Animal tranquilizer ‘xylazine’ is being incorporated into illicit drugs like coke and molly, FDA warns
The animal sedative xylazine has become an increasingly common cutting agent.
Nearly half of the street drugs in the United States are laced with a dangerous animal tranquilizer, a study suggests.
More than 40 percent of the samples tested in Rhode Island contained xylazine, which health officials say can cause “serious and life-threatening side effects.”
Sometimes known as ‘tranq’, xylazine is typically used as a sedative or pain reliever for cows and horses in veterinary medicine.
It became popular recreationally in Puerto Rico and began appearing in Philadelphia in the early 2010s, but has now begun to appear elsewhere as well.
In November, the Food and Drug Administration (FDA) alerted health care workers that the drug was being used as a cutting agent in heroin, methamphetamine, cocaine, and opioids to increase their effects and stretch the supply.
For their analysis, Brown University researchers analyzed 90 drug samples from the Toxicological and Ethnographic Drug Surveillance Testing program.
Although none of the drugs were sold as xylazine, forty contained the animal tranquilizer, mostly fentanyl.
Although the drug is abundant in Rhode Island, researchers say most users and community workers don’t even know what xylazine is.
The FDA has warned health care workers that it can be “difficult to tell” a xylazine overdose from an opioid overdose: Both drugs cause the lungs to begin to fail.
But unlike opioids, xylazine overdoses cannot be reduced with naloxone, the emergency drug for opioid overdose reversal. Another concern is that people can also become physically dependent on the drug.
This creates complications for addicts who want to start using an opioid use disorder medication, such as methadone.
When someone stops using fentanyl as part of that process, they will also experience xylazine withdrawal.
Patients who abuse drugs contaminated with xylazine can also suffer ulcers and wounds that “take a long time to heal,” said Chelsea Shover, an assistant professor at the University of California, Los Angeles. abc.
Xylazine was involved in up to 20 percent of overdose deaths in the hardest-hit states last year, including Massachusetts, Connecticut, Illinois and Pennsylvania.
Sold under the brand name Rompun in the US, it first gained popularity in Puerto Rico in the 2000s, where it is known as ‘horse anesthesia’.
It has become a common heroin adulterant, a cheap way for drug dealers to enhance the drug’s use and increase its potency.
In Puerto Rico, xylazine has been most prevalent in a drug combination nicknamed ‘speedball,’ which is made up of heroin and cocaine and is used to balance the effects of both the tranquilizer and the stimulant.
A 2008 study found that more than 90 percent of syringes used for speedballs tested in Puerto Rico contained xylazine.
Public health officials were alerted in part to the appearance of sores on the skin of users where they injected the drug.
Painful lesions are often made worse when users inject themselves into the same site repeatedly, hoping to benefit from the opioid’s pain-relieving effect.
The drug has left a stain on Philadelphia, home to the largest open-air heroin narcotics market on the East Coast.
Between 2010 and 2015, xylazine was detected in 40 of Philadelphia’s 1,854 unintentional overdose deaths (just two percent) with heroin and/or fentanyl detections.
The presence of xylazine in Philadelphia has skyrocketed ever since.
In 2017, it was detected in 10 percent of deaths due to fentanyl and/or heroin overdose, in 18 percent in 2018, and in 31 percent in 2019.
In 2020, xylazine was present in nearly 26% of overdose deaths in Philadelphia, followed by approximately 19% in Maryland and 10% in Connecticut.
What is xylazine?
Xylazine is a non-opioid agent that was originally approved by the FDA in 1972 as a sedative and analgesic for use in veterinary medicine.
The drug acts as a central alpha-2-adrenergic receptor agonist in the brain stem, causing a rapid decrease in the release of norepinephrine and dopamine in the central nervous system (CNS).
Xylazine can also bind to other CNS receptors, although more research is needed.
Xylazine is not approved for use in humans.
Symptoms and risks
Signs and symptoms of acute xylazine toxicity can include shortness of breath, high blood pressure, slow heart rate, hypothermia, and high blood sugar.
Overdoses can appear similar to opioid overdoses, making them difficult to tell apart.
But unlike opioids, xylazine overdoses cannot be reduced with naloxone, the emergency drug for opioid overdose reversal.
Repeated exposure to xylazine, by injection, has been associated with severe necrotic skin ulcerations that are clearly different from other soft tissue infections (eg, cellulitis, abscesses) often associated with injection drug use.
These ulcerations can develop on areas of the body far from the injection site.