Mid-Michigan Drug Deaths Up 37% as Medical Examiner Detects Carfentanil, Medetomidine in Local Supply

What happened

Drug-related deaths rose sharply across Mid-Michigan in the first quarter of 2026, and the regional medical examiner's latest toxicology results show the local drug supply is becoming more dangerous — not just more deadly.

The Office of the Medical Examiner at University of Michigan Health-Sparrow in Lansing released its 2026 first-quarter drug report, covering January through March across seven counties: Clinton, Eaton, Ingham, Ionia, Isabella, Livingston, and Shiawassee. The report counts 48 drug-related deaths in the quarter, up from 35 in the same period of 2025 — an increase of roughly 37 percent. Health system officials described the findings as evidence of a "persistent crisis."

Ingham County, which includes Lansing, recorded the most deaths at 20 — 19 of them accidental. Livingston County reported 8, Shiawassee 6, Eaton and Ionia 4 each, and Clinton and Isabella 3 each. Clinton, Livingston, Shiawassee, and Ionia counties all saw increases compared with the first quarter of 2025.

Two findings in the toxicology detail stand out for anyone who uses drugs — or loves someone who does:

Carfentanil appeared in a Clinton County death. A 64-year-old woman died with carfentanil, fentanyl, methamphetamine, and morphine in her system. Carfentanil is a fentanyl analogue originally developed as a large-animal tranquilizer and is estimated to be vastly more potent than fentanyl itself. Its presence in the regional supply had been largely absent from recent local reports.
Medetomidine appeared in an Ingham County death. A 37-year-old woman died with medetomidine alongside fentanyl, cocaine, and morphine. Medetomidine — a veterinary sedative sometimes called "rhino tranq" — has been spreading through drug supplies in other parts of the country over the past year and has now been confirmed in Mid-Michigan toxicology.

The report also documented a cluster of deaths in Ionia County involving synthetic cannabinoids: three of the county's four deaths involved MDMB-4en-PINACA and 5F-ADB, potent laboratory-made chemicals often sold as "K2," "Spice," or counterfeit cannabis products. One Livingston County death involved 7-hydroxymitragynine, a concentrated kratom derivative increasingly sold in gas stations and smoke shops.

The report also lists one case involving a 10-year-old child in Ingham County, ruled indeterminate with methadone toxicity — a reminder that opioid medications stored unsafely at home can be deadly to children.

Clinical context: why these adulterants change the risk

Most deaths in the report involved two or more substances, and fentanyl — frequently mixed with cocaine or methamphetamine — remains the primary driver. That pattern matters clinically: people who use stimulants and have no opioid tolerance can be killed by fentanyl they never intended to take.

The two newly detected adulterants add specific dangers:

Carfentanil is so potent that a standard single dose of naloxone may not be enough to reverse an overdose. Multiple doses, given two to three minutes apart, are often required. This is why harm-reduction programs recommend carrying more than one naloxone kit.

Medetomidine is not an opioid, so naloxone does not reverse its effects. It causes profound sedation, a dangerously slow heart rate, and low blood pressure — and it produces a severe withdrawal syndrome of its own that can include dangerous spikes in heart rate and blood pressure. You should still give naloxone in any suspected overdose, because fentanyl is almost always present too, but the person may remain deeply sedated even after the opioid is reversed. That is a medical emergency: call 911 and stay with them.

Synthetic cannabinoids like 5F-ADB and MDMB-4en-PINACA are chemically unrelated to cannabis, far more potent, and wildly unpredictable batch to batch. There is no reversal agent, and standard fentanyl test strips tell you nothing about them.

What you can do

If you or someone in your life uses any substance that didn't come from a pharmacy:

Assume fentanyl may be present in any pill, powder, or rock bought on the street — including drugs sold as cocaine, methamphetamine, or counterfeit prescription pills.
Carry naloxone, and carry more than one dose. With carfentanil in the regional supply, a second dose may be what saves a life. Naloxone is available without a prescription at Michigan pharmacies, and free through many local health departments and community programs.
Never use alone. If that's not possible, have someone check on you by phone, or use a remote spotting service. Most of the people in this report died before help could arrive.
Call 911 first in any suspected overdose. Michigan's Good Samaritan law provides legal protections for people who seek emergency help during an overdose.
Give naloxone even if you're not sure opioids are involved. It won't reverse medetomidine or synthetic cannabinoids, but it won't harm the person either — and fentanyl is involved in the majority of local deaths.
Use fentanyl test strips when available, understanding their limits: they detect fentanyl and some analogues but not medetomidine, xylazine, or synthetic cannabinoids.
Lock up all medications at home — especially methadone and other opioids — anywhere children live or visit.

For families

A one-third jump in deaths is frightening, but panic helps no one. What helps is preparation: keep naloxone in the house and learn how to use it, talk calmly with your loved one about what's now in the local supply, and know that treatment — including medications like buprenorphine and methadone — remains the most effective protection against overdose death. If your family member isn't ready for treatment, harm-reduction steps still save lives and keep the door open.

Where to get help

SAMHSA National Helpline: 1-800-662-HELP (4357) — free, confidential, 24/7 referrals to treatment and support services, in English and Spanish.
Michigan DHHS Opioids and Overdose Prevention: michigan.gov/opioids — statewide naloxone access points, treatment locators, and harm-reduction resources.
988 Suicide & Crisis Lifeline: call or text 988 for mental health and substance-use crisis support.
In an overdose emergency: call 911 immediately, give naloxone, and stay with the person until help arrives.

This alert is based on the University of Michigan Health-Sparrow Office of the Medical Examiner's 2026 Q1 Drug Report (January 1 – March 31, 2026) and state public health resources. It is reviewed by an addiction medicine physician and updated as new surveillance data becomes available.