Xylazine, an animal tranquilizer, is new deadly drug on the street - Detroit Free Press

Xylazine, a fast-acting central nervous system depressant that is not approved for human use, is showing up largely in fentanyl, the ultra-potent synthetic opioid that is mixed into heroin and pressed into counterfeit pills and responsible for more overdose deaths than any other drug.

Adding xylazine to fentanyl, which is also a depressant, increases the already high odds of overdose.

In Michigan, xylazine has turned up in toxicology screenings of almost 200 people who have died from drug overdoses since 2019, said Varun Vohra, who is director of the Michigan Poison and Drug Information Center at Wayne State University in Detroit.

Most hospital emergency department drug tests are not calibrated to detect xylazine and since a xylazine overdose looks similar to an opioid overdose ― pinpoint pupils, loss of consciousness, slowed or no breathing — they're often mistaken for heroin or fentanyl overdoses.

With more than 107,000 people in the United States dying from drug overdoses last year ― including 3,040 in Michigan ― the presence of xylazine could cause even more people to overdose and/or die.

Some drug users may want to consume xylazine, just as some heroin users now want fentanyl in their dope.

Drug users ― including those interviewed in a long-term study by Friedman and colleagues ― have told researchers that xylazine extends the feeling of euphoria they get from a fentanyl high.

Between 2015 and 2020, the percentage of drug overdose deaths involving xylazine jumped from 2% to 26% in Pennsylvania, according to Friedman's study.

In 2020, xylazine was involved in 10% of Connecticut overdoses.

In 2021, it was involved in 19% of overdose deaths in Maryland.

Regionally, xylazine-involved deaths decreased 24.6% in southeast Michigan between 2020 and 2021 and increased 44.4% in southwest Michigan, the MDHHS data show.

But in Washtenaw County, xylazine showed up in toxicology reports of eight ― or 8% ― of the opioid overdose deaths that occurred between Jan.

Overdoses that involve opioids cut with xylazine have "already surpassed the opioid overdose deaths that involved xylazine in 2021.".

Eight percent of opioid deaths involving xylazine doesn't seem like a lot, but it's higher than those analyzed in Friedman's study of drug overdose deaths that involve xylazine.

Researchers in that study looked at overdose deaths in 10 jurisdictions ― none in Michigan ― and found xylazine was present in 6.76% percent of those overdose deaths.

One study that involved people who died in 2019 with xylazine in their systems showed that xylazine was a cause of death in 64% of those cases.

Fentanyl, a synthetic opioid that is up to 50 times more potent than heroin and 100 times more powerful than morphine, is responsible for more overdose deaths than any other drug.

These days it takes more Narcan (generic name: naloxone) than ever — often several doses ― to reverse an opioid overdose because fentanyl has so thoroughly infiltrated the street drug market.

So if someone consumes fentanyl that's mixed with xylazine, it is indeed possible their fentanyl overdose may be reversed but they will die from xylazine.

Also, xylazine is almost always mixed with fentanyl and, said Gina Dahlem, clinical nursing professor at the University of Michigan, "at least naloxone will be effective with the opioid." If naloxone doesn't appear to be working, the overdosing person needs to go to a hospital.