The animal tranquilizer xylazine, also known as tranq, was detected more often in opioid overdose deaths from 2018 to 2022, the Centers for Disease Control and Prevention said in two reports.
The CDC reported Friday that the rate of drug overdose deaths involving xylazine increased 35 times, from .03 per 100,000 people in 2018 to 1.06 per 100,000 in 2021. The analysis of death certificates is the first to examine tranq’s presence in overdose deaths in all 50 states and the District of Columbia.
Geographically, the highest rate of drug overdose deaths in 2021 occurred in the mid-Atlantic region of Delaware, the District of Columbia, Maryland, Pennsylvania, Virginia and West Virginia.
On Thursday, the CDC released a less comprehensive report that found the percentage of fatal opioid overdoses that involved tranq rose in 21 jurisdictions by 276%, from 2.9% in January 2019 to 10.9% in June 2022. The spike occurred in all age groups.
According to Friday’s report, the presence of tranq in opioid overdoses increased for men at more than double the rate it grew for women. The study also found that the synthetic opioid fentanyl was present in 97% to 99% of xylazine-related deaths from 2018 to 2021.
The CDC found rates were highest among Black people, followed by White people and Hispanics. The rates grew fastest among Hispanics (from 0.21 per 100,000 people in 2020 to 0.64 in 2021), followed by Black people (from 0.68 in 2020 to 1.82 in 2021).
“The patterns observed at the national level touch on some important demographic and regional characteristics about the rising number of drug overdose deaths involving xylazine that could inform public health efforts,” CDC statistician Merianne Spencer, a co-author of Friday’s report, told The Washington Times.
Nationwide, tranq-related deaths rose from 102 in 2018 to 627 in 2019, 1,499 in 2020 and 3,468 in 2021.
Xylazine, a nonopioid animal sedative not intended for human use, lulls users into unconsciousness for hours, increasing their vulnerability to robbery or assault.
Drug users have increasingly added xylazine to opioid drugs, creating a narcotics cocktail known as “tranq dope” to extend the euphoria they experience from a “high.” However, the drug causes nasty skin abscesses and ulcers, sometimes resulting in amputations.
Experts stress that fentanyl, not tranq, is killing opioid users.
Despite the mixture of xylazine with fentanyl making fatal overdoses more likely, there is no evidence that tranq by itself causes death, said Keith Humphreys, a Stanford University addiction researcher who tracks the opioid crisis.
“Unfortunately, drug combinations are often particularly dangerous, and that’s the case here. That’s why xylazine combined with fentanyl is increasingly showing up in coroner’s reports,” Mr. Humphreys, a professor of psychiatry, told The Times.
Tranq dope is surging because drug dealers have discovered a booming market for it among people looking for a more intense high, he said.
“Traffickers often combine drugs in the hopes of better attracting or retaining customers,” Mr. Humphreys said.
A CDC study released last year found the U.S. experienced a record 30% increase in drug overdose deaths from 2019 to 2020, driven primarily by fentanyl.
In May, the CDC reported that fentanyl caused the highest rate of drug overdose deaths in 2021, with xylazine not even making the list.
The age-adjusted rate of fatal drug overdoses in 2021 was highest for deaths involving fentanyl, at 21.6 for every 100,000 people, the CDC reported. Next came methamphetamine (9.6 deaths for every 100,000 people), cocaine (7.9), heroin (2.9) and oxycodone (1.5).
Some drug users are unaware that the street drugs they purchase contain mixtures of fentanyl and xylazine, said Hannah Dodd of Ark Behavioral Health, a network of addiction treatment centers.
“The fact that xylazine and opioids are often consumed together, knowingly or unknowingly, is what makes tranq so dangerous,” Ms. Dodd said in an email. “Xylazine is a central nervous system depressant that, like opioids when taken in large amounts, can slow breathing. Depressed breathing is often what causes death in people who use tranq-containing opioids.”
In April, White House drug czar Rahul Gupta designated the combined use of fentanyl with xylazine as an emerging threat facing the country.
“These data show that fentanyl combined with xylazine is increasingly dangerous and deadly,” Dr. Gupta said Thursday in a statement on the new CDC data. “This is why the Biden-Harris administration recently designated it as an emerging threat.”
The White House has requested a record $46.1 billion from Congress for national drug control programs. If approved, that figure would represent an increase of $2.3 billion from the federal funds allocated for fiscal 2023.
“The administration is working tirelessly to launch a whole-of-government approach to tackle this emerging threat head-on, protect public health and public safety, and save lives,” Dr. Gupta said.
The Drug Enforcement Administration says 23% of the fentanyl powder and 7% of fentanyl-laced pills that federal agents seized in 2022 contained xylazine.
In a statement emailed Friday to The Times, the FBI said it was working “to target, disrupt and dismantle violent gangs” that distribute opioids. The statement did not mention xylazine or tranq dope.
“The FBI works to address the opioid threat by targeting the gatekeeper positions first,” the agency said. “We continue to work in collaboration with local, state, tribal and federal partners in both targeting opioid organizations and spreading awareness to the public.”
• Sean Salai can be reached at ssalai@washingtontimes.com.
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