A deadly new street drug has swept America. Experts say something like this will happen again (2023)

enlarge this image

Amy Treglia's hands were marked by xylazine, a veterinary tranquilizer used as a cutting agent for heroin and fentanyl.Chris Craig/Providence Journal/USA TODAY Network μέσω Reuters hide title

title switch

Chris Craig/Providence Journal/USA TODAY Network μέσω Reuters

Amy Treglia's hands were marked by xylazine, a veterinary tranquilizer used as a cutting agent for heroin and fentanyl.

Chris Craig/Providence Journal/USA TODAY Network μέσω Reuters

(Video) New US street drug 'Tranq Dope' rotting people's skin

Public health and law enforcement agencies across the United States are working to mitigate the effects of xylazine, a deadly new threat to street drug-using Americans.

The effort is complicated and, some critics say, flawed because no one is sure who mixed the dangerous chemical into fentanyl, methamphetamine and other street drugs. It's unclear why they did this.

Dr Nabarun Dasgupta, a researcher at the University of North Carolina who tested street drugs collected across the country, said: "Why is it going national? I don't know why. It's a tricky one. question."

Xylazine or "tranq" is a horse sedative used in the veterinary industry. Dasgupta said the mystery surrounding it points to a broader public health problem: the lack of state and federal agencies' ability to identify and track new drug threats in real time.

"We only know what's on the secret streets when people either die or get arrested, but it's too late," Dasgupta said.

NPR reached out to many of the nation's top street drug experts. All agree that the administration was too late to address the proliferation of fentanyl and is now trying to catch up to xylazine.

Without a national system for quickly identifying drug threats, the majority said the U.S. could fall prey to other emerging street drugs.

"What's going on now? I don't know," said Dr. Nora Volkov, director of the National Institute on Drug Abuse.

"If you really want to be flexible and intervene based on observations, you need real-time data," he said. - Otherwise, you do it with your eyes closed.

The Biden administration has improved real-time data collection on street drugs and nonfatal overdoses, but officials acknowledge that national data collection and sharing is still in its infancy.

"It just eats your skin"

"I am deeply concerned about what this threat means for the country," said Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy, has warned that xylazine is a major emerging health threat.

From 2020 to 2021, deaths from xylazine overdoses increased tenfold in the southern U.S., sevenfold in the western U.S., and fivefold in the Midwest, Gupta’s office said. Most drug deaths also involved fentanyl.

Gupta acknowledges that many towns are advancing blindly.

"Xylazine testing is uneven across the U.S., making it difficult to get a national picture," he said. "Many communities don't even realize this threat exists in their own backyards."

Xylazine has been an occasional street drug over the years, but in the past 12 months it has suddenly gone viral.

Overdose deaths and serious medical complications, including horrific bodily harm from the chemical, have increased in the South and West, areas where xylazine is virtually unknown.

"It just eats away at your skin, leaves a hole and then leaves a scar," said Jessica, who lives in Newcastle, Del City. For privacy reasons and because illegal drug use is illegal, NPR has agreed not to use his last name.

U.S. public health and law enforcement agencies say xylazine poses a significant threat to addicts. They struggle to understand why the chemical is in so many street drugs.DEA hide title

title switch

DEA

She was speaking from a trauma vehicle with a bandage around her leg because of the xylazine damage she had received. 'It's so fast it can literally eat your skin,' Jessica said.

Xylazine can also make recovery from a fentanyl overdose more difficult, and the chemical adds another layer of intense addiction and craving.

"People are getting addicted," says KC, who uses street fentanyl in Dover, Delaware. He said xylazine can make addiction more deadly and harder to quit. "It seems a little hopeless now."

Drug experts say they only have theories about who added xylazine to street drug cocktails and why.

"We are unable to provide further details at this time"

One possibility is that this happened locally, with drug gangs in parts of the United States suddenly adopting the deadly new ingredient as a way to cut up or dilute fentanyl powder.

"You can find a kitchen table," says Dasgupta. "You mix the powder the same way you mix baking soda, salt and granulated sugar with flour."

But some experts believe xylazine may have entered the supply chain earlier, before Mexican cartels shipped fentanyl and methamphetamine across the border.

New data from drug samples collected in Mexico support the theory, Volkov said. "Maybe these products will come pre-blended to the US," he said.

Why did cartels and drug dealers suddenly decide to make fentanyl — an already deadly street drug — even more dangerous? Again, political experts have only theory.

One possibility, Volkov said, is simple convenience. Until recently, xylazine was not regulated or controlled, making it relatively easy to obtain.

"Xylazine is a perfect filler. Basically, it's very, very cheap. Also, it extends the life of these drugs," he said.

This leads to another theory about the increased use of xylazine.

Some fentanyl addicts believe Tranq prolongs or delays the onset of withdrawal symptoms.

That could be attractive, in part because police are trying to make fentanyl harder and more expensive, reducing the supply of street fentanyl.

"It's really encouraging drug manufacturers to start putting xylazine in their supply. It's cheaper and it keeps the excitement going longer," said Maritza Perez Medina, a fellow at the Drug Policy Alliance. ) explain.

NPR reached out to the DEA, the nation's primary law enforcement agency fighting street drugs, but DEA officials declined to be interviewed and issued a brief statement.

"The DEA will continue to monitor and track this growing drug threat, including all potential sources and levels of its entry into the illicit drug supply," the statement said. "We are unable to provide any further details at this time."

Why aren't we monitoring the drug threat like we are monitoring the coronavirus?

Lack of accurate, real-time data on emerging drug threat angers those on the front lines of overdose crisisIt killed 110,134 people in the U.S. last yearidentical

"Do you remember when this pandemic started happening? Did you see the map? Did you see where the... hot spots were?" said Levi Wardell, funeral director in Cheyenne, Wyoming. ) responsible for helping families who have lost loved ones to drug overdoses, he said.

"Why can't it be used in this [public health crisis]?" asked.

Existing technology can track emerging drug threats by testing sewage. It would also help if law enforcement agencies were required to quickly share the street drug data they collect in a national system accessible to public health agencies, experts say.

So far, these ideas have not become a reality. That has left harm reduction groups like New York's OnPoint scrambling to obtain local drug samples and gather all the information on new substances that may be circulating.

“We have a national harm reduction call every month, and we’re always talking to each other. What’s out there? What do you find here, what do you find there?” said OnPoint NYC CEO Sam Rivera.

Experts say such local networks can help, but won't be enough at a time when more synthetic street drugs, potentially deadlier than cyperazine, are expected to emerge soon.

Once the xylazine mystery is solved and public health measures are taken to make it less harmful, the next toxic street drug may have emerged, government officials acknowledge.

"We're also looking ahead to what might happen after xylazine as an add-on to fentanyl to get ahead of the next add-on in the drug pipeline," White House's Gupta said.

Madeleine BakerWyoFile, a nonprofit news organization;the paul kiefer in meDelaware Public Mediacontributed reporting to this story.