DEA Reports Widespread Threat of Fentanyl Mixed with Xylazine

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A tranquilizer called Xylazine has been found in illegal drugs linked to overdose deaths. Fentanyl mixed with Xylazine has been declared an emerging threat.

The following are a few facts, with links to more information.

Xylazine is a drug used to sedate large animals such as horses and cows, and it’s showing up in fentanyl, heroin, and other street drugs. The FDA has not classed xylazine as a controlled substance because it has not approved any use in humans.

Known as “tranq” or “tranq dope,” between 2021 and 2022, xylazine overdose deaths in Missouri rose from 39 to 109, a staggering 180% increase. 73% of those deaths were male, and most (86%) occurred in the same part of the state: St. Louis City, St. Louis County, St. Charles County, and Jefferson County. Routine toxicology screening does not test for xylazine, so it’s likely the number of overdoses has been underreported.

Xylazine can be ingested, smoked, snorted, or injected (the most common method of use). The drug depresses the respiratory system and can lead to drowsiness, respiratory failure, and death. Those who inject it can develop wounds with patches of dead and rotting skin—and not only at the injection site—which doctors often must treat with amputation.

Xylazine is not an opioid, so naloxone is not effective in treating overdoses; however, because xylazine is so often mixed with opioids like fentanyl, naloxone may be a necessary part of treatment in cases of overdose. Xylazine overdoses can be treated only with supportive measures, such as keeping the airway open.

The Missouri Department of Health and Human Services recommends further public education about xylazine and more routine testing for the substance in cases of overdose and suspected overdose deaths.

When used in people, xylazine can cause (FDA alert):

• sedation
• difficulty breathing
• dangerously low blood pressure
• slowed heart rate
• wounds that can become infected
• severe withdrawal symptoms
• death

Sources:

https://www.cdc.gov/drugoverdose/deaths/other-drugs/xylazine/faq.html

https://www.dea.gov/alert/dea-reports-widespread-threat-fentanyl-mixed-xylazine

https://www.dea.gov/sites/default/files/2022-12/The%20Growing%20Threat%20of%20Xylazine%20and%20its%20Mixture%20with%20Illicit%20Drugs.pdf

https://www.npr.org/2023/07/11/1186847204/xylazine-fentanyl-biden-plan