As the Baltimore Police Department cracks down harder on those who use drugs, the supply that they claim to be targeting has become increasingly unpredictable and deadly.
About 10.5% of drug samples in Baltimore contained medetomidine, a veterinary sedative, in the fourth quarter of 2025, according to a report earlier this month from the state's Rapid Analysis of Drugs, or RAD, program. As of the first quarter of the year, no samples contained the drug, and just 1.3% contained medetomidine in the second quarter. State health officials have acknowledged that the drug supply shifting to a dangerous sedative can be attributed to interdiction.
"Although veterinary sedatives are not new to the drug supply, their increasing presence may complicate overdose prevention and response strategies,” according to one RAD newsletter. "The emergence of medetomidine in Maryland coincides with a reduction in xylazine that followed the scheduling of xylazine in Pennsylvania and Virginia."
Although the RAD program's third-quarter report did not include medetomidine content broken down by jurisdiction, the available data shows a clear upward trend. While medetomidine does not cause the wounds associated with xylazine, a sedative that has become rarer, it's more potent and shares its naloxone-resistant qualities. It also causes severe sedation and respiratory depression.
Logan Hullinger
The references to Pennsylvania's crackdown on xylazine come from Gov. Josh Shapiro's decision to sign a law in 2024 classifying xylazine as a Schedule III drug after the state temporarily did so in 2023. Subsequently, medetomidine replaced it as the most common adulterant in Philadelphia, one of the cities hit hardest by the overdose crisis.
Crack down hard, face the consequences. The street drug economy can adjust, and it will do so in a deadly manner. Similar efforts have surfaced in Maryland but failed, with the state health department acknowledging the dangers of beefing up regulations.
This trend opens up a large discussion about what public health experts know compared to what local governments and their police forces know.
The state's drug-checking program, the first of its kind in the nation, is not perfect, said Erin Russel, a harm reduction consultant who served as chief of the former Center for Harm Reduction Services, in an interview with Mobtown Redux.
The program provides limited context. It does not, for example, show the progression of a drug making its way to Maryland. It only shows the end result, as with medetomidine. While about 10% of Baltimore's drug supply contained the drug, more than 51% of samples in Cecil County, which borders Philadelphia, contained medetomidine in the most recent RAD report.
Logan Hullinger
"All these whack-a-mole adulterate issues are the result of an unregulated market that gets more and more dangerous with an enforcement approach," said Erin Russel, a harm reduction consultant who served as chief of the former Center for Harm Reduction Services.”Drug checking makes the need for consumer protection so clear."
That enforcement approach includes local policing strategies, such as what's seen in Baltimore. But among other factors, it's impacted by state, federal and international interdiction efforts, she said.
Studies show that heavy-handed drug enforcement can increase overdose death rates by disrupting the drug supply and pushing drug users toward riskier sources, a phenomenon known as the “Iron Law of Prohibition.”
So, in a city where local officials claim the War on Drugs is over, what is happening?
In Baltimore, the police's own data directly contradicts those claims, which have come from Mayor Brandon Scott, the police department's top brass and other local officials. The police commissioner argues that those who use drugs must be targeted to get to the suppliers.
The police department ended 2025 with a 25% increase in misdemeanor drug arrests over the year prior, according to the data. The most recent data, which reflects low-level arrests as of Feb. 14, shows that low-level drug arrests have increased 23% over this time last year.
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The gameplan, therefore, seems lose-lose. Either the city destroys the lives of drug users by feeding them to the carceral beast, or it interrupts the supply and kills them through that means.
The fact that law enforcement has essentially been given carte blanche to continue its assault on drug users in the name of public safety is not only nonsensical but incredibly dangerous.
The state's drug testing program is telling jurisdictions how their actions are impacting the drug supply, which in turn determines the livelihoods of drug users. But that hasn't seemed to lead to drug policy reforms or policing reforms as more people continue to die.
The inaction is a clear indication that those in power simply do not care about what is killing their constituents who use drugs — they'd rather maintain the status quo and pretend that their policing strategies have people's safety in their best interest.
But as the data shows, that's not the case. And until things change, the drug war will rage on, and the death campaign will only hurt our most vulnerable.
Read the last Redux Newsletter: "Baltimore harm reductionists rally in Annapolis to target paraphernalia criminalization"
Harm reductionists from Baltimore and beyond are backing a new iteration of a bill in this year's General Assembly session that has paraphernalia criminalization in its crosshairs — part of a renewed effort to combat the racist War on Drugs in Maryland.
Dozens of people, ranging from harm reduction organizers to abstinence-based recovery advocates, gathered in Annapolis last week for Overdose Prevention Advocacy Day. After rallying at the Lawyers Mall on a frigid Tuesday morning, they lobbied lawmakers to support or oppose a slate of bills being considered in this year's session. For those fighting for the rights of drug users, it was paraphernalia legislation cross-filed in both chambers that took priority, with the day culminating in a hearing before the House Judiciary Committee.
"Legally obtained items should stay legal. Point blank, period," said Candy Kerr, communications manager of the Baltimore Harm Reduction Coalition. "It's the association with drugs that makes it illegal, allowing police officers to stop and harass people who have paraphernalia on them."
Read the full newsletter here.
Mobtown Redux's Overdose Data has been updated with the latest local, state and national data
There were 568 overdose deaths in Baltimore in 2025, marking a historic 27% decrease from the year prior, according to preliminary data from the Maryland Department of Health.
That death toll will likely change as causes of death are finalized, but the decline mirrors the downward trend seen nationally. This was the second consecutive year that Baltimore saw a notable decrease in deaths; there were 777 deaths — a 25.5% decrease from the year prior — in 2024.
The numbers indicate that the city's fatal overdose rate continues to trend downward after years of climbing, with the death toll twice surpassing 1,000 people.
However, the preliminary data also shows that low-income Black neighborhoods in West Baltimore continue to see the highest death rates. Those same neighborhoods are also the most heavily policed, with residents significantly more likely to be arrested on drug charges,
Check out Mobtown Redux's Overdose Data Dashboard here.
Click here to learn more about harm reduction resources in the Baltimore area.
Filter: "SF Advances RESET Sobering Center, Over Concerns of Unlawful Detention"
San Francisco is moving forward with plans to open a controversial sobering center, despite warnings that courts would likely consider the city liable for operating an unlicensed detention center. On February 17, Mayor Daniel Lurie (D) signed legislation that authorizes a $14.5 million contract with Arizona-based Connections Health Solutions to run the Rapid Enforcement, Support, Evaluation and Triage (RESET) center, which has been described by Sheriff Paul Miyamoto as “like a big drunk tank that’s not a jail.”
RESET, which will receive health department funding but operate under the authority of the sheriff’s office, is billed as an alternative to jail and hospitalization. It’s slated to operate as a pilot for 26 months with the option of a one-year extension, and to open its doors in April at 444 Sixth Street in the SoMa neighborhood, across from the county jail.
The center is expected to have 25 reclining chairs where people arrested for public intoxication can be dropped off and can remain for up to 24 hours. Then they’re supposed to be given the option to transfer to a stabilization center, where they could stay for up to 90 days while receiving mental health and substance use services.
Click here to read the full article.
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