As the powerful synthetic opioid fentanyl continues to spread, a new additive is raising even more concern. AltaPointe Health Deputy Chief Medical Officer and Addiction Medicine Fellowship Program Director for the University of South Alabama College of Medicine Luke J. Engeriser, MD, says people are combining fentanyl and an animal tranquilizer, xylazine, also known as tranq, to extend fentanyl’s effects.
Xylazine, commonly used by veterinarians as a sedative for large animals like horses and cows, is not approved for human use. It can increase the risk of a fatal overdose when combined with fentanyl because it can exacerbate the respiratory depression that opioids cause.
“Lately, tranq has been a much bigger part of the overdose deaths. I am increasingly concerned,” said Dr. Engeriser. “It has devastated the Philadelphia community, and I’m hoping it does not become a big problem in our area.”
Narcan (naloxone), widely distributed to treat opioid overdoses, will not help patients using tranq because it is not an opioid. Narcan would counteract the fentanyl, but the animal tranquilizer would require additional medical care.
In addition to extreme sleepiness, blackouts, and depressed breathing/heart function, tranq users experience large wounds that do not heal, resulting in skin rot and even amputation.
Withdrawals from xylazine can cause intense anxiety and dysphoria. And like overdose concerns, the withdrawals cannot be managed with typical opioid treatments such as buprenorphine and methadone.
The White House is investigating tranq as a potential “emerging threat,” which could lead to the development a federal plan for addressing the drug.
While some users may intentionally use tranq to extend the effects of fentanyl, in many cases, people are unaware that it has been cut into other drugs. This is another alarming example of how dangerous illegal street drugs have become.
AltaPointe administers drug screenings to potential clients to identify how best to serve them. Misty Bowen, director of AltaPointe’s substance abuse services, says most people are shocked by the results.
“They may say ‘well, I did some cocaine yesterday, or some methamphetamine.’ And they may say ‘well, I’ve been taking oxycodone pills.’ But when we administer the test and read the results, we see the cocaine, or the methamphetamine, or the oxycodone, but fentanyl is in there as well,” explained Bowen. “They are shocked because they had no idea that they even used fentanyl, but it is showing up everywhere. And our fear is tranq will do the same.”
SUBSTANCE USE TREATMENT
So far, tranq has not been tied to overdose deaths along the Gulf Coast. Healthcare professionals urge users, or anyone struggling with addiction, to seek treatment and begin the road to recovery.
“We have an extensive continuum of care to help you with your substance use disorder. We want you to know recovery is possible and AltaPointe offers free treatment for qualifying individuals. I encourage you to take the first step and call for help,” Bowen added.