Feds try to head off the newest big danger in illicit drugs; xylazine is cheap and causes rotting flesh wounds

Xylazine is legal only as a sedative for animals.
(Photo by Derek Montgomery, The Washington Post; click to enlarge)

Pain pills, heroin, synthetic opioids, fentanyl--what else can drug mixers cut into illegal drugs? Xylazine, that's what. It's a central-nervous-system depressant that is often mixed with fentanyl and can cause a deep stupor, reports Caroline Anders of The Washington Post: "It's known to cause rotting flesh wounds that, left untreated, can lead to amputations." Worsem it's a drug seller's dream: "It's extremely inexpensive, allowing sellers to extend their stores of heroin and fentanyl even further, and some users say it extends the sedative and euphoric effects of the opioids," Anders reports.

Xylazine is FDA-approved for veterinary use; its illegal use began to be noticed in the early 2000s, but "then became rampant in Philadelphia, and is now spreading across the United States. The Drug Enforcement Administration said the sedative was present in 23 percent of fentanyl powder and 7 percent of pills it seized in 2022," Anders writes. "Over 3,000 people died of xylazine-related overdoses in 2021 — triple the fatalities recorded the year before. But, importantly, those overdoses were all from mixtures of xylazine and opioids like fentanyl or heroin. . . . It's unclear exactly how xylazine interacts with opioids, though researchers are looking into the question."

"Last month, the Biden administration designated xylazine mixed into fentanyl as an emerging threat . . . . trying to prioritize federal resources to address the drug from the supply and demand side, both boosting testing and treatment and restricting the illegal supply of the tranquilizer," Anders reports. "In March, lawmakers also introduced bipartisan legislation that would classify the drug as a controlled substance." Rahul Gupta, director of the White House Office of National Drug Control Policy, told Anders that one of the key lessons the government learned from the fentanyl crisis is that "this two-pronged approach is crucial," Anders reports. "He said focusing only on how to cut off the drug supply is futile." Gupta told her, "If we do not address the unmet treatment needs for people with addiction, we will continue to suffer the same fate."

The government's move to criminalize xylazine hasn't made everyone happy. "Harm-reduction advocates argue the government is heading down the wrong path ... saying that the approach will just lead manufacturers and dealers to come up with new, potentially more dangerous substances to cut into their supply," Anders writes. "In the coming months and years, the administration's plan to tackle the crisis from multiple sides will be tested. But regardless of its effectiveness, experts say there will always be a new emerging threat." Mary Sylla of the National Harm Reduction Coalition, told Anders, "It's literally like whack-a-mole, right? We try to stop this here, and then something else pops up."