When Lillian was booked into a rural Pennsylvania jail, she couldn’t stop vomiting. As she showered and changed into her jail uniform, “brain zaps” kept destabilizing her. “The corrections officer watching me kept having to grab me steady or I would have dropped and hit the floor,” Lillian recalled.
She was withdrawing from fentanyl laced with medetomidine, a powerful tranquilizer that started to spread as an adulterant in the illicit opioid supply two years ago. Medetomidine causes excruciating, complicated withdrawal symptoms, often within hours of someone’s last dose, and many institutions are ill-prepared to treat them. The treatment gap is especially acute in carceral settings.
