Them Witches
Bluelighter
- Joined
- Apr 21, 2025
- Messages
- 800
This thread is to document in real time the agents in illicit "Tranq-Dope" or any related "Dope." Please add any information relating to the subject good, bad, and indifferent. Knowing is half of the battle (GI-Joe). Please post links for help, new agents in the illicit drugs, new illicit drugs, hybrid-drugs, and any information related. Thank you in advance.
(1) Medetomidine
References :
https://www.substanceusephilly.com/medetomidine
en.wikipedia.org
It is a racemic mixture of two stereoisomers, levomedetomidine and dexmedetomidine, the latter being the isomer with the pharmacologic effect as an alpha 2- adrenergic agonist. Effects can be reversed using atipamezole.
Medetomidine is a veterinary anesthetic medication with potent sedative effects and emerging illicit drug adulterant. It is a racemic mixture of two stereoisomers, levomedetomidine and dexmedetomidine, the latter being the isomer with the pharmacologic effect as an alpha 2- adrenergic agonist. Medetomidine is a veterinary sedative, similar to xylazine (tranq), that was first found in Philadelphia’s drug supply in May 2024. Medetomidine is 100-200 times more potent than xylazine and can cause longer-lasting sedation, low heart rates, and more severe withdrawal symptoms. It is not an opioid but is found in the dope (street opioid) supply.
Medetomidine is replacing xylazine in the city’s drug supply. Since the introduction of medetomidine, there has been an increase in the variation and severity of withdrawal symptoms, a decrease in the number of patients seeking treatment for xylazine-associated wounds, and a decrease in the presence of xylazine in Philadelphia’s drug supply. From May 2024 to November 2024, the percentage of Philadelphia dope samples with medetomidine increased from 29% to 87%, while the percentage of samples with xylazine decreased from 97% to 42%, suggesting that medetomidine is quickly overtaking xylazine in the dope supply. During this period, medetomidine was also found in overdose death data from the Philadelphia Department of Public Health’s (PDPH) Medical Examiner’s Office (MEO) and, like xylazine, was always found in combination with fentanyl.
The main effect of medetomidine is heavy sedation, but it can also cause low blood pressure and slow heart rate, dizziness, extreme tiredness, shortness of breath, nausea, blurred vision, and confusion.
Because of the heavy sedation, someone who overdosed from a drug containing medetomidine may stay sedated and non-responsive after receiving naloxone, even if the overdose is successfully reversed. That is because medetomidine is not an opioid, so the sedation from medetomidine will not be reversed by using naloxone.
Medetomidine withdrawal has been described in PDPH’s December 2024 HAN and two MMRW reports from the CDC. The symptoms of medetomidine withdrawal can start rapidly and include:
(2) Etomidate
References :
Etomidate is a short-acting intravenous anaesthetic agent used for the induction of general anaesthesia and sedation for short procedures such as reduction of dislocated joints, tracheal intubation, cardioversion and electroconvulsive therapy.
Pharmacokinetics
The onset of action: 30 to 60 seconds, Peak effect: 1 minute
Distribution: 2 to 4.5 L/kg. Limited pharmacokinetic data in patients with cirrhosis and esophageal varices suggest that the volume of distribution and elimination half-life of etomidate are approximately double that seen in healthy subjects. Metabolism is primarily hepatic by ester hydrolysis to inactive metabolites. Minimal anesthetic plasma levels of unchanged drug are equal to or higher than 0.23 mcg/mL; they decrease rapidly up to 30 minutes following injection and more slowly with a half-life value of about 75 minutes.
Excretion: 75% of the administered dose is excreted in the urine on the first day after injection. The chief metabolite is R-(+)-1-(1-phenylethyl)-1H-imidazole-5-carboxylic acid, resulting from hydrolysis of etomidate, and accounts for about 80% of the urinary excretion. Another route of excretion is bile. Like most intravenous anesthetics, etomidate is highly protein-bound (77%). Thus, it can achieve a higher concentration in the brain in low albumin states since it will be less bound to albumin, and more free-drug would be available in the brain.
(3) Xylazine
References :
en.wikipedia.org
Xylazine is a structural analog of clonidine and an α₂-adrenergic receptor agonist, sold under many trade names worldwide, most notably the Bayer brand name Rompun, as well as Anased, Sedazine and Chanazine. Xylazine is a veterinary sedative, anesthetic, and analgesic used for animals like horses and cattle.
In 2023, xylazine was found in 99% of IMF samples in Philadelphia. The weight percentage of IMF in Philadelphia drug samples remained stable (15%), but the weight percentage of xylazine has increased (34% in 2022 to 46% in 2023)
What is Xylazine:
• Xylazine is a non-opioid used as a sedative, anesthetic, muscle relaxant, and analgesic for animals, but it is not FDAapproved for use in humans.i It was not approved for human use due to severe CNS depressant effects.
• Xylazine is a strong synthetic alpha2-adrenergic agonist, synthesized in 1962 as an analgesic, hypnotic, and anesthetic.iiIt has chemical properties similar to other drugs like clonidine and may have similar clinical effects.
• Xylazine has increasingly been found in the illicit drug supply, frequently mixed with fentanyl.iii• It may be referred to as “tranq,” or “tranq dope” when combined with heroin or fentanyl.Xylazine Source and Preparation and Route of Administration
:• Xylazine comes as a liquid solution for injection in 20 mg/mL, 100 mg/mL, and 300 mg/mL strengths for veterinaryuse. The liquid solution can be salted or dried into a powder. In the illicit drug supply, it can appear as a white orbrown powder. Because it can be mixed into other powders or pressed into pills, it can be difficult to identify based onappearance.
• The routes of administration include intravenous, intramuscular, intranasal, and oral; there is currently no information onvaping or smoking.• It has rapid onset within minutes and can last 8 hours or longer depending upon the dose, the way it was taken, andwhether it was mixed with an opioid or other drug(s).
Xylazine Effects:
• Xylazine is a central nervous system depressant that can cause drowsiness, amnesia, and slow breathing, heart rate,and blood pressure at dangerously low levels
.• At very high doses, or with other central nervous system depressants, xylazine can cause:
• Loss of physical sensation,
• Loss of consciousness,
• Intensification of the effects of other drugs, which can complicate overdose presentation and treatment.
Infections Disease Information
Xylazine-associated wounds (XAWs) are often large and chronic and can become superinfected. Since 2020, wound care clinics and hospitals in Philadelphia have observed a dramatic increase in utilization of wound care services, emergency department (ED) visits, and hospitalizations related to XAWs. For the diagnosis of drug-associated skin and soft tissue infections (SSTIs), the number of hospitalizations in Philadelphia hospitals increased from 1791 in 2020 to 2881 in 2022, and the number of ED visits increased from about 125 per quarter in 2020 to about 300 per quarter in 2022. XAWs may be the latest wave of drug use–associated skin lesions affecting the health of persons who use drugs (PWUD) and healthcare costs
Treating infectious diseases in xylazine wounds in humans requires prompt medical attention, wound care, and specific antibiotics targeting the likely bacteria involved. A multidisciplinary approach involving wound care specialists, infectious disease experts, and surgeons is often necessary.
Immediate Steps & When to Seek Medical Care
Seek medical care immediately if any signs of infection or systemic illness develop, including:
Medical Treatment
A healthcare professional will manage the infection through several steps:
Routine At-Home Wound Care (as directed by a professional)
Proper at-home care is essential for healing and preventing secondary infections:
(1) substance use disorder treatment and longitudinal multidisciplinary care including addiction medicine, wound care, infectious diseases, and surgery are imperative
(2) avoid aggressive debridement
(3) administer empirical antibiotics for methicillin-resistant Staphylococcus aureus (MRSA)– and group A Streptococcus (GAS)–infected wounds, specifically oral trimethoprim-sulfamethoxazole for MRSA and oral β-lactams for GAS
(4) administer intravenous daptomycin to reduce the discomfort and challenges associated with frequent phlebotomy for vancomycin therapeutic drug monitoring
(5) create explicit contingency antibiotic plans with potential use of linezolid, tedizolid, or dalbavancin for patient-directed hospital discharge.
==========================================================================
group we need information about Fentanyl, Nitazines, Meth, RC drugs, etc.
(1) Medetomidine
References :
https://www.substanceusephilly.com/medetomidine
Medetomidine - Wikipedia
It is a racemic mixture of two stereoisomers, levomedetomidine and dexmedetomidine, the latter being the isomer with the pharmacologic effect as an alpha 2- adrenergic agonist. Effects can be reversed using atipamezole.
Medetomidine is a veterinary anesthetic medication with potent sedative effects and emerging illicit drug adulterant. It is a racemic mixture of two stereoisomers, levomedetomidine and dexmedetomidine, the latter being the isomer with the pharmacologic effect as an alpha 2- adrenergic agonist. Medetomidine is a veterinary sedative, similar to xylazine (tranq), that was first found in Philadelphia’s drug supply in May 2024. Medetomidine is 100-200 times more potent than xylazine and can cause longer-lasting sedation, low heart rates, and more severe withdrawal symptoms. It is not an opioid but is found in the dope (street opioid) supply.
Medetomidine is replacing xylazine in the city’s drug supply. Since the introduction of medetomidine, there has been an increase in the variation and severity of withdrawal symptoms, a decrease in the number of patients seeking treatment for xylazine-associated wounds, and a decrease in the presence of xylazine in Philadelphia’s drug supply. From May 2024 to November 2024, the percentage of Philadelphia dope samples with medetomidine increased from 29% to 87%, while the percentage of samples with xylazine decreased from 97% to 42%, suggesting that medetomidine is quickly overtaking xylazine in the dope supply. During this period, medetomidine was also found in overdose death data from the Philadelphia Department of Public Health’s (PDPH) Medical Examiner’s Office (MEO) and, like xylazine, was always found in combination with fentanyl.
The main effect of medetomidine is heavy sedation, but it can also cause low blood pressure and slow heart rate, dizziness, extreme tiredness, shortness of breath, nausea, blurred vision, and confusion.
Because of the heavy sedation, someone who overdosed from a drug containing medetomidine may stay sedated and non-responsive after receiving naloxone, even if the overdose is successfully reversed. That is because medetomidine is not an opioid, so the sedation from medetomidine will not be reversed by using naloxone.
Medetomidine withdrawal has been described in PDPH’s December 2024 HAN and two MMRW reports from the CDC. The symptoms of medetomidine withdrawal can start rapidly and include:
- Fast heart rate (>100 beats per minute)
- Dangerously high blood pressure (>180/100)
- Uncontrollable nausea and vomiting
- Tremor
- Excessive sweating
- Changing levels of alertness
(2) Etomidate
References :
Etomidate is a short-acting intravenous anaesthetic agent used for the induction of general anaesthesia and sedation for short procedures such as reduction of dislocated joints, tracheal intubation, cardioversion and electroconvulsive therapy.
Etomidate is an ultrashort-acting, non-barbiturate hypnotic intravenous anesthetic agent. It is administered only by intravenous route. Etomidate has a favorable hemodynamic profile on induction, with minimal blood pressure depression, making it ideal for shock trauma, hypovolemic patients, or patients with significant cardiovascular disease. Etomidate has been approved for use during induction of general anesthesia, rapid sequence intubation, and other indications where short-term anesthesia is warranted.
Etomidate has a chiral carbon atom and exists in the form of 2 enantiomers. Only the R (+) isomer is hypnotically active. The S (-) enantiomer has a 20-fold lower hypnotic effect.[2] Etomidate interacts with gamma-Aminobutyric acid type A (GABA) receptors by binding directly to specific sites and increasing the affinity of the inhibitory neurotransmitter GABA (positive modulation of GABA-mediated activity). GABA is the principal inhibitory neurotransmitter within the central nervous system (CNS) and works with the adrenergic neurotransmitter system to counterbalance the action of excitatory neurotransmitters. Etomidate may have disinhibitory effects on the parts of the nervous system that control extrapyramidal motor activity. This disinhibition offers a potential explanation for the 30% to 60% incidence of myoclonus during induction with etomidate.Pharmacokinetics
The onset of action: 30 to 60 seconds, Peak effect: 1 minute
Distribution: 2 to 4.5 L/kg. Limited pharmacokinetic data in patients with cirrhosis and esophageal varices suggest that the volume of distribution and elimination half-life of etomidate are approximately double that seen in healthy subjects. Metabolism is primarily hepatic by ester hydrolysis to inactive metabolites. Minimal anesthetic plasma levels of unchanged drug are equal to or higher than 0.23 mcg/mL; they decrease rapidly up to 30 minutes following injection and more slowly with a half-life value of about 75 minutes.
Excretion: 75% of the administered dose is excreted in the urine on the first day after injection. The chief metabolite is R-(+)-1-(1-phenylethyl)-1H-imidazole-5-carboxylic acid, resulting from hydrolysis of etomidate, and accounts for about 80% of the urinary excretion. Another route of excretion is bile. Like most intravenous anesthetics, etomidate is highly protein-bound (77%). Thus, it can achieve a higher concentration in the brain in low albumin states since it will be less bound to albumin, and more free-drug would be available in the brain.
(3) Xylazine
References :
Xylazine - Wikipedia
Xylazine is a structural analog of clonidine and an α₂-adrenergic receptor agonist, sold under many trade names worldwide, most notably the Bayer brand name Rompun, as well as Anased, Sedazine and Chanazine. Xylazine is a veterinary sedative, anesthetic, and analgesic used for animals like horses and cattle.
In 2023, xylazine was found in 99% of IMF samples in Philadelphia. The weight percentage of IMF in Philadelphia drug samples remained stable (15%), but the weight percentage of xylazine has increased (34% in 2022 to 46% in 2023)
What is Xylazine:
• Xylazine is a non-opioid used as a sedative, anesthetic, muscle relaxant, and analgesic for animals, but it is not FDAapproved for use in humans.i It was not approved for human use due to severe CNS depressant effects.
• Xylazine is a strong synthetic alpha2-adrenergic agonist, synthesized in 1962 as an analgesic, hypnotic, and anesthetic.iiIt has chemical properties similar to other drugs like clonidine and may have similar clinical effects.
• Xylazine has increasingly been found in the illicit drug supply, frequently mixed with fentanyl.iii• It may be referred to as “tranq,” or “tranq dope” when combined with heroin or fentanyl.Xylazine Source and Preparation and Route of Administration
:• Xylazine comes as a liquid solution for injection in 20 mg/mL, 100 mg/mL, and 300 mg/mL strengths for veterinaryuse. The liquid solution can be salted or dried into a powder. In the illicit drug supply, it can appear as a white orbrown powder. Because it can be mixed into other powders or pressed into pills, it can be difficult to identify based onappearance.
• The routes of administration include intravenous, intramuscular, intranasal, and oral; there is currently no information onvaping or smoking.• It has rapid onset within minutes and can last 8 hours or longer depending upon the dose, the way it was taken, andwhether it was mixed with an opioid or other drug(s).
Xylazine Effects:
• Xylazine is a central nervous system depressant that can cause drowsiness, amnesia, and slow breathing, heart rate,and blood pressure at dangerously low levels
.• At very high doses, or with other central nervous system depressants, xylazine can cause:
• Loss of physical sensation,
• Loss of consciousness,
• Intensification of the effects of other drugs, which can complicate overdose presentation and treatment.
- Severe Wounds: Repeated use, especially through injection, is associated with severe skin and soft tissue wounds (abscesses, ulcers, and necrosis) that can appear at or away from the injection site and may lead to amputation if left untreated.
- Intense Withdrawal: Withdrawal from the combination of fentanyl and these potent sedatives can be severe and complex, often marked by irritability, anxiety, rapid heart rate, and high blood pressure, making treatment challenging.
Infections Disease Information
Xylazine-associated wounds (XAWs) are often large and chronic and can become superinfected. Since 2020, wound care clinics and hospitals in Philadelphia have observed a dramatic increase in utilization of wound care services, emergency department (ED) visits, and hospitalizations related to XAWs. For the diagnosis of drug-associated skin and soft tissue infections (SSTIs), the number of hospitalizations in Philadelphia hospitals increased from 1791 in 2020 to 2881 in 2022, and the number of ED visits increased from about 125 per quarter in 2020 to about 300 per quarter in 2022. XAWs may be the latest wave of drug use–associated skin lesions affecting the health of persons who use drugs (PWUD) and healthcare costs
Treating infectious diseases in xylazine wounds in humans requires prompt medical attention, wound care, and specific antibiotics targeting the likely bacteria involved. A multidisciplinary approach involving wound care specialists, infectious disease experts, and surgeons is often necessary.
Immediate Steps & When to Seek Medical Care
Seek medical care immediately if any signs of infection or systemic illness develop, including:
- Fever or chills
- Severe pain, redness, swelling, or heat at the wound site
- Thick, smelly, yellow, or green discharge from the wound
- Black or dark pieces of dead skin (necrotic tissue)
- Numbness or tingling near the wound
- Signs of sepsis: confusion, difficulty breathing, rapid heart rate, or low blood pressure
Medical Treatment
A healthcare professional will manage the infection through several steps:
- Wound Cultures: Samples from deep tissue are collected to identify the specific bacteria causing the infection and guide antibiotic choices.
- Systemic Antibiotics: For active infections (cellulitis, abscesses, or systemic illness), oral or intravenous (IV) antibiotics are indicated. Empiric coverage should specifically target Methicillin-resistant Staphylococcus aureus (MRSA) and Group A Streptococcus (GAS), which are the predominant organisms found in these wounds.
- Debridement: Nonviable (dead) tissue must be removed to allow the wound to heal. This can involve conservative sharp debridement in an outpatient setting or surgical debridement in a hospital for more severe cases.
- Surgical Intervention: In severe cases with extensive necrosis, deep infection (osteomyelitis, sepsis), or gangrene, surgical reconstruction, skin grafting, or even amputation may be required.
- Supportive Care: Pain management is crucial, often using non-opioid options when possible. Management of any underlying substance use disorder and withdrawal symptoms (xylazine and opioid) is also a critical component of care.
Routine At-Home Wound Care (as directed by a professional)
Proper at-home care is essential for healing and preventing secondary infections:
- Clean daily with plain soap and warm, clean water or saline.
- Avoid harsh cleaners like alcohol or hydrogen peroxide, as they damage healing tissue.
- Keep the wound moist and covered with a non-adherent dressing, such as petrolatum gauze, to promote healing and prevent the dressing from sticking.
- Change dressings daily if possible.
- Do not wrap bandages too tightly, as this can cut off circulation.
- Monitor the wound closely for signs of worsening infection, sometimes by drawing a circle around it with a marker to track its size.
(1) substance use disorder treatment and longitudinal multidisciplinary care including addiction medicine, wound care, infectious diseases, and surgery are imperative
(2) avoid aggressive debridement
(3) administer empirical antibiotics for methicillin-resistant Staphylococcus aureus (MRSA)– and group A Streptococcus (GAS)–infected wounds, specifically oral trimethoprim-sulfamethoxazole for MRSA and oral β-lactams for GAS
(4) administer intravenous daptomycin to reduce the discomfort and challenges associated with frequent phlebotomy for vancomycin therapeutic drug monitoring
(5) create explicit contingency antibiotic plans with potential use of linezolid, tedizolid, or dalbavancin for patient-directed hospital discharge.
==========================================================================
group we need information about Fentanyl, Nitazines, Meth, RC drugs, etc.
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