The Danger of Fentanyl Mixed with Xylazine
According to the US Centers for Disease Control and Prevention, 107,735 Americans died from drug poisonings between August 2021 and August 2022, with 66% of the deaths involving synthetic opioids like fentanyl. The Sinaloa Cartel and Jalisco Cartel in Mexico, using chemicals largely sourced from China, are primarily responsible for the vast majority of the fentanyl that is being trafficked in communities across the United States.
On March 20, the US Drug Enforcement Administration issued an alert about the widespread threat of fentanyl mixed with xylazine, which is an animal tranquilizer. It's not approved for humans but has been found in fentanyl and cocaine supplies. Xylazine surged first in some areas of Puerto Rico and then in Philadelphia. The Drug Enforcement Agency (DEA) has seized xylazine and fentanyl mixtures in 48 of 50 states. In 2022, the DEA Laboratory System detected xylazine in 23% of the fentanyl powder and 7% of the fentanyl pills that had been seized.
There's a lot of speculation about how and why xylazine is on the rise. It may be added to fentanyl or heroin to help extend the effects of an opioid high. It has also been combined with stimulants such as methamphetamine and cocaine. Dealers also may be using this relatively inexpensive and easy-to-order sedative because of supply chain gaps with other drugs.
Xylazine can cause severe, necrotic skin ulcerations. The combination of fentanyl and xylazine make drug overdoses more deadly. Xylazine may contribute to death by slowing breathing and heart rate, as well as decreasing blood pressure.
Some people have said xylazine knocks them out for six to eight hours, raising concerns about the potential for serious injury during this profound sedation.
Patients taking xylazine do not respond to naloxone, but experts recommend giving naloxone to people who may be overdosing on a drug and consider xylazine exposure if the person doesn’t respond to naloxone.
Routine toxicology screens do not detect xylazine, and additional analytical techniques are required to detect xylazine when it might be involved in illicit drug overdoses
Reference
DEA Reports Widespread Threat of Fentanyl Mixed with Xylazine, March 20, 2023, https://www.dea.gov/alert/dea-reports-widespread-threat-fentanyl-mixed-xylazine
