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street drug supply may contain dangerous animal tranquilizer

the animal tranquilizer xylazine, which can't be helped with naloxone, may be present in the supply of illicit drugs.

fda warns of the presence of xylazine in fentanyl, heroin supply
in philadelphia, xylazine was found in 91 per cent of fentanyl/heroin samples tested, according to a 2022 report. getty
xylazine, a potent animal tranquilizer, has made its way into the illicit drug supply and the consequences could be fatal.

in an open letter to healthcare providers, the u.s. food and drug administration (fda) warned this week that some street supplies of fentanyl and heroin — and, in some cases, methamphetamine and cocaine — may include the tranquilizer xylazine. xylazine is primarily used as a painkiller in horses, used to sedate them before surgery, nbc news reports. it has no approved human use, and its sedative effects can last for hours.

critically, overdoses involving xylazine can’t be reversed by using naloxone (also called narcan), used to treat opioid overdose. it also won’t be detected by testing strips that can be used to test other drugs for the presence of fentanyl.

the tranquilizer causes bodily reactions similar to opioids, paramedic and harm reduction instructor claire zagorski told cbs news . it lowers blood pressure and slows down a user’s breathing and heart rate.

but it isn’t an opioid, and its sedative qualities added to fentanyl or heroin can make the effects of both drugs more intense.

“if you have an opioid and a sedative, those two things are going to have stronger effects together,” chelsea shover, an epidemiologist at ucla’s school of medicine, explained to npr in august.

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xylazine also comes with its own distressing side effects. when it’s repeatedly injected, users can develop “severe, necrotic skin ulcerations,” according to the letter from the fda. the substance is also addictive, and withdrawal symptoms might develop in people who stop using it abruptly. but withdrawal can’t be managed by standard treatment like methadone, the fda warns, and “currently, no medications have an fda-approved indication to manage xylazine withdrawal in symptomatic individuals.”

the fda’s warning was released in early november, but the presence of xylazine in street drugs has been an ongoing problem. toronto’s drug checking service warned of its potential presence in the fentanyl supply in october 2020, and it’s been detected in large quantities in puerto rico, philadelphia and massachusetts, npr reports . in philadelphia, xylazine was found in 91 per cent of fentanyl/heroin samples tested, according to a 2022 report .

“we’ve seen an exponential increase during the pandemic,” traci green, director of the opioid policy research collaborative at brandeis university and principal investigator of the massachusetts drug supply data stream, told npr.  “now the sad thing is we’re really seeing it all over the state. it’s definitely hazardous.”

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during the first three months of 2022, canada saw 1,883 opioid-related deaths, primarily in b.c., alberta, and ontario. many experts say it’s more accurate to call these deaths drug poisonings than drug overdoses: often, deaths happen not because a person purposely took too high a dose, but because they didn’t know their drug supply was tainted.

 
maija kappler is a reporter and editor at healthing. 
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