Jessie never injected herself with xylazine. She only smoked drugs mixed with fentanyl in a combination commonly known in the drug industry as “trunks.” In addition, it is also called a “zombie drug” because it falls into a blackout state when awakened and causes grotesque scars when the user uses it repeatedly. So even though she didn’t inject the medicine, her leg was in pain.
“My whole body was swollen, but my legs were the worst,” Jesse said. “It was very itchy.” Scratching “skin flakes off with scabs” and feet “seemed necrotic.”
Xylazine is a common animal tranquilizer commonly used in horses and other large livestock. However, in recent years it has been used to cut other drugs such as fentanyl and heroin. This creates new hurdles that further complicate the fight against the opioid crisis, revealing apparent gaps in US drug policy, with deadly consequences for some.
“Incredibly miserable. People are afraid of losing their hands and arms.”
— Brendan Hart, Temple University Hospital
In April, the U.S. Office of National Drug Control Policy (ONDCP) listed fentanyl mixed with xylazine as a “new threatIt’s exacerbating an already devastating opioid crisis. In addition to increasing the risk of overdose, repeated use of xylazine can lead to abnormally large and persistent skin lesions and abscesses, and in some cases, limb amputation.
Unlike normal wounds that can be treated with antibiotics, flat wounds “may cover half of an arm or leg and remain open for up to six months at a time,” said the emergency room at Temple University Hospital in Kensington. said Dr Brendan Hart. Philadelphia – widely considered the epicenter of the xylazine crisis. On some days, Hart estimates he sees a dozen patients with trunk-related injuries each shift.
“It’s incredibly sad,” Hart told the Daily Beast. “People are afraid of losing their hands or arms.”
But the nature of addiction makes quitting nearly impossible.
Xylazine has been used for decades by veterinarians to put animals to sleep. However, it is not approved for human use. When it was first synthesized in the 1970s, it was found to slow heart rate and breathing to dangerous levels, so the FDA quickly stopped human trials. Exposing humans to xylazine causes scarring, which remains a mystery, and animals such as horses that receive xylazine do not appear to.
Xylazine is not currently approved for human use and is not currently tracked or monitored in any way by the government. This leaves officials relatively clueless about where the epidemic came from and how to stop it.
Congress is now Considering invoice That would add xylazine to the Controlled Substances Act. This would adjust drug schedules, criminalize possession in certain cases, and allow governments to better track their supply.
However, the bill has faced resistance from veterinarians and others who rely on xylazine to treat animals. They argue that tighter regulations will make it harder to obtain for legitimate purposes.
Experts believe that xylazine is heavily diverted from veterinary drug sources to distributors and users through clinic robberies or, more commonly, employees surreptitiously obtaining xylazine and selling it on the black market. I believe it is. In 2022, the DEA reported finding a vial of xylazine labeled for veterinary medicine. hidden house During multiple raids. However, there are no definitive figures as federal agencies do not track supply.
Veterinary medicine uses the same scheduling system as all other pharmaceuticals. Lauren Forsythe, assistant professor of pharmacy at the University of Illinois Veterinary Teaching Hospital, told The Daily Beast that at the federal level, controlled animal drugs should be “stored in a safe place” in a manner that “limits who has access.” Told. You should also keep records and report any discrepancies to the DEA.
How strictly these regulations are enforced varies by state. “Some states are very strict about the exact requirements, others are not,” Forsyth said.
Since xylazine is not planned, “there are no requirements as to how it should be secured,” she explained. “There is no recordkeeping obligation. This is good financial practice, but it’s not a legal requirement. You can keep it on hand as long as you need it.”
So, at this time, we don’t know how much xylazine is being diverted from the veterinary drug supply, but we do know that diversion is likely a big culprit. After all, this is a serious problem in human medicine in general, the study It is estimated that as many as 10 percent of human hospital workers have stolen drugs for personal use or sale.
Forsythe speculates that drug diversion is “at least as much” or even more problematic than human medicine.
But veterinary diversion is only part of the equation. Drug policy experts also point to the influx of drugs from abroad as a reason for the increase in the xylazine problem. Beau Kilmer, co-director of the RAND Center for Drug Policy Studies, told The Daily Beast that it’s possible to buy xylazine online from websites that “do not necessarily confirm that they are veterinarians.” .
It is also possible that most of the xylazine is contaminated with fentanyl from sources in countries such as Mexico and China, where fentanyl is mostly produced. Sheila Vakaria, deputy director of research and academic activities at the Drug Policy Alliance, believes the current wave of xylazine is mainly coming from factories in China and other parts of Central Asia, telling the Daily Beast. told to
How governments deal with the xylazine crisis “hugely depends on where the mixing is happening,” Kilmer said, adding that this was the main scheduling argument. That way the government can know where and how mixing is happening.
“It’s a tragic situation where we keep repeating the same mistakes we’ve made over the last few decades and expecting different outcomes. We turned it into a Whack-A-Mole game.”
— Sheila Vakharia, Drug Policy Alliance
However, representatives of the agricultural and veterinary industry said the tracking requirements associated with xylazine dosing schedules would be more onerous, making it “impossible to afford to buy xylazine and have them use it to treat their animals.” ,” Vakaria said. However, the current iteration would have exempted veterinarians from reporting obligations in the xylazine bill before Congress.
While the current bill does not “formally” schedule xylazine, it does link non-veterinary possession to penalties typically associated with Schedule III drugs such as ketamine and anabolic steroids. But Vaharia thinks the focus on penalties is a mistake.
“The problem with our laws is that they are written so that only certain molecular compounds are criminalized,” she says. This will motivate suppliers to develop new drug compounds and look for other loopholes to stay ahead of the law. “It’s a tragic situation of repeating the same mistakes we’ve made over the decades and expecting different results.
“We turned it into a game of Whack-A-Mole,” added Vakaria.
Instead, Vakaria and Hart argue drug policy should focus on better treatments and harm reduction programs. This can have the greatest impact in terms of saving lives and preventing injuries related to drug use. Additional research is needed to better understand xylazine’s necrotic effects on the human body and how to treat it, Hart said.
But now, in classic fashion, Congress is just lagging behind when it comes to regulating the drug. Scheduling xylazine is a potentially life-saving step forward, but it’s still not enough to fully address the full-blown crisis that continues to harm and kill drug users every day across the country. critics say.
Fortunately for Jessie, those days are over. She was exonerated when she found out she was pregnant in 2022. “She couldn’t have a baby,” she said. Her daughter was born healthy and has been sober for over a year at the time of reporting.
But ask any former drug user like Jesse and they’ll all say the same thing. They have past wounds that will never heal. “I still have scars,” she said. “I still hide my legs.”
