Description
December 11, 2025 | 12:00 – 1:00 PM How Do Adulterants Like Quinine, Metamizole, Xylazine, and Medetomidine Impact the Opioid Epidemic?
Description:
Illicit opioids do not have to be made with good manufacturing practices. This means that the doses or the sought after ingredient from one product to the next (even with the same buyer) could be different. The poor-quality products can cause injection reactions that manufacturers cover up by adding additional hidden ingredients and many products add other hidden ingredients to enhance the opioid effect as well. Many illicit opioid products now contain xylazine or medetomidine, which can alter the risk profile for the products and potentially the standard treatment provided in the community before EMS arrives and how adverse effects of injecting opioids are treated in the hospital setting.
Learning Objectives:
- At the conclusion of the program, the successful learner will be able to:
- Discuss myriad adulterants present in illicit heroin products and their risks.
- Discuss the two main alpha-2 agonist adulterants now appearing in illicit fentanyl (or analogue) products, or that are being used a stand alone illicit substances of abuse.
- Compare and contrast the mechanism of action of xylazine and medetomidine with traditional opioids
- Describe the controversy surrounding the role of naloxone in patients experiencing respiratory depression on xylazine or medetomidine and how it could impact the naloxone protocol for bystanders and first responders
- Describe unique risks that can occur with xylazine and medetomidine products and potential treatment options
Presenter: C. Michael White, Pharm.D., FCP, FCCP, FASHP
Michael White, Pharm.D., FCP, FCCP, FASHP is a Board of Trustees Distinguished Professor and Chair of the Department of Pharmacy Practice at the University of Connecticut School of Pharmacy.
Dr. White’s research interests are in the areas of comparative effectiveness and preventing adverse events from drugs, devices, dietary supplements, and illicit substances. His ~500 publications resulted in 19970 citations, an H-index of 73, and i10 Index of 278; placing him within an elite group of researchers. Five of his publications were among the top 5 read articles in their respective journals in the years they were published. His work has been primarily funded by the Agency for Healthcare Research and Quality with additional grants from the Donaghue Foundation, Pfeiffer Foundation, and American College of Clinical Pharmacy. His work has been published in JAMA, Lancet, Annals of Internal Medicine and Circulation with research coverage by NBC Nightly News, Good Morning America, BBC, CNN, NY Times, Washington Post, LA Times, Boston Globe, PBSNewsHour, WNPR Morning Edition, Prevention Magazine, The Dr Oz Show, and hundreds of other national media outlets. His total media reach exceeds 3.2 billion people.
He is a Fellow of the American College of Clinical Pharmacologists, The American College of Clinical Pharmacy, and the American Society of Health-System Pharmacists. He is a contributing editor for the Annals of Pharmacotherapy and is on the Pharmacy Practice News editorial board. Dr. White is a UConn Teaching Fellow, the highest university teaching designation, and received the Provost’s Award for Public Engagement for his media, migrant farmworker clinic, and COVID-19 work. He has received the American College of Clinical Pharmacist Young Investigator Award, American Society of Health-System Pharmacists Award for Sustained Contributions to the Literature, ASHP Drug Therapy Research Awards, and received the American Association of Colleges of Pharmacy Lyman Award and the Weaver Award.
Continuing Medical Education:
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Hanley Center for Health Leadership and Education and CCSME. The Hanley Center for Health Leadership and Education is accredited by the Maine Medical Association Committee on Continuing Medical Education and Accreditation to provide continuing medical education for physicians.
The Hanley Center for Health Leadership and Education designates this regularly scheduled series for a maximum of 1 AMA PRA Category 1 Credit ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
*Nurses and Nurse Practitioners will be awarded a certificate of participation with a maximum of 1 AMA PRA Category 1 Credit ™.
This course has been approved by Co-Occurring Collaborative Serving Maine (CCSME), as a NAADAC Approved Education Provider, for 1 educational credits. NAADAC Provider #324712, CCSME is responsible for all aspects of the programming.
Contact Hours 1 contact hours for social workers, licensed clinical professional counselors, and behavioral health professionals.
1 Category 1 Contact hours for psychologists. CCSME is a pre-approved sponsor and provider of Professional Education Activities for Psychologists.
1 contract hours CHES. CCSME is a designated provider of continuing education contact hours (CECH) in health education by the National Commission of Health Education Credentialing, Inc.
