The illicit use of xylazine, a veterinary tranquilliser, is rapidly spreading across the United States, posing significant public health challenges. According to a report by Millennium Health, the presence of xylazine in urine drug tests (UDTs) has surged, particularly in the western regions. States like Washington, Oregon, and California saw a 147% increase in xylazine-positive tests from November 2023 to April 2024. Similar trends have been observed in the Mountain West and New England, with substantial increases in xylazine detections. The drug, often mixed with fentanyl, complicates overdose treatments as it doesn’t respond to naloxone and can cause severe necrotic lesions, leading to potential amputations.

Health authorities are grappling with the rising threat, particularly as the White House Office of National Drug Control Policy has designated xylazine combined with fentanyl as an emerging danger. Despite efforts by the FDA and the DEA to curb its trafficking, xylazine’s spread continues unabated. Millennium Health emphasises the need for clinicians nationwide to be vigilant and prepared to manage the unique challenges posed by xylazine, including its resistance to naloxone and the severe injuries it can cause. The evolving drug landscape underscores the necessity for adaptive harm reduction strategies to mitigate the impact of this dangerous substance.

Source: Medscape