Americans are being warned that a dangerous animal tranquilizer could be lurking in illegal street drugs.
The Food and Drug Administration (FDA) has issued a warning about xylazine, which is showing up in a growing number of toxicology reports following fatal overdoses.
Xylazine is not approved for human consumption and is commonly used as a sedative or analgesic for cows and horses in veterinary medicine.
The FDA warns in humans that it can cause “serious and life-threatening side effects similar to those commonly associated with opioid use.”
Still, xylazine is increasingly being used by drug dealers as a cutting agent in heroin, meth, cocaine and opioids, the federal agency told stakeholders in a letter Tuesday.
The warning warned that it can be ‘difficult to distinguish’ a xylazine overdose from an opioid overdose – both of which cause the lungs to begin to fail.
But unlike opioids, xylazine overdoses cannot be mitigated with naloxone, the rescue drug for reversing opioids.
The sedative xylazine is approved for veterinary use only and is commonly used for cows. horses and other animals. In humans, it can depress the central nervous system and respiratory system.
The animal narcotic is becoming an increasingly common adulterant in heroin and some stimulants such as cocaine and meth. Because it is not an opioid, its effects cannot be mitigated with the opioid overdose reversal drug naloxone.
Xylazine is not to be confused with the popular hallucinogenic ketamine, which was originally developed as a sedative for horses.
While national numbers on xylazine are murky — the drug can only be detected using advanced drug screens — several report troubling trends.
It has been implicated in up to 20 percent of overdose deaths in the hardest-hit states, including Massachusetts, Connecticut, Illinois and Pennsylvania.
Xylazine – sold under the brand name Rompun in the US – first became popular in Puerto Rico in the 2000s, where it is known as ‘anestecia de caballo’.
It has become a widely used heroin adulterant, an inexpensive way for drug dealers to improve drug absorption and increase the drug’s potency.
In Puerto Rico, xylazine is most commonly found in a drug combination nicknamed “speedball,” which consists of heroin and cocaine and is used to balance the effects of both the downer and the upper.
A 2008 study found that more than 90 percent of syringes used for speedballs tested from Puerto Rico contained xylazine.
Public health officials there were tipped off in part because of the appearance of sores on the skin of users where they injected the drug.
The painful lesions are often exacerbated when users inject the same spot repeatedly in hopes of taking advantage of the opioid’s pain-relieving effect.
The drug has left a mark in Philadelphia, home to the largest open-air heroin narcotics market on the East Coast.
Between 2010 and 2015 xylazine was detected in 40 of Philly’s 1,854 accidental overdose deaths (just 2 percent) with detection of heroin and/or fentanyl.
The presence of xylazine in Philadelphia has risen sharply since then.
In 2017, it was detected in 10 percent of fentanyl and/or heroin overdose deaths, 18 percent in 2018 and 31 percent in 2019.
In 2020, xylazine was present in nearly 26 percent of overdose deaths in Philadelphia, followed by about 19 percent in Maryland and 10 percent in Connecticut.
The FDA said, “Healthcare professionals treating opioid overdose should consider exposure to xylazine if patients do not respond as expected when naloxone is administered or when signs or symptoms of xylazine exposure (e.g., unusual skin necrosis) are present.”
Health officials are now concerned that the drug is moving west. Xylazine overdoses have also been registered in Cook County, Illinois, Harris County, Texas, Jefferson County, Ala., Milwaukee, Wisconsin, and the state of New Hampshire.
The rise in the drug’s prevalence suggests that the ongoing crisis of drug overdose deaths is far from over.
The overdose epidemic was exacerbated by the Covid pandemic, forcing people to quarantine early and keep their distance from others, leading to feelings of isolation and despair.
Severe movement restrictions introduced in early 2020 have further limited treatment options for people in recovery.
The number of fatal drug overdoses rose 15 percent to more than 107,000 in 2021, catching up with the previous record set the previous year.
The synthetic opioid fentanyl caused more overdoses than any other drug, leading to more than 71,000 deaths, a 23 percent increase from the previous year.
Deadly cocaine-related overdoses are up 23 percent by 2021, while deaths from methamphetamine overdoses are up 34 percent.
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