The health authorities of the United States remain alert for a new substance that adds to the fentanyl crisis: the xylazine, a Chinese anesthetic used by veterinarians. It is a non-opioid central nervous system depressant and not approved for human consumption.
Xylazine is used to sedate horses and other animals for surgical purposes and its effects on humans are easy to detect. Users experience a lethargic state trance-like and often pass out. Its consumption can slow breathing and heart rate of people to dangerous levels and causes bedsores that become infected and can cause amputation of the extremities.
Doctors remain perplexed as to how xylazine causes injuries so extreme that initially look like chemical burns. They may not even appear at the injection sites, but often on the shins and forearms.
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Yet still it is not clear if it is causing more deaths, as suggested by officials in Washington. “We don’t know if xylazine increases the risk of overdose or reduces the risk of overdose,” said Dr. Lewis Nelson from Rutgers New Jersey School of Medicine, who advises federal regulators on drug safety.
“All we know is that there are a lot of people taking xylazine and a lot of them are dying, but that doesn’t mean that xylazine is doing it,” Nelson said. While there is extensive research on opioids, there is almost none on xylazine in humans.
Fentanyl and xylazine, both synthetic, are often taken together, according to the United States Drug Enforcement Agency (DEA). The substance, known as “tranq”, “tranq dope” and “zombie drugs”, usually cut with heroin and fentanyl, and each type of drug binds to different brain receptors. Some epidemiologists theorize that bottles of xylazine purchased online with veterinary prescriptions became popular during the pandemic as an easy and inexpensive replacement for opioids.
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According to the scientific magazine Journal of Forensic and Legal Medicinethe effects of xylazine together with heroin, fentanyl and cocaine are lethal. This is because drugs used to combat an opioid overdose are useless to wake up the person who consumed xylazine, who remains with low heart and respiratory rates.
Also, when opioid withdrawal is contained, the strong xylazine withdrawal. Addicted people continue to use xylazine for fear of the terrible withdrawal: migraines, double vision, nausea, numb fingers and toes, sweating, and quivering anxiety.
The problem is serious in the United States. A study published in June detected xylazine in the drug supply in 36 states. In the New York City, xylazine has been found in 25 percent of drug samplesalthough health officials say that the actual saturation is higher.
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Already overwhelmed by fentanyl, public health officials, clinics, and social welfare organizations are in the early stages of figuring out how to resist its advance. For now, the goal is damage reduction, educating those who might be exposed, urging them not to use alone.
Unfortunately, a great difficulty for addicted people in seeking help is the shame that they feel for their wounds, often infected. Added to this is inequality in access to healthcare in the United States, a right that is not guaranteed, as it is privately managed.
The history of xylazine
Xylazine was developed in 1962 as an anesthetic for veterinary procedures. Human trials were canceled because the drug caused respiratory depression and low blood pressure.
Its use as an addictive substitute for heroin probably began in the 2000s. In 2011, a study found that people in the agricultural areas of Puerto Rico they injected themselves with horse anesthesia and developed severe skin ulcers.
In Kensingtona Philadelphia neighborhood that has a significant Puerto Rican population, the drug was found in 2006. But it wasn’t until around 2018 that tranquilizer use began to escalate there and then throughout the Northeast.
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According to the most recent data, more than 90 percent of drug samples tested at Philadelphia labs tested positive for xylazine. With the end of the pandemic, the consumption of this substance in this Pennsylvania city grew exponentially, along with the already serious problem of fentanyl.
In February, the US health authorities launched an “import alert” to better control the supply of xylazine and ensure that it is destined for veterinary use. Between 2020 and 2021, the detection of xylazine by the United States Drug Enforcement Administration increased almost 200% in the south of the country and more than 100% in the west.
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In April, the United States designated xylazine for the first time as a “emerging threat”in order to be able, among other things, to release funds requested by the president for the 2024 budget to fight against the havoc that it is causing in the country.
Therefore, the government was obliged in this period to present an action plan to Congress, which addresses several areas: more tests to detect the drug and analysis to better understand where it comes from, in order to fight its growing presence in the illegal market.
ML / ED