The U.S. has named a veterinary tranquilizer as an "emerging threat" when it’s mixed with the powerful opioid fentanyl, clearing the way for more efforts to stop the spread of xylazine.
The Office of National Drug Control Policy announced the designation Wednesday, the first time the office has used it since the category for fast-growing drug dangers was created in 2019.
Dr. Rahul Gupta, director of the drug policy office, said xylazine (pronounced ZAI’-luh-zeen) has become increasingly common in all regions of the country.
It was detected in about 800 drug deaths in the U.S. in 2020 — most of them in the Northeast. By 2021, it was present in more than 3,000 fatalities —with the most in the South — according to a report last year from the Drug Enforcement Administration.
"Xylazine is making the deadliest drug threat our country has ever faced, fentanyl, even deadlier," said Administrator Milgram. "DEA has seized xylazine and fentanyl mixtures in 48 of 50 States. The DEA Laboratory System is reporting that in 2022 approximately 23% of fentanyl powder and 7% of fentanyl pills seized by the DEA contained xylazine."
"We cannot ignore what we’re seeing," Gupta said. "We must act and act now."
Xylazine was approved for veterinary use in 1971. Sometimes known as "tranq," it’s been showing up in supplies of illicit drugs used by humans in major quantities in only the last several years.
It’s believed to be added to other drugs to increase profits. Officials are trying to understand how much of it is diverted from veterinary uses and how much is made illicitly.
The drug causes breathing and heart rates to slow down, sometimes to deadly levels, and causes skin abscesses and ulcers that can require amputation. Withdrawal is also painful.
While it’s often used in conjunction with opioids, including fentanyl and related illicit lab-made drugs, it’s not an opioid. And there are no known antidotes.
"Health care professionals should be cautious of possible xylazine inclusion in fentanyl, heroin, and other illicit drug overdoses, as naloxone may not be able to reverse its effects," said the FDA’s recent warning. "FDA is aware of increasing reports of serious side effects from individuals exposed to fentanyl, heroin, and other illicit drugs contaminated with xylazine."
Gupta said his office is requesting $11 million as part of its budget to develop a strategy to tackle the drug’s spread. Plans include developing an antidote, learning more about how it is introduced into illicit drug supplies so that can be disrupted, and looking into whether Congress should classify it as a controlled substance.
Gupta said it needs to be available for veterinary uses even amid crackdowns on the supply used by people. He also said systems to detect the drug and data about where it’s being used need to be improved.
The drug is part of an overdose crisis plaguing the U.S.
The U.S. Centers for Disease Control and Prevention estimates that more than 107,000 people died from overdoses in the 12 months that ended Nov. 30, 2022. Before 2020, the number of overdose deaths had never topped 100,000.
Most of the deaths were linked to fentanyl and other synthetic opioids. Like xylazine, they’re often added to other drugs — and users don’t always know they’re getting them.
The Los Angeles Department of Public Health issued a health alert warning residents of the increased risk of overdose and death associated with xylazine earlier this year.
"Most people who are purchasing or being given illicit drugs are not seeking xylazine and likely do not know that xylazine may be present in the drugs they are trying to obtain," said the County warning. "Increased awareness of the risk of xylazine in illicit opioids, counterfeit pills, stimulants, and other drugs not obtained from pharmacies is necessary to support overdose prevention and harm reduction."
GEOFF MULVIHILL, Associated Press