What is Xyalazine - zombie drug causing havoc in the United States?

The illicit drug known as "tranq," "tranq dope," or "zombie drug," medically referred to as Xylazine, is causing deadly effects in several major cities across the United States. Initially used to cut heroin, the compound has more recently been found in fentanyl and other illegal drugs. Repeated exposure to Xylazine can lead to symptoms resembling sedation, such as excessive tiredness and respiratory depression, as well as physical damage to the skin. 

Legislation in the United States has been introduced by a group of senators and representatives from both political parties to categorise a veterinary sedative, which is contributing to the fentanyl crisis, as a controlled substance. The aim is to assist law enforcement agencies in curbing its unlawful usage, reported Wall Street Journal in an exclusive. 

The dangers of xylazine use are manifold and serious. Unlike naloxone, a drug that reverses opioid overdoses including fentanyl, xylazine cannot be countered by the former. Moreover, xylazine itself can cause grave injuries that, while treatable with proper medical attention, can lead to amputations.

What is Xylazine, also known as ‘trang’?

Xylazine, also known as "tranq," is a drug that is often added intentionally to illicit drugs as an adulterant, which is a substance added to enhance the effects of the drug. Illicit drug manufacturers may use xylazine to extend the duration of opioid highs or to prevent withdrawal symptoms.

Xylazine, initially used as a veterinary anesthetic, has been identified as an adulterant in heroin supplies since the early 2000s. Despite not being an opioid, xylazine can induce opioid-like effects such as sedation, slow heart rate, and constricted pupils, similar to its pharmaceutical relative clonidine. Its use is also linked to severe skin and soft tissue ulcers and infections, according to an essay in The Conversation, an online publication with the latest research.

How are overdose cases occurring?

Mixing opioids with sedating drugs like xylazine can increase the risk of a fatal overdose. However, people who use drugs may not realise that xylazine is present in the drug supply, making it difficult to identify exposure. Hospital drug tests also do not typically detect xylazine, adding to the challenges of surveillance.

Xylazine overdoses rarely occur alone. In Philadelphia, xylazine was found in less than 2% of heroin and fentanyl-related deaths before 2015, increasing to over 31% in 2019. A study of 210 xylazine-related deaths in Chicago from 2017 to 2021 found that fentanyl or a chemically similar substance was detected in 99.1% of overdose cases. These findings highlight the significant role that fentanyl plays in fatal overdoses when xylazine is present, with evidence suggesting that the issue is becoming more prevalent.

Many drug samples from 2021 in Philadelphia contained Xylazine, and it is often mixed with other illegal drugs to prolong the opioid high. However, the combination of drugs raises the risk of an overdose. This has led to concern about the emergence of "tranq" trends, particularly after the New York City Department of Health reported 2,668 overdose deaths in the city in 2021. Xylazine has been found in 36 states, and a report from 2022 indicated that it was discovered in 25% of samples tested in New York City.

Scientists warn that Xylazine may exacerbate the current drug epidemic, as it eliminates any sense of pleasure associated with being high. Additionally, users may not be aware that they are consuming the drug since it can be concealed in other medications. Recently, the San Francisco Department of Health reported that four overdose victims had low levels of Xylazine in their systems, indicating that the drug may be present in medicines that users are unaware of.

US issues warning 

On March 21, 2023, the Drug Enforcement Administration (DEA) released a warning regarding a surge in the trafficking of fentanyl-laced with xylazine. The addition of xylazine to fentanyl, an already lethal drug, increases the likelihood of overdosing. Illicit opioids, such as fentanyl and heroin, in the US are increasingly contaminated with xylazine. The DEA reported confiscating mixtures of xylazine and fentanyl in 48 states out of the 50.

On Tuesday, US lawmakers introduced Senate and House bills that would reclassify xylazine as a Schedule III drug, a category that includes substances like ketamine and anabolic steroids with moderate-to-low potential for dependence. This would make it easier for law enforcement to crack down on xylazine trafficking.

According to Senator Catherine Cortez Masto, who is leading the Senate bill with Senator Chuck Grassley and others, the legislation is necessary because law enforcement currently lacks the means to tackle this dangerous drug. Representatives Jimmy Panetta, Ken Buck, and August Pfluger are among those backing the House bill.

The American Veterinary Medical Association has expressed support for the Senate and House bills and stressed the importance of xylazine for treating livestock, wildlife, and zoo animals. The legislation seeks to anticipate potential variations of xylazine that illicit manufacturers might create to circumvent regulations. It also aims to determine the origin of xylazine that is mixed into fentanyl.

The DEA has stated that Chinese suppliers sell xylazine inexpensively, which may make it more attractive to local-level dealers who mix it with fentanyl. Sometimes dealers purchase legitimate chemicals and use them illegally. The legislation would require the attorney general to provide a report within a year on the extent to which illegally used xylazine originates from legitimate manufacturers, among other questions about the drug's origins.

An official from the Chinese Embassy in Washington, D.C., has noted that xylazine has legitimate uses and that it is the responsibility of importing countries to ensure that it is used appropriately.