Those who take street drugs in the Chicago region are now at risk from a potent tranquillizer that has contaminated the substances.
Criminals may be spiking cheaper opioid products with more potent xylazine to enhance profits. However, the drug’s unintended human use means it carries the risk of severe injuries, amputations, and even death.
A large amount of xylazine was noted on the toxicology report of Thomas Benson Krausmann, who passed away in October 2021 at the age of 29.
The Krausmanns have stated that their musically gifted and caring son began experimenting with narcotics such as Oxycontin and Norco during his high school years. The rumour is that he eventually turned to heroin.
Simply Put, What Is Xylazine?
To put it simply, xylazine is a drug used in veterinary medicine. It does not belong to the class of drugs known as opioids. As a sedative, tranquillizer, and pain reliever, it has FDA approval for use ONLY in veterinary medicine.
There are currently no human applications approved by the Food and Drug Administration. Animals as diverse as cats, dogs, horses, and cattle all benefit from its use into both surgical and diagnostic procedures in the field of veterinary medicine.
Recently, xylazine has been discovered as a common adulterant in heroin and fentanyl sold on the streets. The anti-overdose drug naloxone has not been shown to be effective against xylazine, despite the drug’s molecular similarity to opioids.
In terms of molecular structure, xylazine is most comparable to the phenothiazines. Including other medicines like clonidine, levamisole, and tizanidine, xylazine shares chemical characteristics that suggest it may produce similar therapeutic effects.
It has a similar effect on the brain’s central alpha-2 adrenergic receptors as clonidine. Rapid suppression of norepinephrine and dopamine release results from this. There’s a chance it affects other receptors, but we need to learn more about it first.
Significant quantities of xylazine have been seized in recent years in the states of Pennsylvania, Ct, Maryland, Puerto Rico, and California. In 2021, xylazine was linked to 19% of deaths from drug overdose in Maryland and 10% in 2020 in Connecticut.
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Can You Tell Me About Xylazine’s Background?
In 1962, Bayer produced xylazine; by 1972, the FDA had approved it for use in treating animals. In veterinary medicine, this non-opioid drug is utilised for its sedative, pain-relieving, and muscle-relaxing effects. The FDA has not cleared it for use on people.
Bayer previously investigated xylazine to be used in humans, but the drug’s severe adverse effects, including very low blood sugar levels (severe hypertension) and serious major central nervous system opioid agonists effects, led to its discontinuation.
Since its discovery as a constituent of street drugs, xylazine has added a new layer of complexity to the clinical governance of overdoses involving opioids. Medical professionals need to be aware among its rising prevalence in street drugs. Unusual necrotic skin sores or patients who do not react to naloxone treatment may have been overexposed to the drug.
The FDA issued a Letter to Stakeholders and a Drug Alert to healthcare professionals in November 2022 warning about the dangers of xylazine exposure by humans.
How Is Xylazine Taken By Patients?
Xylazine is typically discovered as a contaminate in street-sold fentanyl and heroin. The most common route of administration is intravenously. When mixed with heroin or fentanyl, for example, it might be injected without the user realising it.
However, xylazine may be intentionally abused by some in order to prolong the euphoric impact (or “high”) of fentanyl injections. A growing number of illegal substances, including xylazine, pose a serious threat to drug injectors.
Synthesis of xylazine with stimulants like methamphetamine and cocaine has also been attempted. Users have reportedly counteracted the negative side effects by combining it with “speedballs,” or a combination of an opiate and stimulant.
Do You Think Xylazine Would Become Addictive?
Yes, xylazine can cause dependence, addiction, and withdrawal symptoms like agitation or extreme anxiety if the drug is suddenly stopped or the dosage is significantly reduced.
These complications may discourage recovery from an opioid use disorder and encourage further addiction (OUD).
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Is There Anything That Can Be Done For A Human Xylazine Overdose?
There is not currently a human-safe and effective xylazine antidote available. It has not been established that the opiate antidote naltrexone (Narcan, Kloxxado, Zimhi, nonprescription drugs) can reverse the effects of xylazine.
If a patient does not show an acceptable response to naloxone treatment, medical staff should give appropriate supportive care.
Since xylazine is not an opioid, the narcotic antidote naloxone may not work to reverse the potentially fatal effects of xylazine use. To date, there is no evidence that the xylazine reversal medications used in animal (such minor amounts or tolazoline) are either safe or efficacious for a xylazine overload in people.
Given that it isn’t known whether they will be efficient or safe in this group, reversal agents that are commonly used in animal medicine ought to not be utilised in humans.
Since xylazine is not typically detected by standard toxicology screenings, it might be difficult to verify whether or not it played a role in a given overdose without the use of more sophisticated analytical methods like gas chromatography-mass spectrometry (GC-MS).
The quick elimination of xylazine first from body (quarter of 23 to half an hour) may further complicate detection.
If a patient doesn’t respond to naloxone and the healthcare provider suspects an opioid overdose, they should evaluate the possibility that xylazine was also used.
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Conlcusion
Despite having some effects that are comparable to opioids, xylazine does not contain an opioid and is not believed to be reversed by the opioid antidote naloxone. Since xylazine is not typically detected by standard toxicology screenings, it might be challenging to tell if it is implicated in an overdose unless resorting to more in-depth analytical methods.