US News reports that there is a new and dangerous trend emerging in the overdose crisis. By now, everyone living above ground has grasped the heroin threat of yesteryear, the Opioid crisis that has marred the twenty-first century, and the present dire situation with Fentanyl. But have you heard of Xylazine?
In a recent article, the everyday world is introduced to this emerging threat, a "horse tranquilizer," that is impacting those who seek solace and comfort in the world of recreational pharmaceuticals. At the same time, there is the ongoing fentanyl infiltration and challenges with countering its impact and effects.
The newcomer, xylazine (also known as "tranq"), is "a sedative used for animal surgeries." It is potentially "life-threatening" in the manner one might expect of a powerful sedative. But it can also cause "life-threatening wounds and sores" it can cause. The Drug Enforcement Agency (DEA) says these "severe wounds," can also involve "necrosis - the rotting of human tissue." There have been instances that required amputation.
US News notes that those who work in the rehabilitation and addiction business perceive "a marked increase in the extreme wounds." In some areas, records support "that almost 1 in 3 opioid overdose deaths so far this year involved xylazine." Statistics tell us the opioid deaths last year were around 111,000, so perhaps 33,000 of those involved this sedative?
The DEA is striving to warn of the Xylazine threat. It describes how users are mixing this sedative with fentanyl and essentially poisoning themselves. This is a sedative, "not an opioid." Therefore the front line defense against opioid and fentanyl overdose, naloxone, is of no help. Despite that, it encourages the use of naloxone in any overdose, in hopes of addressing at least some portion of whatever cocktail by which the user is affected.
There is some tendency, perhaps, to fault the user. Who would inject themselves with horse tranquilizers? But, there is evidence that some of the victims are perhaps using Xylazine unwittingly. The DEA says that it is finding Xylazine mixed in the fentanyl powder and pills that law enforcement is seizing. Thus, some who are using illicit drugs may be unwittingly exposed to two substances that are unexpected and deadly, fentanyl and Xylazine.
For the last several years, there have been reports about the deadly nature of fentanyl. It takes very little of this synthetic to be dangerous. See A Vaccine Against Being High (January 2023), and the posts linked there. Despite that profound threat, the DEA characterizes Xylazine as making fentanyl "even deadlier.”
And, as noted above, the overdose numbers continue to soar. People are continuing to adopt drug use as their course, and the path from prescription medicine to street drugs is all too well-known. Synthetic substances like fentanyl and xylazine are said to be more difficult to escape, and the threats of this latest addition are frankly unfathomable. Each state is struggling with the impacts and effects of these poor personal choices.
There are those who advocate for more drug use in response. They are adamant that known alternatives such as methadone are the best tool in the war against these substances. They argue that easier access to such drugs would perhaps deter people from street substances and the threats they pose. There are easier answers, such as abstinence. The difficulty with these, from my conversations, is that no one believes they will become addicted, nor intends that outcome.
Those who seek out drugs are too often afforded the opportunity for overuse and dependency in the wake of medical care. There has been contention for years that limited opioid use post-injury is a critical step, and workers' compensation is one path to such injury and treatment. There is potential for any such care and treatment to lead to a path that could eventually include these illicit substances. That is a contingency worth considering.
Beyond the potential for such limitation and perhaps abstinence, there is the conclusion that addiction can be overwhelming and overpowering. There is the real potential for people to become quickly dependent upon the illicit market, and find themselves unwittingly exposed to increasingly dangerous types and quantities of substances. The implications are frankly unthinkable, yet real.
Xylazine is the story today, layered on yesterday's unprecedented fentanyl threat. What will tomorrow bring from the cartels and China importing through our porous national borders?