Bags of heroin, some laced with fentanyl, are displayed before a press conference on the office of the Recent York Attorney General regarding a serious drug bust, Sept. 23, 2016.
Drew Angerer | Getty Images
The Biden administration unveiled a plan Tuesday to eliminate the growing threat of fentanyl laced with xylazine, an illegal street drug cocktail that’s fueling a wave of overdose deaths.
Fentanyl is an especially potent synthetic opioid with its own soaring death toll. Xylazine, also referred to as “tranq,” is an affordable animal sedative not meant for human consumption.
The plan is the administration’s first concrete motion to deal with the harmful combination since declaring it an “emerging threat” in April.
It also builds on President Joe Biden’s national drug control strategy — which goals to tackle the country’s addiction and overdose epidemic — and his administration’s other efforts to crack down on illegal fentanyl.
“At the same time as we work to avoid wasting lives from illicit fentanyl, this administration is hyper-vigilant in reacting to changes within the drug supply, like xylazine,” Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy, said during a call with reporters Monday.
The plan directs several federal agencies, including the Centers for Disease Control and Prevention in addition to the Food and Drug Administration, to expand access to testing, prevention and overdose recovery resources. It also goals to disrupt the illegal xylazine supply chain, amongst other efforts.
Those agencies must develop and submit an implementation report back to the White House in 60 days.
The plan’s long-term goal is a 15% reduction in xylazine-positive drug overdoses in no less than three of 4 U.S. Census regions by 2025.
Xylazine was detected in nearly 11% of fentanyl overdose deaths through June 2022, in keeping with a report from the CDC released last week, up dramatically from about 3% of cases in January 2019.
“The proportion of xylazine-involved deaths is repeatedly growing and is a fantastic concern. Every one in every of these numbers is tragic,” White House domestic policy advisor Neera Tanden said during a call with reporters. “They represent individuals, families and communities torn apart.”
The U.S. has been grappling with an opioid epidemic for years, and xylazine only adds to it.
Drug dealers often mix the tranquilizer with fentanyl to increase the duration of the opioid’s effects, which may include rest and euphoria. But dealers may use xylazine as an affordable bulking agent to spice up their supply of fentanyl.
Xylazine can do major damage to the human body, including leaving drug users with severe skin ulcers, soft-tissue wounds and necrosis — sometimes described as rotting skin — that may result in amputation.
Treatment, testing and provide reduction
Fentanyl laced with xylazine poses several health threats, including severe hypoventilation, the event of significant wounds and extreme withdrawal symptoms.
To deal with those health challenges, the administration’s plan will develop and deploy a treatment framework for patients exposed to xylazine. That involves identifying essentially the most effective practices for withdrawal management and clinical stabilization, or returning a patient to constant and regular function.
The plan will even evaluate and deploy overdose reversal strategies that health-care providers, first responders, harm reduction staff, drug users and community bystanders can use.
Those strategies will concentrate on using assisted respiration, hands-only CPR and naloxone, the first medicine approved within the U.S. to reverse opioid overdoses.
Naloxone, marketed as Narcan, is effective against fentanyl but can have an insufficient response against xylazine for the reason that tranquilizer shouldn’t be an opioid.
Even then, Gupta said, “I need to emphasize that these medications should still be used regardless.”
The plan also goals to ramp up testing for xylazine in other drugs.
That involves developing and authorizing rapid test strips for clinical settings and deploying tests “in any respect levels of the availability chain, from wholesale seizure quantities to retail levels inside communities,” in keeping with the plan.
It also includes standardizing testing practices across health workers, coroners, public health laboratories and drug evaluation laboratories.
“Testing is currently ongoing in community and law enforcement settings, but not enough,” Gupta said on the decision. “We’d like more testing.” Gupta said xylazine may be purchased from online vendors in China and Puerto Rico. “To a lesser extent,” some drug traffickers are mixing xylazine with fentanyl in Mexico, in keeping with Gupta.
One other major component of the plan will discover the particular sources of xylazine and determine whether the tranquilizer was diverted from legitimate supplies or synthesized for illegal use. The plan will even enhance the Biden administration’s ability to control the xylazine supply chain while maintaining the tranquilizer’s availability for legitimate uses in animals in research.
The administration will even explore potential regulatory options for disrupting the production, distribution and sale of illegal xylazine, in keeping with the plan.
That might potentially include scheduling xylazine under the Controlled Substances Act, which might designate a rating for the tranquilizer in keeping with its abuse risk.
The administration will even consider potential avenues for prosecuting those that manufacture, import, export, sell or distribute xylazine to support fentanyl trafficking.
The last two components of the plan are scaling up research efforts on xylazine-laced fentanyl and developing an epidemiological data system to trace the spread and effects of the drug combination.
The “excellent news,” is many actions outlined within the plan are “already underway,” Gupta said.
For instance, the Drug Enforcement Administration in March warned the American public of a pointy increase within the trafficking of fentanyl mixed with xylazine. A month earlier, the FDA restricted the illegal entry of xylazine within the U.S.