Powerful veterinary sedative being added to street fentanyl, leaving Canadian ERs struggling to cope | CBC

A changing drug supply

Saskatchewan and Yukon have recorded sharp increases this year. Emergency physicians and overdose prevention workers say the drug’s presence alongside fentanyl is creating new challenges in responding to overdoses.

Overdose response differs

Medetomidine is a sedative and does not respond to naloxone, which reverses opioid overdoses. Substance Use Philly has advised responders to focus on breathing rather than whether a person is responsive when medetomidine may be involved.

Dr. Monty Ghosh, a Calgary-based addictions physician and researcher, said withdrawal can cause dangerous blood pressure changes that may lead to heart attacks or strokes. He also warned that the drug can slow breathing and reduce blood flow to vital organs.

Withdrawal needs close care

Toronto physician Dr. Sahil Gupta said people experiencing medetomidine withdrawal may need hospitalization or intensive care medication. Their breathing and consciousness can require monitoring longer than in opioid withdrawal.

The immediate priority is supporting breathing so the brain receives oxygen. Gupta said some patients in extreme circumstances may need a ventilator, while the additional care can put pressure on high-resource hospital units.

Pressure on emergency departments

Gupta said the demands can contribute to disruption, longer waits and overcrowding. Patients needing hospitalization or intensive care add further strain to those services. Some clinicians say supervised consumption sites could help. Dr. Raghu Venugopal, an emergency physician at three downtown Toronto hospitals, said staff at such sites could assess people who are comatose after an overdose and potentially provide oxygen or a small naloxone dose.

Housing and supervised sites

In Edmonton, the Bridge Healing program aims to address homelessness among people who make repeat hospital visits, said Dr. Louis Hugo Francescutti, an emergency physician and University of Alberta professor. With consent and an available bed, participants are sent by cab to purpose-built buildings offering free accommodation and access to services, including a medical clinic and social workers.

Some practitioners say the closure of safe consumption sites in provinces such as Ontario has left more people needing emergency care. A 2026 report by Memorial University’s Gillian Kolla and epidemiologist Tara Gomes suggests that people once revived at supervised sites now go to emergency departments, potentially delaying care for other life-threatening conditions, including heart attacks and injuries from vehicle collisions.