What is Xylazine?

The ongoing opioid crisis in the United States has taken an even more sinister turn with the emergence of a new and dangerous substance: Xylazine. This veterinary tranquilizer, never approved for human use, has become an increasingly common adulterant in illicit drug supplies, particularly in combination with fentanyl. As the prevalence of xylazine-tainted drugs continues to rise, it has become imperative for the public to understand the grave risks associated with this powerful substance.

Xylazine, also known by its street name "tranq," is a central nervous system depressant that was originally developed for use in veterinary medicine. It is a potent sedative and analgesic, commonly employed to sedate large animals such as horses and cattle during medical procedures. However, the substance has now found its way into the illicit drug market, where it is often mixed with other drugs, particularly opioids like fentanyl, to enhance their effects and reduce production costs.

The Prevalence of Xylazine

While the full scope of the xylazine crisis is still being uncovered, research has shown that its presence in overdose deaths has been steadily increasing across the United States. In Philadelphia, for example, the percentage of drug overdose deaths involving xylazine rose from 2% in 2015 to a staggering 26% in 2020. Similarly, xylazine was detected in 19% of all drug overdose deaths in Maryland in 2021 and 10% in Connecticut in 2020.

The Dangers of Xylazine

The use of xylazine in combination with other drugs, especially opioids, poses a grave threat to public health. Xylazine can cause a range of dangerous side effects, including drowsiness, amnesia, and the slowing of vital functions such as breathing, heart rate, and blood pressure to dangerously low levels. When taken with opioids, alcohol, or benzodiazepines, the risk of life-threatening overdose increases exponentially.

Xylazine and Naloxone

One particularly concerning aspect of the xylazine crisis is the limited effectiveness of naloxone, the standard opioid overdose reversal medication, in addressing the effects of this veterinary tranquilizer. Since xylazine is not an opioid, naloxone does not effectively counteract its impact on respiratory function. This has led experts to worry that the growing prevalence of xylazine in the illicit drug supply may render naloxone less effective in some overdose situations.

Long-Term Effects of Xylazine Use

Prolonged use of xylazine can also lead to a range of severe health complications, including skin ulcers, abscesses, and other related issues. These conditions can be particularly challenging to treat and may require specialized medical intervention.

Patterns of Xylazine Use

Individuals who use xylazine-containing drugs report various methods of administration, including injection, snorting, swallowing, and inhalation. This versatility in consumption methods further contributes to the widespread appeal and accessibility of xylazine among people struggling with substance abuse.

The Emergence of Xylazine in the Illicit Drug Supply

Researchers believe that xylazine is often added to illicit opioids, including fentanyl, to lengthen the duration of the euphoric effects and reduce production costs. This practice has led many users to unknowingly consume xylazine, as they may be unaware that it has been mixed into the drugs they are using.

Polysubstance Use and Xylazine

Most overdose deaths linked to both xylazine and fentanyl also involve the use of additional substances, such as cocaine, heroin, benzodiazepines, alcohol, gabapentin, and prescription opioids. This pattern of polysubstance use further compounds the risks associated with xylazine, as the combination of multiple central nervous system depressants can have catastrophic consequences.

The Impact of Xylazine on Overdose Rates

The growing prevalence of xylazine in the illicit drug supply has contributed to a significant increase in overdose deaths nationwide. Experts are particularly concerned about the potential for xylazine to exacerbate the ongoing opioid crisis, as the substance's ability to prolong the effects of opioids and its potential to reduce the effectiveness of naloxone pose a grave threat to public health.

Addressing the Xylazine Crisis

In response to the emerging xylazine crisis, the White House has recognized the substance as an "emerging threat" and is taking steps to address the issue through prevention, treatment, and supply reduction efforts. Additionally, NIDA-supported research is ongoing to better understand the evolving patterns of drug use and changes in the illicit drug supply, including the use of xylazine, synthetic opioids, and patterns of polydrug use.

Seeking Help and Support

The emergence of xylazine as a dangerous adulterant in the illicit drug supply has exacerbated the ongoing opioid crisis in the United States, posing a significant threat to public health. By understanding the risks associated with this veterinary tranquilizer and the importance of seeking appropriate medical care and support, we can work towards mitigating the devastating impact of xylazine and saving lives. It is crucial that the public remains informed and vigilant in the face of this evolving public health challenge.

For individuals struggling with substance abuse, including the use of xylazine-containing drugs, recovery is possible. If you or someone you know is in need of assistance, reach out to us and we can help. 

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