Fentanyl pills. Credit: DEA
About five years ago, xylazine—a non-opioid sedative used in veterinary medicine—made its way to Philadelphia from Puerto Rico. Although not approved for human use, xylazine by itself is nowhere near as deadly as fentanyl or other strong opioids. However, when mixed with fentanyl as a low-cost cutting agent, the combination is particularly dangerous.
Due to its use as a veterinary tranquilizer, xylazine is easily accessible. Also known as “tranq,” the sedative causes depressed breathing, lower blood pressure and heart rate, unconsciousness and necrosis that may lead to amputation—hence its “zombie drug” nickname.
In 2021, researchers linked xylazine to 1 in 3 overdoses in the City of Brotherly Love, and expressed concerns about it spreading to other parts of the U.S. Now, it appears those concerns have become reality.
In a new public safety report, the Drug Enforcement Administration (DEA) says they have seized xylazine and fentanyl mixtures in 48 of 50 states. In fact, 23% of fentanyl powder and 7% of fentanyl pills seized by the DEA in 2022 contained xylazine.
On the heels of this report, a bipartisan group of Congressional lawmakers moved to restrict xylazine in an effort to crack down on the drug's spread.
The proposed “Combating Illicit Xylazine Act” would classify xylazine as a Schedule III drug, putting it on par with ketamine and anabolic steroids. The bill also seeks to declare xylazine as an emerging drug threat, which would automatically trigger the development of a federal plan to address the crisis. Lastly, the bill allows the DEA to track the drug's manufacturing to ensure it is not diverted to the illicit market.
“The proliferation of xylazine as an additive to illicit drugs, such as fentanyl and other narcotics, threatens to exacerbate the opioid public health emergency,” the proposed bill reads. “The spread of illicit xylazine use has followed geographic patterns seen in the spread of recreational fentanyl use, with proliferation beginning in the Northeastern United States and later spreading south and west. Prompt action to control illicit xylazine will help limit further proliferation of illicit xylazine, saving countless lives.”
According to the CDC, 107,735 Americans died between August 2021 and August 2022 from drug poisonings, with 66 percent of those deaths involving synthetic opioids like fentanyl. Since xylazine is not an opioid, naloxone does not reverse its effects.
“Xylazine is making the deadliest drug threat our country has ever faced—fentanyl—even deadlier,” said DEA Administrator Anne Milgram.
In February, the FDA took action to restrict the unlawful entry of xylazine active pharmaceutical ingredients (API) and finished dosage form drug products into the U.S. The move aims to prevent the drug from entering the market for illicit purposes, while still maintaining availability for its legitimate uses in animals. The veterinary use of xylazine is essential to sedate large animals—a legitimate pathway the Combating Illicit Xylazine Act intends to preserve.
“The American Veterinary Medical Association fully supports this congressional effort to combat illicit xylazine,” said Lori Teller, president of the veterinary advocacy group. “The proposed legislation will equip law enforcement with additional tools to stop xylazine trafficking. We urge Congress to pass the Combating Illicit Xylazine Act quickly as it strikes the right balance of protecting our communities while preserving veterinary access to this critically important animal drug.”