Dealing with an unabated wave of fentanyl use, federal law enforcement officials in Arkansas are targeting an emerging and potentially even more dangerous wave: the powerful large animal tranquilizers xylazine and fentanyl. Expressed concerns about mixed ones.
Xylazine is a non-opioid sedative or tranquilizer approved for veterinary use only, according to the U.S. Centers for Disease Control and Prevention. However, it is increasingly being used in illicit drugs such as fentanyl, heroin, and cocaine to increase the potency of the drug with which it is mixed, or as a cleaving agent to add weight to the drug and increase profits. or both.
Side effects in humans include sedation, dyspnea, dangerously low blood pressure, slow heart rate, and even an increased risk of death from overdose. Another side effect is skin ulcers, which get worse quickly and may require amputation if not treated.
Also, because xylazine is a non-narcotic sedative, naloxone, which is used to reverse opioid overdoses, is ineffective against tranquilizers.
Xylazine was first synthesized by Bayer Pharmaceuticals in 1962, and clinical trials investigating its use in humans were halted due to serious and life-threatening side effects, according to recommendations issued by the Drug Enforcement Administration in May. In March, the DEA reported that fentanyl with xylazine was seized in 48 states, and that about 23% of fentanyl powder and 7% of fentanyl tablets seized by the agency in 2022 contained xylazine.
According to the CDC, between August 2021 and August 2022, 107,735 Americans will die from drug overdoses, with 66%, or 71,000, associated with synthetic opioids such as fentanyl. there were. Mexico’s Sinaloa and Jalisco cartels, which use chemicals sourced primarily from China, are largely responsible for the bulk of the fentanyl trafficked in communities across the United States.
Fentanyl use in Arkansas is so prevalent that the U.S. Attorney’s Office for the Eastern District of Arkansas prioritizes prosecuting fentanyl crimes above prosecuting violent gun crimes and child sexual abuse.
Fentanyl, a synthetic opioid up to 50 times more potent than heroin and 100 times more potent than morphine, is the leading cause of both fatal and non-fatal overdoses in the United States, according to the CDC. The drug fentanyl is prescribed by doctors to treat severe pain, especially after surgery or in advanced cancer, but illegal fentanyl is marketed through the illicit drug market as having heroin-like effects, according to the agency. , because it is so potent that it is often added to other drugs, or counterfeit tablets are made to resemble pharmaceuticals. The CDC said it’s potency that makes fentanyl so dangerous.
And with the introduction of xylazine, fentanyl has become cheaper, more potent, more addictive and more dangerous, the CDC said. A total of 102 xylazine-related overdose deaths were reported in the United States in 2018, according to data from a CDC report released last month. By 2021, just three years later, that total had risen to 3,468. Although this number appears small compared to the total number of reported overdose deaths from fentanyl alone, this rapid increase is of concern to law enforcement agencies.
The dangers of xylazine and the surge in illegal use of the drug prompted the Biden administration to designate the drug as a new drug threat in April and to release a national response plan to address the threat in July. The response plan calls for, among other things, standardized forensic testing practices, rapid laboratory test development, and testing to detect xylazine in drug samples at all levels of the supply chain, from wholesale seizures to the regional retail level. Looking for development and expansion.
Dr. Michael Mancino, program director of the Center for Addiction Services and Treatment at UAMS, said at this time there are no documented cases of overdose associated with fentanyl with xylazine at UAMS, both of which are due to the drug. is not yet firmly established in the state. and the current lack of clinical laboratory capacity.
“Part of the problem is that there are no drug tests that detect xylazine as part of a typical panel of drug screening results,” he said. “In crime laboratories, people undergoing autopsies are identified, but even then, the number of people who end up in crime laboratories is limited because everyone who may have died in a crime because it is impossible to dissect it.” …but we do not test for xylazine as part of our drug testing panel. ”
However, fentanyl overdose is still at alarming levels.
“If there are 10 people who are hospitalized for treatment, probably eight of them are using fentanyl,” he said. “Fentanyl is almost everything people are using in Arkansas, and it’s been going on for five years, and it’s only going to get more prevalent.”
Mancino said he is not aware of any plans to establish xylazine testing at UAMS at this time. The main reason is that the nature of the drug itself is not approved for human use.
“Part of the problem is that there is nothing we can do to treat it. [testing] “In terms of directing treatment, it doesn’t really provide any useful information. There are no drugs that can reverse the effects…we don’t have drugs because they don’t act in terms of opioid receptors like fentanyl does.” Because there isn’t,” he said. That way, you might be able to prevent or even reverse its effects. ”
But Mancino said even people who have overdosed on fentanyl with xylazine should be given naloxone treatment to reverse the effects of fentanyl.
“If you reverse the effects of fentanyl, xylazine alone may not be enough to trigger an overdose,” he said.
Dr. Lynn Beach, a veterinarian practicing in the East End, said her concern about xylazine is that the drug’s legal status, which is currently not a controlled substance under federal law, may change. So far, the federal government has not moved to make xylazine a controlled substance, but five states have passed legislation to make it more or less a controlled substance, and four others are considering it. Arkansas is not one of those states.
He said such a designation could create headaches for veterinarians, including additional costs and safety measures that were not previously necessary. But he agreed that the drug is dangerous if used improperly, and said there is no proper use for humans.
“This is highly toxic to humans because it slows down and even stops the respiratory system and causes a slow heart rate,” he said. “For people who already have heart problems, it can cause fatal cardiac side effects. We couldn’t even say a safe dose for humans.”
Jarad Harper, an assistant special agent in charge of the Little Rock DEA office, said it was difficult to determine how long fentanyl with xylazine had been in Arkansas, largely because authorities That’s because the state wasn’t tested for animal tranquilizers until they found out, he said. its usage.
“We’re starting to understand more because the labs are noticing,” he said.
Harper said the emergence of xylazine as a cleaving agent for illicit fentanyl is driven by the same force that has driven the shift from black market pharmaceutical opioids to fentanyl-based counterfeit drugs: profit. Just as fentanyl is much cheaper than pharmaceutical oxycodone, but much more potent, xylazine is cheaper than illicit fentanyl and significantly increases its potency.
“Fentanyl is cheaper for dealers, and users like it more expensive,” he said. “Undoubtedly, everything from street dealers to Mexican cartels is all about money, and Xylazine fits that business model.”[Fentanylischeaperforthedealersanduserslikethehighbetter”hesaid”MakenomistakefromthestreetdealerstotheMexicancartelsit’sallaboutthemoneyandxylazinefitsthatbusinessmodel”
Generally, illicit fentanyl precursors are shipped from China to Mexico, where the drug is manufactured, and then to the United States, both in powder form and counterfeit tablets made to look like legal drugs, Harper said. said to be transported to A method of transportation with space to hide illegal cargo.
According to Harper, the most common counterfeit pills in Arkansas and throughout the South are 30-milligram counterfeit oxycodone pills (blue with an M stamped on one side and a score of 30 on the other side). pressed). Take orally or crush and inject or inhale.
“Just looking at the DEA cases here in Arkansas and with local partners, I’d say we’ve seized 450,000 of them over the last few years,” he said.
Assistant U.S. Attorney Chris Givens, who handles many federal fentanyl prosecutions in the Eastern District of Arkansas, said the appearance of fentanyl with xylazine appears to be on the rise, but it’s hard to pinpoint how widespread its use is. agreed. He said the drug’s use as an additive to fentanyl and heroin first appeared on the East Coast and “and enlisted across the country.” But understanding the true scope of the problem is an ever-changing goal, he said.
On-site drug test kits are designed to detect the presence of a wide range of drugs encountered by law enforcement, including methamphetamine, fentanyl, heroin, marijuana, and other substances, he said, but they also measure drug purity. Additives such as xylazine that cannot be used or identified as other substances. That would require more sophisticated laboratory analysis, which could take six months to a year to come out, he said.
“We just got a lab report that tested positive for xylazine,” Givens said. “Based on those reports, the first known case of xylazine in fentanyl appeared here in the summer or fall of 2022.”
Xylazine was identified in a total of 64 drugs seized between 2019 and 2022, with 2 in 2019, 5 in 2020, 10 in 2021 and 47 in 2022, according to the State Crime Institute. Item identified.
A key component of the state’s anti-drug campaign is supplied by the Arkansas State Police, which will sell nearly $12 million worth of £65.84 of fentanyl in 2022, according to Arkansas Police Communications Director Cindy Murphy. £56 of that total will be seized in September 2022. 1 person. Murphy said enforcement is complicated because the way fentanyl is transported continues to evolve. Fentanyl, in the form of powder and counterfeit pills, is mainly shipped from states bordering Mexico, he said, and is flowed in and out of the state by drug couriers known as “mules” and a wide variety of other smuggling methods. It is said that there is
“Fentanyl was found hidden in hidden compartments built into vehicles, as well as in spare tires, seats and inside car doors,” Murphy said in an email. They’re also getting into Arkansas by plane, hidden in luggage or hidden by passengers.” Fentanyl is often mailed or shipped using the US Postal Service, UPS, or FedEx. ”
