The United States experienced over 100,000 drug overdose deaths in the past 12 months, for the first time ever. Source – Amait053 (CC BY-SA 4.0)
According to a report from the Centers for Disease Control and Prevention (CDC) this autumn, xylazine, a veterinary sedative, was involved in fatal drug overdoses in 23 states in 2019, with the highest rate – 67 percent – happening in the Northeast.
The animal sedative used in veterinary medicine to sedate cows, horses, sheep, and other animals is being added to other drugs, mostly fentanyl and heroin, as a cutting agent, officials said, reports the Miami Herald.
But while illicit drug users think they are covered, in case of an overdose, think again. Unlike opioids, there’s no antidote like Narcan specific to a xylazine overdose, reports the Associated Press.
“If somebody’s overdosing on xylazine or on heroin cut with xylazine, that naloxone is not going to have much of an effect on the part of the overdose that’s driven by the xylazine,” said Dr. Scott Hadland of MassGeneral Hospital for Children in Boston.
Supportive measures can be used if a person is attended to early enough, such as resuscitation, getting them fluids, and other sorts of hospital care, Hadland said.
“But this is much more difficult to manage out in the community because it’s inevitably going to be an overdose that involves multiple substances including opioids,” he said.
Veterinarian examining a cow. Source – Bobjgalindo, CC SA 4.0.
What is Xylazine?
Xylazine is used for sedation, anesthesia, muscle relaxation, and analgesia in animals such as horses, cattle, and other non-human mammals. Veterinarians also use the drug as an emetic, especially in cats. For those of you who may not know what an emetic is – basically, it makes you throw up.
The US Food and Drug Administration has not approved Xylazine for use in humans for a very good reason, according to the CDC. In humans, it acts as a central nervous system depressant and can cause respiratory depression, slowed heart rate, and hypotension, increasing the risk for fatal overdose.
Several states have reported increases in xylazine-involved overdose deaths; However, the prevalence of xylazine involvement in drug overdose deaths has not been extensively studied, particularly in the United States
It is believed the drug gained popularity in the early 2000s, quite often being mixed with heroin to enhance the high. Xylazine is also frequently found in speedball. Xylazine users are more likely to be male, under the age of 30, living in a rural area, and injecting versus inhaling xylazine.
In 2019, fewer than 2 percent of State Unintentional Drug Overdose Reporting System (SUDORS) overdose deaths from 38 states and DC were xylazine-positive. Xylazine contributed to death in approximately one-half of deaths in which it was detected and was primarily co-involved with fentanyl.
While the percentage of deaths attributed to xylazine may seem low, the CDC notes that data reviews revealed instances where xylazine presence was noted at the scene of the overdose but not detected on postmortem toxicology. It is likely that the number of xylazine-involved deaths is much higher.
Routine postmortem toxicology panels might not have included tests for xylazine, and current testing protocols for xylazine are not standard, which could result in missed detection.