Joshua Rivera

Medetomidine withdrawal is an emerging severe withdrawal syndrome linked to repeated exposure to medetomidine in the illicit fentanyl supply. It can involve dangerous hypertension, rapid heart rate, tremor, vomiting, and altered alertness.

Xylazine-associated wounds can appear away from injection sites and even in people who smoke or snort drugs containing xylazine. The exact mechanism is still being studied, but the injury is not explained by needle trauma alone.

Yes. Methamphetamine can contain fentanyl or other opioids, sometimes without the user’s knowledge, creating unexpected opioid-overdose risk in people who may have little opioid tolerance.

Yes. Cocaine can contain fentanyl or fentanyl-related substances, sometimes without the user’s knowledge. This creates opioid-overdose risk for people who may have little or no opioid tolerance.

Mixing depressants such as opioids, benzodiazepines, alcohol, or sedating medications can compound central nervous system depression and sharply increase the risk of slowed breathing, coma, injury, and overdose.

Polysubstance use means using more than one substance, either at the same time or within a short period. Clinically, a person may have one or more substance use disorders involving different substances rather than a single diagnosis called polysubstance use disorder.

GHB withdrawal can occur after frequent or dependent use and may progress rapidly to severe agitation, hallucinations, delirium, autonomic instability, or seizures, making medical supervision important in high-risk cases.

Yes. Recreational ketamine use can lead to tolerance, craving, and dependence in some people, especially with frequent or escalating use and high cumulative exposure.

Ketamine-induced cystitis, sometimes called “ketamine bladder,” is painful inflammatory injury to the bladder and urinary tract associated with frequent or heavy ketamine use.

Ketamine use disorder is a problematic pattern of ketamine use involving impaired control, craving, tolerance, continued use despite harm, or other substance-use-disorder features.