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A horse tranquilizer often mixed with opioids is increasingly implicated in overdose deaths in some states in the United States.
The drug, called xylazine, is a sedative used in veterinary medicine, and it is not approved for use in humans. Recently, the tranquilizer has started to appear in the illegal drug supply of the United States, frequently in combination with heroin or fentanyl (both types of opioids), a mixture sometimes called “tranq dope”, Previously reported live science.
Now Connecticut is the latest state to report an increase in overdose deaths involving xylazine, according to a report published Thursday, September 16 in the journal Centers for Disease Control and Prevention (CDC). Morbidity and Mortality Weekly Report. In the new study, researchers from the Connecticut Department of Public Health found that unintentional overdose deaths in the state involving xylazine fell from 5.8% in 2019 to 11.4% in the first half of 2020. Virtually all of the xylazine-associated deaths (99%) also involved fentanyl, according to the report.
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The results are similar to those found in Philadelphia and published in a study earlier this year in the journal Injury prevention. This study found that between 2010 and 2015, xylazine was only detected in 2% of accidental overdose deaths involving heroin or fentanyl. But by 2019, that figure had risen to 31%, Live Science previously reported.
It is not clear exactly why xylazine is being added to the US drug supply and whether people who overdose know they are taking the drug. In Philadelphia, some focus groups found that people who use illegal drugs report that xylazine prolongs the duration of the effects of opioids, Live Science previously reported.
In another study, also published Thursday (September 16) in MMWR, CDC researchers looked at the extent of these xylazine-associated deaths in the United States as a whole. Researchers found that out of 38 states, xylazine-associated deaths were identified in 25 states in 2019.
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Still, the total number of overdose deaths involving xylazine in the United States appears to be low – of the more than 45,000 overdose deaths reported in 2019, only about 2% were positive for xylazine, the CDC researchers found. But when xylazine was detected, it was listed as a factor in death in about two-thirds of cases.
Additionally, the number of xylazine-related overdose deaths may be underestimated – the CDC authors note that routine postmortem screening tests may not seek out the drug.
In humans, xylazine is known to cause potentially dangerous side effects, including low arterial pressure and a slow motion heartbeat. Although studies on the health effects of xylazine in combination with opioids are limited, some research suggests that the mixture may increase the risk of death from opioid overdose. Indeed, xylazine may increase the toxic effects of opioids by “potentiating sedation and causing respiratory depression,” as well as low blood pressure and slow heart rate, the Connecticut researchers said.
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CDC researchers note that because xylazine is not an opioid, it will not respond to naloxone, the drug that can reverse opioid overdoses; and therefore naloxone may be less effective in reversing overdoses in cases where xylazine is also used.
The detection of xylazine-associated overdose deaths in half of the US states is concerning and warrants “continued monitoring” of the drug, the CDC authors said. Laboratories should implement routine postmortem testing for xylazine, which could help researchers better understand the drug’s role in overdose deaths, they said.
Originally posted on Live Science.
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