The use of a large animal tranquilizer as an additive in street drugs has medical experts sounding the alarm and local authorities scrambling to stop it.
The tranquilizer, xylazine, is FDA-approved for use in animals only. It is used as a sedative and pain reliever for large animals but is being linked to an increasing number of overdose deaths in humans, according to the National Institute on Drug Use.
Authorities are finding traces of xylazine mixed with other drugs like fentanyl, cocaine, and heroin. The drug is primarily impacting the northeastern part of the country, but experts in every state are working with the Centers for Disease Control and Prevention to trace where it is coming from and stop it.
“They’re using any data they can get their hands on to track xylazine and its complicated set of symptoms and effects on users,” said the Association of State and Territorial Health Officials’ senior director of overdose prevention Richa Ranade, according to The Pew Charitable Trusts.
Xylazine is a nervous system depressant that can slow a person’s heart rate and breathing, causing drowsiness, amnesia, and a dangerous and potentially fatal drop in blood pressure. It can also result in severe skin lesions that can necessitate amputations.
Symptoms of the tranquilizer are similar to those of opioids, making it hard to identify the drug in routine toxicology screens. People have admitted to taking xylazine alongside fentanyl to lengthen effects, according to data from the FDA.
Although xylazine has been on the radar in drug supply as early as 2019, The Pew Charitable Trusts reported, officials started to see numbers increase during the COVID-19 lockdowns in 2020.
Health departments and epidemiologists in several states are attempting to address the issue.
New York City, Rhode Island, North Carolina, and Boston have come up with new ways to quickly test for xylazine in illicit drugs and have launched initiatives to spread the word about its dangers to drug users who could unintentionally become exposed to the substance.
Traci Green, director of the drug testing projects at Brandeis University, is worried that the time it takes to determine xylazine’s prevalence in the illicit drug supply will cost people their lives.
“That’s something we haven’t had to think about before,” she said, per The Pew Charitable Trusts. “We’ve had a singular focus on fentanyl for a long time and we’ve made a lot of progress preventing overdose deaths. But many of the tools we have aren’t addressing this particular drug.”
In 2022, the Office of the Chief Medical Officer in Austin suspected that the illicit drug supply had been tainted with xylazine and linked this to several drug overdoses.
“We greatly exceeded the number of overdoses that we normally see and usually we see two or three a day. We saw 18 in a one-day period including four cardiac arrests,” said Jason Pickett, the City’s chief deputy medical director, as reported by CBS Austin.
The FDA noted that someone overdosing on xylazine might appear to be overdosing on an opioid and therefore mistakenly treated with naloxone. Naloxone is used to reverse opioid overdose, but xylazine is not an opioid. As a result, naloxone is ineffective in restarting someone’s breathing if they overdose on the tranquilizing drug, making the situation especially dangerous.