The Biden administration has unveiled a new strategy to tackle the escalating number of overdose deaths linked to xylazine, a potent animal sedative increasingly combined with opioids and other drugs. As part of the plan released on Tuesday, the White House aims to curb the distribution of xylazine, which is easily obtainable, and reduce xylazine-related fatalities by 15% in at least three of the four US census regions by 2025.
The use of xylazine in combination with opioids has contributed to the alarming rise in overdose deaths, adding to the already devastating opioid crisis. According to data from the CDC, there has been a more than 30-fold increase in overdose deaths involving xylazine, with 3,468 deaths reported between 2018 and 2021. Nearly all of these cases involved fentanyl as well.
Rahul Gupta, the director of the White House's Office of National Drug Control Policy, warned that the combination of fentanyl and xylazine is even deadlier than fentanyl alone. One of the concerning aspects of xylazine is that it does not respond to medications like naloxone, which are used to reverse the effects of opioid overdose. Additionally, the animal sedative has been associated with severe flesh wounds that can lead to tissue necrosis, sometimes resulting in amputations. Despite being unapproved for use in humans, xylazine remains legal and readily available, even on websites that don't verify veterinary need for it, according to the Drug Enforcement Administration.
In April, the White House used executive designation authority for the first time, declaring the combination of xylazine and fentanyl as an emerging threat. This prompted the drug control office to develop a response plan within 90 days. The plan encompasses a comprehensive approach, including expanding data collection, standardizing testing procedures, and evaluating potential overdose-reversal agents. However, the safety and effectiveness of drugs like yohimbine and tolazoline in reversing xylazine's effects in humans remain unknown, as stated by the US Food and Drug Administration.
To address the issue at hand, test strips for xylazine have become available, allowing for better detection of the drug. Several states, such as New York and Delaware, have taken steps to expand testing using these strips. Moreover, efforts are being made to make it more difficult to acquire xylazine. The administration is exploring regulatory options to disrupt the illegal supply of the substance, while still maintaining a legitimate inventory for veterinary medicine and research purposes.
According to the DEA's report, it is likely that drug dealers are purchasing cheap xylazine and mixing it with opioids to maximize profits. While the wholesale prices of heroin or fentanyl can reach tens of thousands of dollars per kilogram in the US, xylazine can be easily obtained from Chinese suppliers for $20 or less.
The drug control office is required to publish an implementation report on the plan's objectives by February, signaling the commitment of the Biden administration to address the xylazine-related overdose crisis and mitigate its devastating consequences.