By know many of us have heard about a new substance that is frequently seen among drug users. There are disturbing videos circulating the internet that shows this drug use from the famous Kensington avenue in Philadelphia. The popular belief is that this drug causes people to fall asleep while standing, which is partially true. (See attached news media clip as an example[1])
The other common name for this drug is “tranq” when used alone or “tranq dope” when mixed with other substances. In Puerto Rico (where some of the first documented illicit use was recorded) it was known as “Anesthesia de Caballo” or horse tranquilizer.
The active ingredient in this emergent drug is Xylazine, developed in 1962 by Bayer pharmaceuticals as a medication to treat high blood pressure. In medical terms it is classified as an alpha 2 agonist and falls into the same class of medication as, for example, clonidine, which is commonly prescribed for high blood pressure. interestingly, clonidine can also be used to help patients going through opioid withdrawal.
However, Xylazine was not approved for use by the FDA due to its side effects which includes sedation, muscle relaxation, and respiratory depression, as well as a profound decrease in blood pressure known as Hypotension.
In 1972 the medication was approved for veterinary use under the trade names of Rompun, Sedazine and Anased.[2] It is commonly used for procedures on large animals as it produces pain relief, sedation and muscle relaxation.
Xylazine is currently not listed as a controlled substance and can be obtained with a veterinarian’s prescription only. There are several states however that are working towards designating it as a controlled substance[3]
Since 2006, it has been detected intermittently in drug samples in the United States particularly in Philadelphia and Connecticut. However since 2021 it has been detected in more than 90% of drug samples.[4] Its use is spreading rapidly throughout the United States and in Canada. As of March 2023, Xylazine has been found in drug seizures from 48 states. Therefore all those treating patients with addiction needs to be on high alert for the presence of Xylazine.
Although Xylazine produces euphoria (a sense of well being) and can therefore be addictive in itself, it is used most commonly to prolong the effects of Fentanyl which produces a relatively short effect. Xylazine is also commonly mixed with other illicit substances including stimulants and sedatives. [5]
Xylazine use has an additional side effect that it causes skin sores with ulceration. Interestingly this does not occur only at the site of injection but anywhere on the body, and it occurs also with smoking or snorting of the substance.
Responding to Someone who has taken an overdose of an illicit substance we should be aware of this substance and know that commercially available Naloxone which is used to reverse the effects of Opioids (ie Fentanyl) will not work or have only a partial effect.
If encountering someone who has taken an overdose of any illicit substance it is good to remind ourselves of the necessary steps:[1]
• Call for Help - 911
• Administer Naloxone[2]
• Try to keep the person awake
• Turn them on their side if they appear to be vomiting
• If sleepy and not breathing perform a chin lift or open their airway, if not breathing at all perform rescue breathing and chest compression. (If you have first aid training)
• Stay with the person until paramedics arrive.
Although the use of Xylazine is becoming more widespread, at iRecover we are aware of its harms. There is hope for anyone using these substances and it is our firm resolution to provide effective high quality help and support for those afflicted by these substances. Recovery is possible!
[1] https://www.youtube.com/watch?v=3EGmgQUIgx8 [2] Drug Enforcement Administration. Xylazine. Feb. 2021, https://www.deadiversion.usdoj.gov/drug_chem_info/Xylazine.pdf. [3] “Slaying the Monster: Senate Passes Murphy’s Bill Designating Xylazine as a Controlled ” NY State Senate, 24 Apr. 2017 https://www.nysenate.gov/newsroom/press-releases/terrence-murphy/slaying-monster-senate-passes-murphys-bill-designating [4] Rahul Gupta., David R. Holtgrave, and Michael A. Ashburn. Xylazine — Medical and Public Health Imperatives. New England Journal of Medicine Apr 2023 [5] Government of Canada. (2023). Health Canada Drug Analysis Service. Spotlight: The Emergence of Xylazine in Canada. Longueuil (QC), 2023. Retrieved from https://www.canada.ca/en/health-canada/services/publications/healthy-living/emergence-xylazine-canada.html.
[1] https://www.cdc.gov/stopoverdose/naloxone/index.html [2] https://dss.sd.gov/formsandpubs/docs/BH/BHAO01_Naloxone_Brochure.pdf
By Dr. Hilgard Goosen - CEO , iRecover US
iRecover US is considered by many to be the top alcohol rehab and drug rehab in South Dakota. iRecover US employs evidence based treatment programs to provide the best alcohol addiction treatment and drug addiction treatment to all residents of South Dakota and the Mid-West. We accept insurance and self-pay options are available.
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