Dr. Steven Corder, a physician in Wheeling, West Virginia, is facing a new challenge in his job treating people addicted to fentanyl. Patients are now presenting with addictions to both fentanyl and the livestock tranquilizer xylazine, making withdrawal even more difficult to manage. According to the Centers for Disease Control and Prevention, xylazine is now present in one out of every nine overdose deaths involving illicit fentanyl nationwide.
In West Virginia, which has been heavily impacted by the opioid crisis, xylazine is appearing in at least half of the needles in the city of Wheeling and between 15% and 20% of needles used statewide. This drug is known for causing deep flesh wounds that can lead to amputations. Laura Weigel, who runs a treatment center for the local YWCA, shared a harrowing story of a patient who had to undergo a breast and shoulder amputation due to xylazine use.
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Xylazine is a sedative used by veterinarians on large animals and has never been approved for human use. Addiction and withdrawal from xylazine seem to be similar to those of another sedative used in human intensive care units called etomidate. Dr. Corder explained that the severe withdrawal symptoms are likely due to xylazine being mixed with illegally manufactured fentanyl or other opioids.
Law enforcement and researchers are unsure how xylazine became mixed with fentanyl, but it is not uncommon for cheaper or widely available substances to be cut with drugs like cocaine and opioids. Xylazine initially appeared in Puerto Rico before making its way to Philadelphia and Connecticut. While it is now showing up across the country, its impact has been most significant in Pennsylvania and the Northeast.
Efforts to curb the use of xylazine have been met with challenges. While the Food and Drug Administration and the Drug Enforcement Administration have taken steps to stop some imports, the drug is easily available from overseas pharmacies. Buyers in the US typically need a prescription, but NBC News was able to find multiple suppliers in India willing to ship xylazine without one.
Lawmakers are pushing to schedule xylazine as a drug with potential for abuse, but the bill has not yet passed. Local police and public officials in 11 states have issued warnings about xylazine, and California Governor Gavin Newsom has pledged a crackdown. West Virginia’s attitudes towards scheduling xylazine are mixed, with some skeptical about the impact it would have.
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Despite the challenges, stakeholders are determined to address the xylazine crisis. Dr. Corder expressed the need for better methods to prevent access, while Charles Mueller, a public health professional at West Virginia University, emphasized the importance of providing users with test strips to detect xylazine in their drugs. Mueller hopes that funding for these programs will be revived to empower law enforcement and public health officials in combating this destructive drug.
