Friday, July 7, 2023

Xylazine Present in Increasing Number of Fentanyl Overdose Deaths, CDC Finds

Overdose deaths involving illicitly manufactured fentanyl where the veterinary tranquilizer xylazine (“tranq”) was also detected jumped 276% from January 2019 through June 2022, a study in Morbidity and Mortality Weekly Report has found.

“It is important for overdose prevention and response messages to highlight the potential presence of xylazine in [illicitly manufactured fentanyl] products and emphasize the need for respiratory and cardiovascular support to address the sedative effects of xylazine,” Mbabazi Kariisa, Ph.D., of the Center for Disease Control and Prevention (CDC) and colleagues wrote.

The researchers analyzed data from the CDC’s State Unintentional Drug Overdose Reporting System to compare monthly deaths involving illicitly manufactured fentanyl with and without xylazine. A drug was considered involved or co-involved if it was listed as a cause of death on the death certificate or medical examiner or coroner report, versus only being detected in the body after death.

In 21 jurisdictions that included 20 states and the District of Columbia, the monthly proportion of deaths involving fentanyl with xylazine detected increased from 2.9% in January 2019 to 10.9% in June 2022. The number of cases where xylazine was co-involved rose from 12 to 188 over the same period. 

The researchers then expanded their analysis to include 32 jurisdictions spanning 31 states and the District of Columbia and narrowed the timeframe. They found that from January 2021 to June 2022, xylazine was detected in 9.0% deaths involving illicitly manufactured fentanyl and co-involved in 6.9%. The highest percentages and deaths involving fentanyl with xylazine detected were in Maryland, Connecticut, and Pennsylvania, at 27.7%, 26.4%, and 23.3%, respectively. Compared with deaths without xylazine, a higher percentage of deaths with xylazine had evidence of injection drug use, 28.6% versus 19.5%.

“Expanded postmortem and illicit drug product testing for xylazine is needed to clarify prevalence in drug supplies,” Kariisa and colleagues wrote. “[F]urther investigation of xylazine’s effects on humans is necessary to characterize morbidity and overdose risk.”

For related information, see the Psychiatric News article “Xylazine Increasingly Found in Overdose Deaths.” 

(Image: iStock/piranka)

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