Overdose redux

To the dismay of many of us, use of so-called recreational drugs is proliferating — both the party stuff our neighbors use in their back yards and the heavy drugs favored by addicts.

We’re talking about all types of narcotics, from the relatively benign to killer opioids like fentanyl that continues to pour in unchecked at our southern border.

President Biden, with a shrug, pardoned past marijuana users, opening the door for widespread use of recreational weed without fear of federal reprisal. After all, what’s a joint or two between friends? Not to worry we are told. Everyone tokes.

And cocaine, heroin and crystal meth are old friends, as addicts and the homeless know all too well. Our officials just want to be sure the needles are clean. Getting high, we are assured, is a God-given right, like voting and tickets to LGBTQ+ festivals.

But things have gotten worse, much worse, and an unlikely drug is to blame.

It’s called xylazine — a veterinarian medicine used to sedate horses and cattle. Discovered and first used in 1962 by Bayer in Germany, it filled an unmet need for animal treatment. It’s not approved in any form for human use.

TRECKER

Xylazine is a simple molecule, easily synthesized in 3 or 4 steps and, as such, is readily available from rogue labs around the world. Like fentanyl, it’s easy to make.

And, like fentanyl, it’s a medicine gone astray. It made its way into street use in the early 2000s and became a serious problem a decade or so later. Called “tranq,” the illegally produced vet medicine is often used in “speedballs” along with cocaine, heroin or other killer mixtures. In combination with fentanyl, it’s called the “zombie drug.”

What does xylazine do to humans? Like mainstream opioids, it provides a euphoric high. It also depresses breathing and heart rate and lowers blood pressure. Overdoses can induce comas.

A particularly gruesome side effect is its tendency to rot flesh, to cause massive, spreading sores on arms and legs. Amputation is sometimes necessary.

Like opioid drugs, xylazine gets into the blood stream by smoking, snorting, injecting, swallowing or inhaling. There is no current treatment. Naxolone deals with fentanyl in overdoses from fentanyl/ xylazine mixtures, but does not offset the dangers from xylazine. The Centers for Disease Control and Prevention says, “There is no approved reversal agent.”

Why bring this up now? The xylazine problem hasn’t been widely reported. What raised its profile? People are starting to pay attention because it’s rapidly spreading throughout the country. The U.S. Drug Enforcement Agency says it has seized fentanyl/xylazine mixtures in 48 of the 50 states.

As cited in the Wall Street Journal, illegal xylazine first appeared on the streets of Philadelphia and rapidly spread from there to surrounding areas. Besides Pennsylvania, top detection rates have been in North Carolina, Ohio, Maryland and Virginia.

According to the CDC, xylazine has been involved in over 30% of overdose-related deaths in the mid-Atlantic corridor.

It’s not yet a problem in Florida, but you can be sure it’s coming.

How big a deal, really, is xylazine? It’s very troublesome.

Rahul Gupta, director of the Office of National Drug Control Policy, was quoted as saying, “The combination of fentanyl and xylazine is the deadliest [drug] threat the U.S. has ever faced.” At the local level, Brianna Goodwin, a community leader in rural North Carolina, added, “Some areas stand to lose a generation of people.”

But things aren’t all bleak. Treatments are under development and clinical testing is due to begin. Let’s hope medical science is up to the task. ¦

— Dave Trecker is a chemist and retired Pfizer executive living in Florida.

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