The essay below 
The Conversation, an online publication covering the latest research.
The U.S. Drug Enforcement Administration issued a warning on March 21, 2023 about the increased trafficking of fentanyl laced with xylazine. Xylazine is increasingly appearing in the U.S. supply of illicit opioids such as fentanyl and heroin.The FDA said it had seized mixtures of xylazine and fentanyl in 48 of the 50 states.
Xylazine, commonly referred to as tranq, is a drug contaminant that is intentionally added to pharmaceuticals to enhance their efficacy. Illegal drug companies sometimes include xylazine to prolong opioid highs or prevent withdrawal symptoms.
As a doctor who cares for people who use fentanyl, I am concerned about how xylazine increases the risk of overdoses. If you suspect an overdose, calling emergency medical services and administering naloxone is an important first step in saving lives.
Trunk Overdose and Fentanyl
Xylazine was originally developed as a veterinary anesthetic. It was first identified in the early 2000s as an adulterant in heroin supplies. Xylazine is not an opioid, but it induces opioid-like effects such as sedation, decreased heart rate, and constricted pupils. Xylazine use has also been associated with serious skin and soft tissue ulcers and infections.
Using opioids with sedatives like xylazine increases the risk of a fatal overdose. Historically, people who use drugs were unaware that xylazine was in their drug supply and were unable to determine if they had been exposed to it. This makes monitoring even more complicated.
Xylazine overdose rarely occurs alone. Xylazine detections in heroin- and fentanyl-related deaths in Philadelphia have increased from less than 2% before 2015 to more than 31% in 2019. A chemically similar substance was detected in 99.1% of overdoses. The data underscore the critical role fentanyl plays in causing fatal overdoses when xylazine is found, and anecdotal evidence suggests a growing problem.
naloxone and xylazine
Unfortunately, the growing awareness of xylazine has contributed to the “naloxone-tolerant” overdose myth. You may not wake up immediately after administration. Naloxone may not reverse the effects of xylazine, but it can reverse the effects of fentanyl, which is often mixed with fentanyl, so it is used in all cases of suspected opioid overdose. need to do it.
An important goal of naloxone administration is to prevent patient death from dangerously low respiratory rates. Bystanders who suspect an overdose should always call 911 and bring a professional in case treatment is needed.
This article originally appeared on The Conversation. Please read the original article.
