Fentanyl-xylazine combination An emerging threat

April 12, 2023 — The spread of the animal tranquilizer fentanyl and xylazine is an “emerging threat” to the United States, the White House said Wednesday, allowing it to quickly develop a response plan to reduce the supply of illicit drugs, improve testing and provide more treatment.

The action comes on the heels of a Warning from the United States Drug Enforcement Administration about a surge in trafficking and overdoses of fentanyl combined with what is more commonly known as ‘tranq’ or ‘zombie drugs’. The rapid increase in overdoses, serious health consequences such as deep skin wounds that do not heal, and deaths led to the new warning from the White House’s Office of National Drug Control Policy.

“As a physician, I am deeply troubled by the devastating impact of the fentanyl-xylazine combination, and as President Biden’s drug policy adviser, I am extremely concerned about what this threat means for the nation,” he said. said Rahul Gupta, MD, MPH, Director of the Office of Drug Policy, in a report.

Gupta DEA data cited this shows that between 2020 and 2021, forensic laboratory identifications of xylazine have increased in the United States, particularly in the South (193%) and West (112%). DEA statistics also showed that xylazine-positive overdose deaths increased by 1,127% in the South, 750% in the West, more than 500% in the Midwest, and more than 100% in the North-east.

THE SUPPORT Law 2018 gave the Drug Policy Office new powers to designate emerging drug threats. A special committee that met throughout 2019 and 2020 determined the criteria when a substance poses a significant threat to the public.

This is the first time these powers have been used. Gupta said a drug policy task force will soon begin meeting to come up with a plan that would improve testing for xylazine – as it goes undetected in routine drug tests; developing protocols for treatment and supportive care; reduce the illicit supply of xylazine; and support rapid research that could, for example, investigate interactions between xylazine and fentanyl.

It’s unclear how much money will be dedicated to the effort, but in March, as part of the fiscal year 2024 budget, the Biden administration requested $46.1 billion to support its drug control policies, including the fight against fentanyl. That’s $2.3 billion more than what Congress approved for 2023.

Congress also took note. At the end of March, a bipartisan group of members of the Senate and House presented the Illegal Xylazine Control Act, which would make the drug a controlled substance. This would give the DEA increased authority to track and regulate it.

“This bipartisan legislation will ensure that the DEA and local law enforcement have the tools they need to remove xylazine from our streets while protecting its important use as a veterinary tranquilizer,” said Senator Catherine Cortez Masto (D -Nevada) in a report.

The FDA in March issued an import alert for xylazine, giving it the power to withhold raw ingredients or bulk quantities of the drug if the shipments are suspected of being illegal. Xylazine was first approved by the FDA in 1972 as a sedative and pain reliever for use in animals only.

In November, the FDA knowledgeable healthcare professionals that the overdose agent naloxone is unlikely to reverse a xylazine-related overdose because the animal tranquilizer is not an opioid.

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