Several states, including Pennsylvania, Delaware and South Dakota, have taken steps to address the growing issue of xylazine abuse and its contribution to overdoses amid the ongoing opioid crisis.
The states have classified xylazine, a veterinary tranquilizer, as a controlled substance in order to curb its illicit use and protect public health.
In Pennsylvania, Acting Health Secretary Dr. Debra Bogen submitted a notice to add xylazine to the list of schedule III drugs, with the measure taking effect on June 3.
The decision aims to safeguard veterinarians and legitimate users while penalizing those who illicitly introduce xylazine into the drug supply.
“Our focus remains on developing strategies that help connect people with substance use disorder to treatment and other resources,” Bogen said in a statement.
According to the Pennsylvania governor’s office, scheduling a drug requires manufacturers and distributors to ensure that practitioners — such as vets — are licensed and can legally purchase the controlled substances.
The classification also mandates that clinicians reduce theft and diversion associated with a drug while introducing checks into the ordering system.
Greg Rowe, executive director of the Pennsylvania District Attorneys Association, commented on the deadly rise of the drug.
“We’re seeing it more, we’re seeing it in more counties and that’s been the trend nationwide,” he said.
In Philadelphia — one of the cities hit hardest by the drug — around 90% of opioid samples on the street tested positive for the tranquilizer.
According to law enforcement and public health officials, fentanyl is frequently cut with the drug to increase its potency while cheaply expanding the supply of the drug.
Rowe said that the new regulations — which will last for one year until the Legislature can make it a permanent law — will help prevent the drug from flowing onto the streets, while also allowing law enforcement to hold traffickers accountable.
“[It’s] just a great use of the authority it has and that will give law enforcement the tools it needs to hold traffickers of this devastating drug accountable,” he said.
The Pennsylvania Veterinary Medical Association also released a statement on the policy.
“This action will preserve a critical veterinary sedative to the benefit of animals, especially livestock, and the farmers and veterinarians who treat these animals every day. Losing this critical medication would have been devastating for livestock farmers and veterinarians and we are grateful for this solution that preserves legal access for veterinarians,” the association said.
In a similar move, Delaware’s Secretary of State Jeff Bullock recently issued an emergency order to classify xylazine as a schedule III drug after a recommendation from the Delaware Controlled Substance Advisory Committee. The order acknowledges xylazine’s dangerous impact on human health and seeks to reduce its misuse as a drug additive, particularly in cases of opioid abuse.
South Dakota also recognized the need to address xylazine abuse, which has been associated with severe health consequences.
Commonly referred to as “tranq” or “the zombie drug,” xylazine is primarily intended for veterinary use but has been detected alongside other illicit drugs such as fentanyl.
According to the U.S. Department of Health and FDA, misuse of the drug is an “emerging threat” that has resulted in a significant increase in overdose deaths, rising from 90 in 2017 to 575 in 2021, a surge of over 600% in just five years.
Its presence in the illicit drug supply poses significant safety risks, including the potential for respiratory complications and the development of necrotic wounds that may result in amputations.
Although xylazine overdoses do not respond to the fentanyl overdose reversal medication naloxone, health officials say it is still useful to administer as many overdoses of the drug are mixed with fentanyl.
Law enforcement agencies and health care professionals are currently collaborating to combat xylazine abuse through a variety of prevention, treatment and enforcement strategies.
While law enforcement plays a crucial role, prevention efforts, early education and seeking help for individuals with substance use disorders are equally important.
“We’re the enforcement end, but we also try to match up resources with people who have substance abuse disorder. Prevention and treatment are huge components. Enforcement is important, but it’s just one of the things that would help us combat this issue,” Minnehaha County Sheriff Mike Milstead said.
South Dakota’s attorney general, Marty Jackley, also advocated for legislative changes at the federal level to list xylazine as a controlled substance and address the challenges posed by this drug.
However, Milstead ultimately referenced that the root cause of the opioid crisis comes from the southern border, which needs to be addressed.
“It would be handy if they could shut off the southwest border flow of drugs into the U.S. that is coming across at an unprecedented rate,” Milstead added.