada for the transfer of knowledge on new substances in circulation and best intervention practices.
“But unfortunately, what is flat is that when you start to know a product and the practices to adopt, there is another that already happens on the market,” he said.
In the current context, marked by a constant evolution of illicit drugs, he insists on the importance of supporting supervised injection centers. “These places are essential to apply best practices and keep people in our community. »»
The Dr Alexandre Larocque also recalls that it is essential to never consume alone, to have naloxone on hand and, if possible, to have a small dose tested before taking the whole quantity.
