• Why is xylazine combined with fentanyl designated as an 'emerging threat' by the Office of National Drug policy?
• Why are the U.S. House and Senate moving to regulate and restrict xylazine?
• What will the proposed xylazine legislation accomplish?
• What are the street names for xylazine?
• Will xylazine still be available for legitimate veterinary use?
• What is the AVMA position on the proposed xylazine legislation?

The White House's U.S. Office of National Drug Policy on April 12 designated the sedative xylazine, when combined with fentanyl, as an "emerging threat." The action initiates a 90-day timeline for the Biden administration to coordinate a national response to the drug.  This is the first time this procedure has been used to alert the public to a dangerous new drug by the. 

Xylazine, known by the street name "tranq," was approved by the Food and Drug Administration in 1972 for use as a sedative in veterinary medicine; it has never been approved for human use. Recently it has been blended with illicit substances as a cheap means of extending their effects, even though many users aren't aware of it's presence. Human use of the drug is associated with severe skin ulcerations and tissue death, conditions which may require amputation. Since xylazine is not an opioid, opioid overdose-reversing medications, like naloxone, do not counter its sedative effects. Xylazine laced drugs are increasing involved in overdose fatalities. 

Related from VIN News Service:

Patchwork effort to curb illicit use of xylazine raises concerns

The Drug Enforcement Administration reported in March that xylazine had been detected in the drug supply in 48 U.S. states, an exponential rise over the last five years. 

Meanwhile, the U.S. Congress to poised to make xylazine a controlled substance, as the country fights the latest wave of the opioid crisis. 

The U.S. House and Senate introduced bipartisan legislation on March 30, 2023 to help the Drug Enforcement Administration (DEA) and local law enforcement "get xylazine off our streets," according to Sen. Catherine Cortez Masto, D-Nev. 

"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," said Cortez Masto, lead sponsor of the Senate bill. 

Nearly 25% of fentanyl powder seized in the United States last year was mixed with xylazine, a horse and cattle tranquilizer, according to Drug Enforcement Administration. 

Known on the street as "tranq," "tranq dope" or "zombie heroin," xylazine is dangerous because it depresses breathing, lengthens overdoses, and causes skin ulcers and sores that last for months.  

Despite reports about the alarming rise of xylazine, also called a “zombie drug,” federal law enforcement has not had the tools to regulate it.

The proposed legislation would address this gap by making xylazine a Schedule III drug under the Controlled Substances Act, a category on the five-level system for substances with moderate to low potential for physical or psychological dependence. Xylazine would be one level below opioids like fentanyl.

The bill would also require manufacturers to send reports on production and distribution to the DEA so the agency can ensure that it is not being diverted to the black market.

Xylazine is essential in veterinary medicine to sedate large animals like horses and cattle, and it still would be available for legitimate veterinary uses.

Dr. Lori Teller, president of the American Veterinary Medical Association, said the group “fully supports this congressional effort to combat illicit xylazine.”

“We urge Congress to pass the Combating Illicit Xylazine Act quickly as it strikes the right balance of protecting our communities while preserving veterinary access to this critically important animal drug,” Teller said.

Additionally, The Food and Drug Administration recently took action to restrict the unlawful importation of xylazine into the U.S.

Veterinarians should be aware of the increased and often fatal street use of the drug xlyazine, which has been commonly used in large animal veterinary practices for decades. As always, veterinarians should protect their drug inventory from diversion and theft. Veterinarians should also stay up-to-date on pending legislative changes to the regulatory status of xylazine and have their concerns heard by state and federal rulemakers.