DEA officials: Xylazine linked to increasing fentanyl overdoses nationwide. What to know

The U.S. Drug Enforcement Administration is warning Americans about a sharp rise in the trafficking of fentanyl mixed with xylazine, a powerful animal sedative tranquilizer.

The combination has been found in 48 states — including Ohio — and has been linked to an increasing number of overdose deaths nationwide, in part because the addition of the nonopiod xylazine makes Naloxone, a medication that can reverse an overdose from opiods, far less effective.

The Office of National Drug Control Policy designated fentanyl combined with xylazine as an emerging drug threat earlier this month.

"Fentanyl is the deadliest threat in the U.S., and it's even deadlier when mixed with xylazine," said DEA Detroit Special Agent-in-Charge Orville Greene.

Officials with the DEA Detroit Division, which oversees Michigan and Ohio, held a virtual press conference Tuesday afternoon to warn about the drug's growing danger and prevalence.

"We are in the midst of what many have called the third wave of the opioid epidemic," said Mark Totten, U.S. Attorney for the Western District of Michigan.

First, Totten said, it was the rise in use of prescription drugs, then heroin, and now, fentanyl, "a synthetic, cheap opioid in seemingly endless supply that is incredibly lethal."

Totten said the U.S. is seeing the highest number of drug poisonings ever recorded, and xylazine is adding to that misery.

What is xylazine?

Xylazine is a powerful non-opiate sedative, painkiller and muscle relaxant that has only been authorized by the U.S. Food and Drug Administration for veterinary use, according to the National Health Institute.

Also known as “tranq,” the drug has increasingly been identified as a cutting agent or adulterant used in the illicit drug supply, most often mixed with fentanyl.

Greene said xylazine is not considered a schedule controlled substance under the federal Controlled Substance Act, but Ohio classified xylazine as a Schedule III controlled substance in March.

Ohio is one of the first states in the nation to make xylazine a controlled substance drug, citing its low to moderate potential to create a psychological dependence.

Greene said xylazine is increasingly used as a cutting agent for fentanyl because it is cheap and, although designed for animal use only, does not require credentials as a veterinarian to buy online.

It has similar opioid-like effects in slowing down the respiratory system, which is another reason for its rise in popularity, Greene said.

How prevalent is xylazine in Ohio?

Overdose deaths involving xylazine have increased each year in Ohio since 2019, with 15 overdose deaths in 2019, 45 in 2020, and 75 in 2021, according to the Ohio Department of Health.

Mortality data for last year hasn't been completed yet, but the state Department of Health recorded 113 xylazine-involved overdose deaths as of March 14, 2022. Of 248 unintentional drug overdose deaths, nearly 100% involved fentanyl.

Nationally, the DEA Laboratory System reported that approximately 23% of fentanyl powders and 7% of fentanyl pills seized by the DEA in 2022 contained xylazine.

Greene didn't have exact numbers on precisely how much xylazine has been found in Ohio and Michigan over the last year, but anecdotally, agents have seen a sharp increase in the number of samples containing the drug and have found unused xylazine on a number of drug seizures.

Why is xylazine dangerous?

Xylazine and fentanyl drug mixtures place users at a higher risk of suffering a fatal drug poisoning, Greene said.

Part of the reason for that is because naloxone, also known as Narcan, cannot reverse the effects of xylazine during an overdose because it is not an opioid.

Still, experts always recommend administering naloxone if someone might be suffering a drug overdose. People who inject drug mixtures containing xylazine also can develop severe wounds, including necrosis, the rotting of human tissue, that may lead to amputation.

According to the Centers for Disease Control and Prevention, 107,735 Americans died between August 2021 and August 2022 from drug poisonings, with 66% of those deaths involving synthetic opioids like fentanyl.

What can individuals do to help?

Totten made it clear: "We are never going to prosecute our way out of the opioid epidemic."

While law enforcement agencies play a role in preventing the spread of opioids, Totten said combating this epidemic will require an "all-hands-on-deck approach." That includes harm reduction advocates, medical professionals, social service providers and others working together to educate people, he said.

Saturday marks the DEA'a 24th annual National Prescription Drug Take Back Day. People with unused prescription drugs can drop them off at a number of safe-collection sites statewide. In October, 290 sites in Ohio collected nearly 40,000 pounds of prescription drugs during the event.

The event will run from 10 a.m. to 2 p.m. You can find a collection site near you at www.dea.gov/takebackday.

Sheridan Hendrix is a higher education reporter for The Columbus Dispatch. Sign up for her Mobile Newsroom newsletter here and Extra Credit, her education newsletter, here.

shendrix@dispatch.com

@sheridan120

This article originally appeared on The Columbus Dispatch: Xylazine is linked to a number of Ohio overdoses. Here's what to know