Rowan County Overdose Spike: Animal Tranquilizers Xylazine and Medetomidine Found in Drug Supply

Rowan County, North Carolina — Local health officials are warning residents about a dangerous spike in drug overdoses linked to the presence of veterinary tranquilizers in the illicit drug supply. According to an alert from the North Carolina Department of Health and Human Services (NCDHHS), suspected opioid overdose emergency department visits in Rowan County more than doubled between April and May 2026, increasing from 5 to 11 visits—a 120% jump that exceeds the county's average monthly overdose visits over the previous six months.

The concerning trend comes as Rowan County now ranks second highest in North Carolina for fentanyl-positive death rates, with 24.1 deaths per 100,000 residents—more than double the statewide rate of 11.8.

What Health Officials Have Found

Laboratory testing conducted by the Rowan County Health Department has confirmed the presence of fentanyl, xylazine, and medetomidine mixed into illicit drugs being sold in the community. These substances have been detected in drugs sold as cocaine, methamphetamine, and counterfeit prescription pills.

Xylazine (sometimes called "tranq") is a non-opioid sedative used in veterinary medicine that is not approved for human use. It can cause severe sedation, slowed breathing, and dangerously low blood pressure. When combined with opioids like fentanyl, the risk of fatal overdose increases significantly.

Medetomidine is a powerful veterinary sedative increasingly found in the illegal drug supply across the United States. According to the Centers for Disease Control and Prevention (CDC), reports of medetomidine submitted to the National Forensic Laboratory Information System increased 950% between 2023 and 2024, rising from 247 to 2,616 reports, and continued to climb sharply to 8,233 reports in 2025.

Why This Complicates Overdose Response

The presence of xylazine and medetomidine in the drug supply creates serious challenges for overdose reversal. Naloxone (Narcan®), the medication used to reverse opioid overdoses, does not work on these veterinary tranquilizers. While naloxone remains essential and should always be administered when an opioid overdose is suspected, it will not reverse the sedative effects of xylazine or medetomidine.

"If someone is overdosing due to an opioid, Narcan can reverse that opioid overdose, but it is not affecting that animal tranquilizer piece of this overdose effect," explains Hayley Edwards, Rowan County's Public Health Substance Use and Program Manager. "A lot of individuals are not waking up from their remaining sedative."

This means overdose victims may require additional medical care and monitoring even after receiving naloxone. The sedative effects can last longer than the opioid effects, leaving individuals vulnerable to complications.

Clinical Implications

For clinicians and first responders, the CDC recommends considering medetomidine intoxication when a patient experiences prolonged sedation after a suspected opioid overdose that continues after naloxone administration. Medetomidine withdrawal can also present with distinctive symptoms including rapid heart rate, severe high blood pressure, fluctuating alertness, tremor, chest pain, or persistent nausea and vomiting.

Healthcare providers are advised to consult with a toxicologist or contact Poison Control at 1-800-222-1222 when managing suspected cases involving these substances.

What Families and Community Members Should Know

If you or someone you know uses substances, or if you are a family member concerned about a loved one, health officials emphasize several key harm reduction strategies:

1. Carry Naloxone and Know How to Use It

Despite its limitations with veterinary tranquilizers, naloxone remains the first-line treatment for suspected opioid overdoses. It is safe, easy to administer, and available without a prescription in North Carolina. Free naloxone is available at multiple locations throughout Rowan County, including:

• Rowan County Health Department (1811 E Innes St, Salisbury)
• Rowan County Library Headquarters (201 W. Fisher St, Salisbury)
• Various community churches and fire stations

2. Use Drug Test Strips

Fentanyl test strips and medetomidine test strips can help identify dangerous substances before use. While no testing method can guarantee safety, these strips provide critical information that can help reduce overdose risk.

3. Never Use Alone

Using substances alone significantly increases the risk of fatal overdose. If an overdose occurs with no one present to respond, the chances of survival decrease dramatically.

4. Call 911 Immediately

If an overdose is suspected, call 911 immediately. North Carolina's Good Samaritan law provides limited immunity from prosecution for certain drug-related offenses when calling for emergency medical assistance during an overdose. Stay with the individual until emergency responders arrive.

5. Recognize the Signs of Overdose

Signs of an opioid overdose include:

• Slow or stopped breathing
• Blue or gray lips and fingernails
• Unresponsive to stimulation
• Pinpoint pupils
• Choking or gurgling sounds

With xylazine or medetomidine present, additional signs may include severe sedation that persists even after naloxone administration.

The Broader Context

Rowan County's situation reflects a national trend. The CDC reports that medetomidine is being found throughout the United States, with the highest concentrations in the Northeast (74.2% of tested sites) and Midwest (56.2%). The South, including North Carolina, has seen 30.1% of tested sites with medetomidine-positive samples.

Year-to-date data from the North Carolina Office of the Chief Medical Examiner shows Rowan County has recorded 15 fentanyl-positive deaths through April 2026, compared to 14 deaths during the same period in 2025—a 7% increase. At least 15 people have died of overdoses in the county this year.

Most overdose patients have been from Salisbury, particularly within the 28144 and 28146 zip codes. The affected individuals are primarily adults ages 25-44, with cases occurring equally among White and Black residents and more frequently among males.

Where to Get Help

If you or a loved one is struggling with substance use, resources are available:

• SAMHSA National Helpline: 1-800-662-HELP (4357) — Free, confidential, 24/7 treatment referral and information
• 988 Suicide & Crisis Lifeline: Call or text 988 for mental health and substance use crisis support
• North Carolina Peer Warmline: 1-855-PEERS-NC (1-855-733-7762) — Support from trained peer specialists
• Rowan County Health Department: Contact Hayley Edwards at Hayley.edwards@rowancountync.gov or 704-216-8884 for naloxone, test strips, and treatment resources

For treatment options and support, families can also contact NW Recovery Centers to learn about available resources and pathways to recovery.

This alert is based on official public health communications from Rowan County Public Health and the North Carolina Department of Health and Human Services, along with clinical guidance from the Centers for Disease Control and Prevention.