Xylazine, also known as “trunk,” is apparently causing havoc in the United States. Health officials detected the substance in black market fentanyl. new mexico, California, west virginiaand—well, almost every state.is associated with death from overdose in philadelphia and other places all over the country.Beyond the sea, new study Researchers at King’s College London have shown that xylazine is present in counterfeit marijuana e-cigarettes, knock-off codeine and Valium tablets.
Veterinarians use xylazine alone For sedation, muscle relaxation, and analgesia.that approved However, only in these cases are they expressly intended for use on animals only. When mixed with fentanyl and used by humans, it can be a dangerous combination.In fact, many mass media People started calling it the “zombie drug” because it has a sedative effect on users and can rot and cause large wounds if used frequently.
Here, we break down what’s going on, the main concerns experts have about its spread, and why they say this scary-sounding drug isn’t the main concern.
How does fentanyl get into drugs for animals?
Jean-Marie Perrone, director of the Center for Addiction Medicine and Policy at the University of Pennsylvania, said drug dealers have been mixing it with heroin since at least the early 2010s. than what we’re seeing now. ” It basically went under the radar for a while. And now it’s being added to opioids.
Why… would someone add that?
Simple logistics play a role here. Fentanyl can be administered by adding something to it. Typical doses of fentanyl are in the sub-milligram range, essentially the amount on the head of a pin. “If I sell it to you, you can’t see it or use it,” explains Lewis Nelson, a medical toxicologist and chair of the Department of Emergency Medicine at Rutgers New Jersey Medical School. By mixing these trace amounts with something, the user can maintain a small amount.
Usually it’s sugar and starch. Xylazine as a mixture has its own effects. It is often called an adulterant because it is intentionally added. Not only does it carry fentanyl, but it also adds potentially appealing psychoactive properties. Xylazine may potentiate the effects of opioids. “Fentanyl is basically meant to increase the overall euphoria or high that you experience with fentanyl,” said Kim Janda, a professor of chemistry and immunology at the Scripps Research Institute in California. To tell.
OK, but there are other things going on. What if Xylazine has adverse effects?
The main negative effects of xylazine go back to its original purpose of sedation. Xylazine causes sedation more quickly than fentanyl, Nelson said. That sedative state is commonly compared to being severely intoxicated, to the point where a person no longer feels comfortable or has no control over their body, explained Claire Zagorski, a graduate research assistant at the University of Texas. do. Co-author Paper on reducing the harm of xylazine.
And being sedated for very long can lead to health problems.
“For example, we see people developing pressure sores just from not moving for hours,” Zagorski says. “That’s causing damage and destruction to the skin.”
Users have reported small pimples as well as skin ulcers. In extreme cases, skin ulcers can cause tissue loss in the arms and legs. It’s not necessarily new, since people who use drugs intravenously can develop infections, but the way the scars look and progress is very different, Perrone says.
Researchers don’t know exactly what causes the scars, but Perrone suggests frequency of use may be involved. Too many injections can cause itchy scabs, and the itching can lead to further scarring. “People who use it frequently tend to be less prone to scratches,” she added.
another theory These scars are directly related to xylazine’s ability to constrict blood vessels, making it harder for blood to pass through tissues. Zagorski believes it is unlikely that the wounds were caused by action, as there are dark patches of dead tissue in places such as the users’ fingers and toes, and that poor blood flow is also involved. This suggests that there may be. But again, experts aren’t so sure.
Is it as deadly as fentanyl?
Probably not. There is less good data on the mortality rate of use in the illicit drug supply. One thing that confuses things is that xylazine rarely exists on its own.Seattle police did that. I recently found Although it was first sold as a standalone pill, it is most often used in combination with fentanyl or other opioids. And while there have been numerous reports of “xylazine-related” or “xylazine-involved” deaths, that doesn’t necessarily mean xylazine was the direct cause of death, Nelson said.
However, there is reason to believe that xylazine is not the direct cause. Professor Zagorsky points out that there have been cases of people working in the veterinary field overdosing on just xylazine. Even in such cases, it was usually not fatal. One very important difference between xylazine and fentanyl, she says, “is that they don’t block the urge to breathe like opioids do.”
If not fatal, what are the main concerns?
Many people who take fentanyl with xylazine are not housed. “It’s very saturated with opioid sources,” Zagorski says. “So we’re seeing a whole new set of problems related to people being sedated, especially if they don’t have a place to live and can’t go to a safe place to get sleepy. This is especially true when you can’t.
Needless to say, scars pose major problems during treatment. “Facilities refuse to accept patients because of the wound, so the barrier of waiting for a bed where someone can address the wound problem further increases the gap between treatments and allows the wound to progress.” says Perrone. Leaving a wound untreated can lead to infection and further problems in the future.
I heard Narcan doesn’t work in Tranq. That’s bad.
If you overdose on opioids, you will ingest so much that you stop breathing. Naloxone, also known by the brand name Narcan, essentially blocks the receptors that opioids act on, allowing you to breathe again. However, xylazine is not an opioid. “Naloxone specifically talks to just the opioid receptors,” Zagorski says. “So it’s like having the wrong key in the lock.”
However, since most products combine both xylazine and fentanyl, it is still worth administering Narcan to reverse the effects of the opioid. “We give them naloxone and they can breathe again,” Nelson said. However, if it contains xylazine, you simply won’t wake up.
If Narcan has already been administered, Zagorski recommends shaking the patient, calling their name, rubbing their chest, and trying to wake them up from sedation.
Is there a way to test for xylazine? And is there a treatment?
Yes, there are test strips that use exactly the same type of technology as pregnancy tests. The problem, Nelson says, is that given the prevalence of xylazine in the illicit drug supply, it may be difficult to find products that don’t contain it.
In terms of treatment, Janda is currently working on developing a vaccine that blocks xylazine’s sleep-inducing effects. Janda and his team recently paper They suggest that their vaccine has the potential to reverse xylazine-induced behavior in mice, and they hope to replicate their findings in humans. But an actual vaccine is years away.
Some patients have reported xylazine withdrawal syndrome, which researchers are still trying to understand. “We’re still characterizing it and considering how it might need to be treated differently than fentanyl,” Perrone said.
How concerned should I be about this?
If you are not a drug user, the risk is very low. It’s not something that would affect you if you were nearby. “If you touch it or lick your hand, that’s a problem,” Nelson said.
“But just being present in the space you’re in, exposed to your surroundings, isn’t the problem.”
Interestingly, Nelson says there is data suggesting that xylazine has protective factors. People hospitalized with fentanyl and xylazine are less likely to require CPR or cardiac arrest. And Nelson says it probably won’t increase addiction.
As with any new health crisis, experts stressed that the situation is still forming and further research is needed. But as it stands, they believe fentanyl is a bigger problem.
“We see headlines saying that xylazine is the most dangerous drug in the world,” Nelson says. “In fact, the 800-pound gorilla here is fentanyl. Xylazine is just bystander. ”
