Last week, the Combating Illicit Xylazine Act was proposed to the U.S. Congress “to crack down on and schedule the highly dangerous sedative causing fatal overdoses nationwide." The bill noted that:

"Xylazine, also known as “tranq,” is an easily accessible veterinary tranquilizer that is being used as a low-cost [drug] cutting agent ...
“Xylazine causes depressed breathing and heart rate, unconsciousness, necrosis, and even death, and naloxone [NARCAN] does not reverse its effects because it is not an opioid."

The U.S. Drug Enforcement Administration (March 20, 2023) said:

“[There is] a sharp increase in the trafficking of fentanyl mixed with xylazine. Xylazine, also known as “Tranq,” is a powerful sedative that the U.S. Food and Drug Administration has approved for veterinary use."
DEA Administrator Anne Milgram said “Xylazine is making the deadliest drug threat our country has ever faced, fentanyl, even deadlier … in 2022, approximately 23% of fentanyl powder and 7% of fentanyl pills seized by the DEA contained xylazine.”

The U.S. Food and Drug Administration (Nov. 8, 2022) said:

"Health care professionals should be cautious of possible xylazine inclusion in fentanyl, heroin, and other illicit drug overdoses, as naloxone may not be able to reverse its effects.
"Xylazine is FDA-approved for use in animals as a sedative and pain reliever. Xylazine is not safe for use in humans and may result in serious and life-threatening side effects that appear to be similar to those commonly associated with opioid use, making it difficult to distinguish opioid overdoses from xylazine exposure."

The U.S. Centers for Disease Control said:

“Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine. It is a major contributor to fatal and nonfatal overdoses in the U.S.
“It is often added to other drugs because of its extreme potency, which makes drugs cheaper, more powerful, more addictive, and more dangerous.
“Powdered fentanyl looks just like many other drugs. It is commonly mixed with drugs like heroin, cocaine, and methamphetamine and made into pills that are made to resemble other prescription opioids.
"Fentanyl-laced drugs are extremely dangerous, and many people may be unaware that their drugs are laced with fentanyl."

The chart below presentsU.S. overdose deaths by drug type from 1999 to 2021. In 2021, there were106,000 overdose deathsand synthetic opioids (primarily fentanyl)contributed67% of the total.

Chart 1: U.S. Drug Overdose Deaths (1999-2021)

Source: U.S. Centers for Disease Control

OUR TAKE

Fentanyl, Xylazine and other drugs can provide medical value but their use is also resulting in devastating addiction and overdose trends. NOTES: 1) overdose death rates are likely undercounted and 2) addiction rates, which are likely higher, represent a significant societal problem.

Controlling the drug problem is complicated - and it will 1) stress government resources, 2) lead to hard economic choices and 3) require some “tough love” recovery approaches.

There are linkages to other social challenges - such as public safety, homelessness, housing; as a result, addressing the drug crisis can help drive improvements in these areas as well.

On Fentanyl, Xylazine and Illegal Drug Trends