New Analysis Tracks Rise of Dangerous Drug Adulterant and Public Health Response in New York State

By Erin Frick

ALBANY, N.Y. (May 28, 2026) — A dangerous sedative called medetomidine has been quietly spreading through New York's illicit drug supply. A new analysis shows how, over several years of careful tracking and coordination, public health agencies in New York State executed a data-driven response to alert the public, make health practitioners aware of the emergent substance, distribute test strips and ultimately save lives.  

The study, published last month in the New England Journal of Medicine (NEJM) Evidence, was co-led by University at Albany’s John Angles PhD '26, who just completed his doctorate in Biostatistics at the College of Integrated Health Sciences, together with collaborators at the New York State Department of Health (NYSDOH), the New York City Department of Health and Mental Hygiene (NYCDOHMH) and the New York City Office of Chief Medical Examiner. 

Medetomidine is highly a potent veterinary sedative not approved for human use. Typically mixed with other drugs, medetomidine induces a state of extreme sedation that is deeper and more prolonged than sedative effects associated with opioids. It can also cause a complicated withdrawal response, meaning that risks to health do not stop after use. 

“Medetomidine is especially dangerous because even after stopping use, repeated exposure can trigger a serious withdrawal that may require intensive medical care,” Angles said. “Tracking where medetomidine is appearing in the drug supply, and keeping the public and health providers informed, can enable effective interventions to reduce harm.”

The NEJM Evidence study aimed to document medetomidine’s emergence in New York State, how its prevalence changed over time and how public health organizations put the data to use. The analysis illustrates how community drug-checking programs can generate actionable data to drive public health responses and reduce harm.

The researchers analyzed data from drug-checking programs operated by NYSDOH and NYCDOHMH at 21 sites across New York where technicians test drug samples provided by community members and return real-time results. 

They found that for several months following its initial detection in May 2024, medetomidine showed up in fewer than 10% of opioid samples. Then, in October 2024, it surged to more than 20% of collected samples and stayed elevated into 2025. The peak came in May 2025, when medetomidine was detected in 44% of opioid samples tested statewide. The study reported prevalence through December 2025, when it was found in 30% of samples tested.

Alongside surveillance data, the researchers documented the programmatic responses that NYSDOH and NYCDOHMH carried out as medetomidine spread. 

Starting in June 2024, NYSDOH and NYCDOHMH issued public alerts that included information on medetomidine's prevalence in drug samples, what substances it was typically found alongside and best practices for harm reduction. Later alerts, issued in December 2025 and January 2026, addressed clinical management of medetomidine withdrawal and guidance to always administer naloxone in the event of a suspected overdose. In January 2026, NYSDOH distributed 15,000 medetomidine test strips to nine partner organizations.

By documenting this timeline alongside drug-checking data, the analysis demonstrates how near-real-time surveillance can drive a timely public health response. 

“The emergence of medetomidine in the illicit drug supply requires a collaborative, interagency and community-based approach to ensure timely identification of this emergent substance and rapid dissemination of information to the public and clinicians,” said Angles. “This study underscores the vitality of community drug checking programs operated by New York State and New York City and their utility in informing harm reduction and public health response strategy as we remain committed to preventing the negative impact of medetomidine on our communities.”

“This study is a useful example of how health departments can closely work together to generate timely data that allows for real-time public health action,” said senior author David Holtgrave, SUNY Distinguished Professor Emeritus and special advisor to the Commissioner of the New York State Department of Health. “Here, collecting data on medetomidine informed stronger surveillance efforts, stimulated the issuance of health alerts for the public and clinical providers, and set the stage for the distribution of medetomidine test strips, which play a critical role in harm reduction.”

“Timely surveillance studies like this one are important for the rapid dissemination of findings that can ultimately save lives,” said co-first author Lucila Zamboni PhD '17, director of the Drug Overdose Surveillance and Epidemiology Unit at the NYS Department of Health and Rockefeller College of Public Affairs alum. “This study provided critical and timely public health data that lead to real action steps: surveillance activities were strengthened, public health alerts were issued, and medetomidine test strips are now being utilized. Further, the DOH issued a ‘What Clinicians Need to Know’ about medetomidine document—another example of how these data lead directly to quick, meaningful action.”