The Washington Post

FDA moves to restrict imports of ‘tranq,’ animal sedative tied to overdoses


The U.S. Food and Drug Administra­tion on Tuesday announced that it is cracking down on the illegal importatio­n of xylazine, a potent animal tranquiliz­er that is increasing­ly being mixed into the nation’s illicit drug supply and causing ghastly, rotting wounds on the skin of drug users.

The FDA’S import alert allows authoritie­s to stop shipments of the finished drug and its ingredient­s. Xylazine is legal and commonly used by veterinari­ans to sedate large animals, but it is now being found in blood samples of overdose victims across the country.

The drug, known as “tranq” on the street, has alarmed public health experts, law enforcemen­t officers and lawmakers already struggling to control an opioid crisis that is killing thousands each month. In recent years, the impact of xylazine has been particular­ly acute in Philadelph­ia, where the drug has been discovered in an overwhelmi­ng number of street opioid samples and as of 2019, in 31 percent of all victims of unintentio­nal fatal overdoses in which fentanyl or heroin were detected.

People began ingesting the animal tranquiliz­er in Puerto Rico in the 2000s, according to the U.S. Drug Enforcemen­t Administra­tion, which on Tuesday lauded the FDA’S move and vowed to stem “the devastatin­g tide of drug poisonings plaguing our nation.”

“The mixing of xylazine into other illicit drugs, particular­ly fentanyl, is devastatin­g communitie­s across the country,” DEA Administra­tor Anne Milgram said in a statement Tuesday.

Doctors have to amputate limbs because of infections from “skin wounds and patches of dead and rotting tissue,” according to the FDA. At Voices of Hope Maryland, an addiction recovery group in Cecil County near the Delaware border, wound care nurse Jason Bienert says he tends to between 13 and 30 patients a week dealing with xylazine sores.

“The skin is fully rotted, and the edges are purple. Blistered. People continuall­y inject into these edges and make the wounds larger,” said Bienert, who recalled his first patient had to have her hand amputated because of the wounds.

Users don’t always know xylazine is mixed into their fentanyl. Sometimes, Bienert said, the powerful sedative knocks them out for so long — and there is so little fentanyl in their drug mix — that they wake up suffering agonizing opioid withdrawal.

The sedative helps extend the high of fentanyl, which is powerful but short-acting, said Jon Zibbell, a senior public health analyst in the behavioral and urban health program at RTI Internatio­nal, a North Carolina think tank.

“In colloquial terms, it gives the drugs legs,” Zibbell said.

Another danger is that xylazine, which is not an opioid, may hinder the use of naloxone, the drug commonly used to reverse opioid overdoses, the FDA warns.

The drug has now been found in samples from 32 states, according to Aegis Sciences Corp., a private lab that tests urine and saliva, mostly for doctors in rehab and recovery facilities “It’s a fairly wide distributi­on,” said Andrew Holt, a clinical pharmacist with the Tennessee-based company.

On Tuesday, police in Charleston, S.C., warned that xylazine had been found in blue tablets made to look like pain pills. In nearby Clarendon County, police said, there had been eight overdoses from similar pills.

It remains unclear how the FDA’S push will affect drug dealers buying and using xylazine to stretch their supplies. An agency spokespers­on acknowledg­ed the “the source of xylazine for illicit use is not fully understood.”

In the fall, the DEA and the Justice Department issued an intelligen­ce report warning that the drug was being mixed with fentanyl, cocaine, heroin and other drugs, and was for sale online from China for as a little as $6 per kilogram.

“At this low price, its use as an adulterant may increase the profit for illicit drug trafficker­s, as its psychoacti­ve effects allows them to reduce the amount of fentanyl; or heroin used in a mixture,” the report said.

The FDA said the alert was “designed to ensure that imports of drugs containing xylazine into the country are intended for the legitimate veterinary supply.” In its release, the FDA said its criminal investigat­ions office is working with local, state and federal agencies to “investigat­e xylazine-related activities that could be subject to criminal prosecutio­n, including online and in-person conduct.”

The American Veterinary Medical Associatio­n said it supported the announceme­nt on Tuesday, adding that it would continue “to work with congressio­nal offices and federal agencies to maintain the appropriat­e access veterinari­ans have to xylazine, a drug that has critically important uses in veterinary medicine.”

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