The Combating Illicit Xylazine Act: A New Drug Overdose Prevention Strategy and an Implication for the Children’s Health
The U.S. government issued a grave new warning Wednesday about a cocktail of illegal street drugs made of fentanyl and xylazine that’s fueling another wave of American overdose deaths.
The move, announced Wednesday, marks the first time in history that any administration has declared a substance to be an emerging threat to the country, said Dr. Rahul Gupta, director of the Office of National Drug Control Policy. The SUPPORT Act of 2018 established that the office has authority to declare such “emerging threats,” and no administration has used it until now.
Speaking with reporters ahead of this morning’s announcement, Gupta said that Biden will inform Congress about the threat of public health and then present a plan to fight it over the next 90 days.
Gupta has been on the front lines of the opioid-fentanyl epidemic for decades as drug overdoses surged above 100,000 deaths a year. He said that the new drug mix could make things worse.
In March, bipartisan legislation – the Combating Illicit Xylazine Act – was introduced in the House and Senate. It says that illegal xylazine is an urgent threat to public health and safety and that it should be on a list of drugs that have moderate to low potential for dependence. Xylazine would be one level below opioids like fentanyl.
“I think it’s a tremendous public health risk,” said Dr. Stephanie Ann Deutsch, a pediatrician who treats kids exposed to drugs at the Nemours Children’s Hospital in Delaware.
Deutsch published a paper in December warning other pediatricians about her experience struggling to treat young children sickened by fentanyl and xylazine.
In the coming months, the Biden administration’s response is expected to include more testing to identify where xylazine is prevalent in the street drug supply.
The bill protects the public from abusing animal tranquilizers by providing a new set of tools to combat the problem, according to the statement.
Gupta said it may also make sense for Congress to increase criminal penalties, as police try to crack down on dealers and gangs adulterating street drugs with xylazine.
Maritza Perez Medina with the Drug Policy Alliance is worried that the fear of xylazine and other synthetic drugs will prompt more arrests rather than better treatment.
Perez Medina said that they were targeting people who could benefit from health services. Congress criminalizing these substances is my overall concern with the direction the federal government is taking.
“This drug, which is an animal sedative, is being mixed with fentanyl and is being found in almost all 50 states now,” Gupta said Tuesday. “It’s become an important part for us to make sure that we’re declaring it an emerging threat.”
This year, the Biden administration announced that the President has called on Congress to invest $46.1 billion for agencies overseen by the Office of National Drug Control Policy to tackle the nation’s illicit drug crisis.
If the budget request is not approved, there could be the option to reallocate money within the Office of National Drug Control Policy, but “we don’t want to be in a position where moneys that are being utilized for some other important aspect of saving lives has to be moved away for this purpose,” Gupta said Tuesday. It is the reason we are asking Congress to act.
Such funds could be used to develop treatments for xylazine related overdoses, gather data on FAAX and test drugs on the street.
The medication naloxone, also known as Narcan, is an antidote for an opioid overdose, but people who have overdosed on a combination of opioids and xylazine may not immediately wake up after taking naloxone, as it may not reverse the effects of xylazine in the same way it does opioids.
The impact of adulterants, stimulants, and cannabinoids on the laws regulating the sale and production of xylazine
He said the way drugs are bought and sold have changed, but that the different types of drugs have remained the same. All you need is a phone and a social media app for order and purchase of dangerous substances on planet Earth.
“All of a sudden, you can synthesize hundreds of compounds and kind of mix them together and see what does the best in the market,” Joseph Friedman, a researcher at the University of California, Los Angeles, told CNN in March. “People are synthesizing new benzodiazepines, new stimulants, new cannabinoids constantly and adding them into the drug supply. People don’t know what they’re buying or consuming.
Some of these adulterants may be as simple as sugar or artificial sweeteners added for taste or additives or fillers that bulk up the drug. Sometimes, they may be contaminants left over from the manufacturing process.
But all of these things can carry real-life health harms, says Naburan Dasgupta, an epidemiologist and senior scientist at the Gillings School of Global Public Health at the University of North Carolina, Chapel Hill.
The bipartisan bill would give law enforcement more authority to crack down on the distribution of xylazine and it would also put harsher penalties on criminals who distribute the drug.
The bill would also require manufacturers to send reports on production and distribution to the DEA so the agency can ensure that the product is not being diverted to the black market.