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March 28, 2023

Federal bill aims to make xylazine, the animal sedative used in 'tranq dope,' a Schedule III controlled drug

Officials say the veterinary tranquilizer, used as a cutting agent for fentanyl, has worsened the opioid epidemic in the U.S.

A federal bill introduced in the Senate on Tuesday would make the veterinary tranquilizer xylazine a controlled substance, giving the U.S. Drug Enforcement Agency more power to crack down on manufacturers who divert the drug to be mixed with fentanyl.

The animal sedative has become an increasingly common cutting agent for fentanyl, the powerful synthetic opioid fueling the nation's overdose crisis. Drug interactions between fentanyl and xylazine inhibit efforts to reverse overdoses and can lead to serious skin wounds among people who use "tranq dope," the street name for the mixture.

“Drug overdoses remain unacceptably high as cartels and traffickers continue to flood our nation with deadly and ever-changing poison. We cannot successfully prevent these tragedies with one hand tied behind our back," said Sen. Chuck Grassley, a Republican from Iowa. "We must keep pace with the evolving tactics of the drug trade. This bill recognizes the dangers posed by the increasing abuse of animal tranquilizers by drug traffickers, and provides new tools to combat this deadly trend."

The bipartisan bill is co-sponsored by Grassley and Democratic Sens. Catherine Cortez Masto and Maggie Hassan. The legislation would make xylazine a Schedule III drug under the Controlled Substances Act, one level below fentanyl on the five-tiered scale.

Xylazine is only approved for veterinary use in large animals such as horses and cattle. This makes it more difficult for federal agents to intercept because it isn't tracked in drug surveillance systems like the Prescription Drug Monitoring Program, although scheduling it would not change that. The bill would instead give the DEA more authority to track manufacturers of the sedative, requiring producers and distributors to report quantities purchased to the DEA.

In recent years, as fentanyl has replaced heroin as the dominant opioid in the U.S., dealers have turned to xylazine as a way to prolong the high that users experience, since fentanyl is not as long-lasting as heroin. Cutting fentanyl with xylazine also increases profit margins for drug dealers. Fentanyl can be produced in a lab and it is at least 50 times more powerful than heroin, by volume, making it cheaper and easier for drug dealers to acquire.

The Senate bill is the latest move in a series of federal efforts to contain the spread of xylazine. The U.S. Food and Drug Administration took action this month to restrict importation of the drug and the DEA issued a safety alert last week warning about the dangers of xylazine.

Because xylazine depresses breathing, blood pressure, heart rate and body temperature, it often leads to additional complications during a fentanyl overdose. Xylazine can mask the effects of the overdose reversal drug Narcan, making it difficult for first responders to tell whether an initial dose of the drug has worked. This can delay attempts to address urgent breathing difficulties caused by xylazine. The drug may keep a person sedated even after the effects of fentanyl have been reversed, costing first responders valuable time in their efforts to save lives.

People who use drugs mixed with xylazine are also known to suffer from painful skin wounds that put them at risk of serious infections. The medical science of xylazine wounds still isn't understood, since the lesions don't appear in animals who receive the medication. 

The DEA's labs found that 23% of the fentanyl powder and 7% of the fentanyl pills the agency seized last year contained xylazine.

Tranq dope is even more pervasive in the drug supply in Philadelphia, which has been called a "ground zero" for the sedative's wider entry into the nation's illicit drug market, particularly in hard-hit neighborhoods like Kensington. 

Xylazine was found in 90% of the dope samples the Philadelphia Department of Public Health tested in 2021 and was detected in more than 44% of fentanyl-involved overdose deaths in Philadelphia. It was found in 34% of overdose deaths across all categories — a 39% increase from 2020.

Epidemiologists at the Philadelphia Department of Public Health said in December that they opposed scheduling xylazine as a controlled substance. They argued doing so would reinforce a punitive approach to substance use disorder and might encourage drug dealers to produce more potent alternatives.

"There are dangers in talking about limiting, monitoring and scheduling xylazine because it is so prevalent in the drug supply," said Jennifer Shinefeld, a field epidemiologist for the health department "People are dependent on it at this point because of the withdrawal and detox management, and everything that goes with it. The idea of scheduling is not even putting a band-aid on it. It's opening up a whole pipeline for something else to jump in and be more dangerous."

The health department could not immediately reached for comment about the proposed Senate bill when contacted Tuesday.

The legislation calls for declaring xylazine an emerging drug threat and ensuring that all ingredients used in its production are covered by new restrictions on the drug. It has been endorsed by the American Veterinary Medical Association and other trade groups connected to xylazine's use in animals.

“Drug traffickers are going to great lengths to pad their profits with dangerous drugs like tranq, and we need to empower law enforcement to crack down on its spread in our communities,” Sen. Cortez Masto said.

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