{"id":23420,"date":"2023-03-21T20:50:55","date_gmt":"2023-03-21T20:50:55","guid":{"rendered":"https:\/\/todaysveterinarybusiness.com\/?p=23420"},"modified":"2023-03-21T20:50:55","modified_gmt":"2023-03-21T20:50:55","slug":"dea-xylazine-032123","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarybusiness.com\/dea-xylazine-032123\/","title":{"rendered":"DEA: No More Horsing Around With Xylazine"},"content":{"rendered":"

The U.S. Drug Enforcement Administration has issued a public safety alert warning of \u201ca sharp increase\u201d in the trafficking of fentanyl mixed with the equine sedative xylazine.<\/p>\n

\u201cXylazine is making the deadliest drug threat our country has ever faced, fentanyl, even deadlier,\u201d agency administrator Ann Milgram said in a statement released March 20. \u201cDEA has seized xylazine and fentanyl mixtures in 48 of 50 states. The DEA Laboratory System is reporting that, in 2022, approximately 23% of fentanyl powder and 7% of fentanyl pills seized by the DEA contained xylazine.\u201d<\/p>\n

Highlighting the human toll, the U.S. Centers for Disease Prevention and Control found that during the 12 months ending in August 2022, more than 70,000 Americans died from drug poisonings involving synthetic opioids such as fentanyl.<\/p>\n

The Role of Xylazine<\/strong><\/h3>\n

Xylazine is a non-scheduled drug used in equine medicine, cattle and other animals to produce sedation. Veterinarians also use it as an analgesic and preanesthetic.<\/p>\n

In veterinary medicine, xylazine is known by the brand names Rompun, Sedazine and AnaSed. On the street, it goes by \u201ctranq,\u201d \u201ctranq dope,\u201d \u201csleep cut\u201d and \u201czombie drug.\u201d<\/p>\n

The drug has no approved antidote for human use and is resistant to typical reversal agents such as naloxone, significantly raising the odds of an overdose death.<\/p>\n

What makes a horse sedative attractive as a cutting agent for illicit opioids? As a long-acting sedative, xylazine can lengthen an opioid\u2019s euphoric effects. As an unscheduled substance, the drug is easier to obtain than other adulterants and is less likely to lead to law enforcement scrutiny.<\/p>\n

The public health risk is high, as xylazine-induced blackouts can leave fentanyl users unconscious for hours, with dangerously low blood pressure and heart rates. In addition, xylazine can cause severe wounds, known as eschars, that affect the skin, muscles and nerves. Unlike scabs, eschars are flush within the skin surface, highly persistent and easily infected. Eschar patches can form anywhere on the body and, when left untreated, can lead to necrosis, amputation and other life-threatening conditions.<\/p>\n

Getting to the Source<\/strong><\/h3>\n

According to the DEA, most fentanyl<\/a> trafficked in U.S. communities comes from Mexican drug cartels that use chemicals primarily sourced from China. Where the xylazine comes from is up for debate. Some blame diversion from the veterinary supply chain, while others point to illicit underground manufacturing. The reality is likely both.<\/p>\n

The sedative has been diverted from veterinary practices and supply chains for years. For example, a 2010 break-in at a Michigan veterinary clinic led state police to stolen vials of ketamine mixed with xylazine. In 2020, three horse sedatives \u2014 ketamine, Dormosedan and Rompun \u2014 were stolen during a clinic break-in in Alberta, Canada.<\/p>\n

In an article published by MedPage Today, Dr. Joseph D\u2019Orazio of Temple University Hospital in Philadelphia said, \u201cWhat is clear is that the xylazine on the streets is not illicit. It\u2019s pharmaceutical-grade, and it\u2019s being diverted. \u2026 They\u2019re finding empty bottles of pharmaceutical-grade xylazine \u2026 where dealers are bagging [drugs].\u201d<\/p>\n

Philadelphia is among the hardest-hit U.S. cities. According to the Philadelphia Department of Public Health, xylazine is the most common adulterant in the city\u2019s illicit drug supply chain. In addition, the DEA and U.S. Department of Justice reported finding the drug in more than 90% of the heroin and fentanyl samples collected in Philadelphia in 2021.<\/p>\n

The Regulatory Environment<\/strong><\/h3>\n

This past February, the U.S. Food and Drug Administration moved to restrict the unlawful import of xylazine pharmaceutical ingredients. The FDA also will review xylazine shipments to ensure they go to state-licensed pharmacies, agency-approved manufacturing facilities and veterinarians.<\/p>\n

Meanwhile, some states are enacting controls. In New York, for example, xylazine was labeled a Schedule III controlled substance depressant in 2017. In addition, a bill introduced in Illinois this year would make the drug a Schedule I controlled substance.<\/p>\n

Nationwide, xylazine is subject to state regulations and the federal Food, Drug and Cosmetic Act. However, because xylazine is not scheduled under the Controlled Substance Act, the DEA is not authorized to control it.<\/p>\n

Further federal action is possible. One example involves ecstasy, or MDMA, which became a federally scheduled controlled substance in 1985. Doing the same with xylazine would raise questions such as these:<\/p>\n