Polysubstance Use Is Rewriting the Rules of Addiction Medicine

• By: Dr. Ryan Cole, PsyD Achieve Whole Recovery
• August 14th, 2026
• addiction medicine, Contingency Management, fentanyl, medetomidine, opioid use disorder, polysubstance use, stimulant use disorder, xylazine
• 274    0

Key Takeaways: Fentanyl increasingly contains sedative adulterants like xylazine and medetomidine, plus stimulants, which is complicating standard opioid use disorder treatment protocols. Xylazine's own withdrawal syndrome and its masking of opioid withdrawal signs are pushing providers...