{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:56:18Z","timestamp":1790751378342,"version":"4.1.0"},"reference-count":15,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Medetomidine is an \u237a2 adrenergic agonist that has rapidly emerged as an adulterant in the US illicit opioid supply. Clinicians should suspect medetomidine exposure when opioid overdoses respond poorly to naloxone. Medetomidine withdrawal is clinically distinct from opioid and xylazine withdrawal and should be suspected when a patient with opioid withdrawal presents with significant rebound sympathetic activation, including hypertension, tachycardia, tremor, agitation, and refractory vomiting despite opioid agonist treatment. Management requires concurrent treatment of opioid withdrawal, early use of \u237a2 agonists, and escalation to dexmedetomidine infusion for severe cases. Greater access to testing and prospective treatment data are needed.<\/jats:p>","DOI":"10.1002\/jhm.70506","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:02:50Z","timestamp":1790748170000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical progress note: Management of the hospitalized patient with medetomidine withdrawal"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6795-8815","authenticated-orcid":false,"given":"Rachel C.","family":"Caulkins","sequence":"first","affiliation":[{"name":"Department of Family Medicine The Christ Hospital &amp; University of Cincinnati Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7929-3839","authenticated-orcid":false,"given":"Michael R.","family":"Lawson","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Neuroscience, Department of Emergency Medicine University of Cincinnati Medical Center Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9879-3472","authenticated-orcid":false,"given":"Melissa","family":"Previtera","sequence":"additional","affiliation":[{"name":"Health Sciences Library, University of Cincinnati Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8182-5826","authenticated-orcid":false,"given":"Carolyn A.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Neuroscience, Department of Internal Medicine University of Cincinnati Medical Center Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Only 1 in 5 US Adults With Opioid Use Disorder Received Medications to Treat it in 2021","author":"National Institute on Drug Abuse","year":"2023"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.15992"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1021\/acschemneuro.4c00583"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7415a2"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0278-5846(89)90051-1"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0028-3908(87)90262-0"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7415a1"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000001500"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2025.12.004"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaclp.2025.06.005"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7415a3"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000001560"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/17576180.2025.2572959"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCE.0000000000000035"},{"key":"e_1_2_6_16_1","unstructured":"Penn Med.Medetomidine: An Emerging Adulterant in the Illicit Opioid Supply. Center for Addiction Medicine and Policy; 2025. Accessed February 21 2026.https:\/\/penncamp.org\/medetomidine\/"}],"container-title":["Journal of Hospital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/shmpublications.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jhm.70506","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/shmpublications.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jhm.70506","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/shmpublications.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jhm.70506","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:02:52Z","timestamp":1790748172000},"score":1,"resource":{"primary":{"URL":"https:\/\/shmpublications.onlinelibrary.wiley.com\/doi\/10.1002\/jhm.70506"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":15,"alternative-id":["10.1002\/jhm.70506"],"URL":"https:\/\/doi.org\/10.1002\/jhm.70506","archive":["Portico"],"relation":{},"ISSN":["1553-5592","1553-5606"],"issn-type":[{"value":"1553-5592","type":"print"},{"value":"1553-5606","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"assertion":[{"value":"2026-04-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jhm.70506"}}