PITTSBURGH — A person using the first name Chris died in June 2026 after suffering multiple heart attacks linked to medetomidine withdrawal while incarcerated at the Allegheny County Jail. Chris experienced cardiac arrest at the facility, and after a subsequent arrest, his heart failed following recovery from an induced coma.

During a prior incarceration at the Allegheny County Jail, Chris received Ativan and phenobarbital to manage medetomidine withdrawal. "I was grateful to get that, because I didn't think that was something that they would do for you in the county jail," Chris said. Medetomidine withdrawal caused a heart attack in Chris while he was incarcerated at the jail.

One week after being interviewed, Chris was arrested again and taken to a hospital while experiencing withdrawal. He then suffered a second heart attack. Chris spent five days in an induced coma.

Medetomidine, a powerful tranquilizer, began spreading as an adulterant in the illicit opioid supply two years prior to June 2026. Medetomidine withdrawal can cause life-threatening complications, including stroke and heart attacks. Treating medetomidine withdrawal may require complex care involving oral and intravenous medications, some of which are typically administered in intensive care unit settings.

The Centers for Disease Control and Prevention (CDC) reported in April 2026 that medetomidine was present in drug samples across all 20 sentinel sites surveyed. The CDC's report also indicated that the prevalence of medetomidine was highest in the Northeast and lowest in the West.

There are multiple Food and Drug Administration (FDA)-approved medications for opioid withdrawal. Medications such as buprenorphine and methadone can treat both opioid use disorder and withdrawal. The National Commission on Correctional Health Care has issued a position paper emphasizing the importance of offering a range of FDA-approved medications for individuals in jail suffering from opioid use disorder. The Allegheny County Jail initially offered only Sublocade, an injectable medication, for opioid withdrawal but has expanded its medication offerings for opioid withdrawal over the past two years.

Many jails already stock clonidine, which is a blood pressure medication and an important tool for treating medetomidine withdrawal. However, medetomidine withdrawal often necessitates much higher than typical doses of clonidine. Federal law prohibits Medicaid from covering medications for people in jail.