Medetomidine & Xylazine: Alpha-2 Agonists Reshaping the Overdose Crisis

Alpha-2 agonists like xylazine and medetomidine are rapidly changing the illicit drug supply — and creating a new, more severe dependence and withdrawal syndrome that clinicians are now confronting across the U.S. East Coast and increasingly in British Columbia.

In this episode, Dr. Pouya Azar speaks with Dr. Jeanmarie Perrone, Professor of Emergency Medicine at the University of Pennsylvania and a leading expert in medical toxicology and addiction medicine, about how these non-opioid sedatives entered the fentanyl supply, why they are so potent, and what their emergence means for overdose risk, withdrawal management, and frontline care.