How Xylazine Is Making The Fentanyl Crisis Worse

In recent years, the US has been in the grip of an Opioid epidemic that has taken countless lives and devastated communities. However, a dangerous drug has emerged that is proving to be a deadly threat to the already troubling crisis: Xylazine-laced Fentanyl

The US Drug Enforcement Administration (DEA) recently issued a public safety alert to warn Americans of the sharp increase of trafficked Fentanyl mixed with Xylazine, a powerful non-Opioid sedative used in veterinary care. Despite the emerging public health threat, routine toxicology tests are not yet testing for the substance. 

“Xylazine is making the deadliest drug threat our country has ever faced, Fentanyl, even deadlier,”

- DEA Administrator Anne Milgram

Although Xylazine misuse was previously reported in Puerto Rico in the early 2000s, its use has remained largely unnoticed until recently. The introduction of Xylazine has only exacerbated the dangers of Fentanyl abuse. Known colloquially as “Tranq,” Xylazine-laced Fentanyl significantly increases the risk of fatal drug poisoning, with 22% of Fentanyl powder and 7% of Fentanyl pills containing Xylazine in 2022. That same year, drug overdose deaths reached 107,000, with Fentanyl-laced drugs accounting for 66.5% of those fatalities.

How Dangerous Is Xylazine-Laced Fentanyl?

There is growing concern over Xylazine use due to its increasing association with Fentanyl-related overdose deaths and severe side effects, such as skin ulcers, abscesses, and tissue death (necrosis). Xylazine can also cause wounds containing scaly dead tissue called eschar, which, if left untreated, can lead to amputation. 

“In the case of Xylazine or other drugs used in an intravenous method, drugs “cut” or mixed with other drugs may be the cause [of necrosis]…the sharing of infected needles, unsterile IV techniques for example, all of which can contribute to various types of skin infections or possibilities as to why these symptoms may be occurring,”

- Dr. Ashish Bhatt, MD, MRO

Since Xylazine is a potent tranquilizer, it can cause individuals to enter a blackout stupor for several hours, leaving them vulnerable to sexual assault and other crimes, such as robbery. What adds to the danger of Xylazine is that individuals often do not know the drug is present in a substance. Now, not only do individuals have to worry about Fentanyl being present in a substance, they have the presence of Xylazine to consider. Individuals who use Xylazine often experience extreme sedation, respiratory depression, and other life-threatening side effects that can quickly lead to overdose and death.

Additionally, since Xylazine is not an Opioid, it is not responsive to common overdose reversal treatments like Naloxone. Researchers are concerned that the presence of Xylazine in the illicit drug supply may weaken Naloxone’s effectiveness, making overdoses harder to treat.

Safety Alarms Are Sounding Nationwide

In recent months, reports of Xylazine-laced Fentanyl have increased in cities nationwide. In New York City, officials have issued warnings about the drug and its potentially deadly effects, with health officials stating that Xylazine has been found in 25% of drug samples, but the number may be a lot higher. 

In Philadelphia, Xylazine was present in 34% of all fatal overdoses in 2021, a 39% increase from the previous year. According to Substance Use Philly, a city health department division, Xylazine was present in over 90% of tested drug samples in 2021. What adds concern is that individuals cannot currently test substances for Xylazine using drug-testing tools; the health department acquired their data from a toxicology lab.  

The presence of Xylazine is spreading throughout the states, but it is hitting the Northeast especially. The National Institutes of Health (NIH) states that overdose deaths linked to Xylazine have spread westward, including states like Texas and Ohio. Xylazine was involved in 10% of all drug overdoses in Connecticut in 2020 and 19% in Maryland in 2021. 

As safety alarms continue ringing throughout the nation, experts and politicians are looking to find the best approach to mitigate the issue. Some have called for increased public awareness campaigns and educational programs to help individuals better understand the risks associated with the drug. In contrast, others have called for more aggressive law enforcement efforts to crack down on the suppliers of the drug.

The Introduction Of Legislation To Combat Xylazine-Laced Fentanyl

Congress has been taking action to address the issue at the federal level. One proposal that has gained traction is to designate Xylazine as a controlled substance, making it illegal to possess, distribute, or sell the drug.

The proposal, introduced on Tuesday by US Senators Catherine Cortez Masto (D-Nev.) and Chuck Grassley (R-Iowa), would better allow authorities to track Xylazine and prosecute traffickers. If passed, the measure would add Xylazine to the list of drugs regulated by the DEA under the Controlled Substances Act, making Xylazine a Class III controlled substance.

However, some experts and advocacy organizations have raised concerns that the designation may have unintended consequences. According to a March RAND report, making drugs illegal can discourage individuals with an Opioid use disorder from seeking treatment. According to the same report, increasing access to and use of treatment for substance use disorders (SUD) remains the top priority for curbing addiction and overdoses. Still, that alone will not adequately address the increase in overdose deaths.

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Don’t Wait To Pursue Treatment

As the debate over Xylazine-laced Fentanyl unfolds, one thing is clear: the crisis severely threatens public health and safety, and urgent action is needed to prevent further harm. Whether through increased public awareness, targeted policy changes, or other strategies, it is essential to address this deadly epidemic to ensure a brighter future for our communities.

In the face of this crisis, it is more important than ever for individuals, families, and communities to take action to prevent further harm. Action may include seeking treatment and support for addiction, advocating for policy changes, prioritizing public health and safety, and raising awareness about the dangers of Xylazine-laced Fentanyl and other lethal drug combinations. If you or a loved one is struggling with Opioid use, don’t wait to pursue treatment. Contact a treatment provider to start your recovery today. 

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Carmen McCrackin

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  • Carmen McCrackin earned a B.A. in Journalism from the University of Auburn and has over 4 years of professional writing experience. Her passion for writing and educating others led her to a career in journalism with a focus on mental health and social justice topics. Her main mission is to be a platform for all voices and stories, and to provide tangible resources to those seeking recovery for themselves or loved ones.

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