Horse tranquillizer increasingly common in opioid overdoses, Kentucky poison control says

LOUISVILLE, Ky. (WDRB) -- The U.S. is seeing an alarming increase in opioids laced with xylazine, a tranquillizer for horses and other animals.

Kentucky has had more than a handful of xylazine overdoses, and, to make matters worse, xylazine is resistant to Narcan and other medicines used to reverse overdoses in emergency situations.

"Gone are the days when you can trust your drug dealers," said Dr. Peter Akpunonu, Kentucky Poison Control's medical director.

Like other cutting agents, xylazine benefits dealers: It's often cheaper and easier to get than fentanyl. Chinese websites sell a kilogram for $6 to $20, no prescription required. Chemicals used to produce fentanyl can cost $75 or more per kilogram.

It's meant for veterinarian use, so people typically are unaware they're swallowing animal medicine. There is a drug veterinarians use to reverse the tranquilizer's effects, but Akpunonu said it's never been tested on humans.

"It is definitely more dangerous when you don't know what you're taking," Akpunonu said.

A six-point plan released by the White House's drug control office Tuesday aims to scale up testing, treatment and efforts to intercept illegal shipments of xylazine. The animal tranquilizer, sometimes known as "tranq,"can cause breathing and heart rates to fall to dangerous levels when used in humans. When injected, it's linked to severe skin ulcers and abscesses, which can lead to infections, rotting tissue and amputations.

The White House declared xylazine-laced fentanyl an "emerging threat" in April and called for a national strategy to combat its use.

Forensic labs have seen a 193% increase of xylazine overdoses in the south, according to the U.S. Drug Enforcement Administration. But it's unclear how people get their hands on this sedative, since it's not sold over the counter.

"That is always the $6 million question," Akpunonu said. "Where is it coming from?"

Current testing for xylazine is a patchwork of different approaches, with some medical examiners and health departments regularly detecting the drug in deceased overdose victims and collected drug paraphernalia. Recent federal figures suggest use has mushroomed in recent years, but a standardized testing approach is needed to understand the trajectory and scope of the drug's spread.

The bulk of the White House's plan focuses on improving how use of the drug is tracked and treated by health professionals. There's currently no approved treatment, but physicians have been using the blood pressure-lowering drug clonidine, which is sometimes prescribed for anxiety.

"The most important thing — if you're with someone that's experiencing an overdose — is to immediately administer Narcan and allot someone to call 911," Akpunonu said.

The plan also calls for the development of rapid tests for use by hospital staff and community workers who treat patients experiencing overdoses. Developing medical billing codes for the treatment of xylazine-impacted patients is another step needed to complete the data picture, officials said.

The plan does not include new federal funding, which senior administration officials said depends on Congress. They noted that President Joe Biden's most recent drug control budget called for $46 billion to expand addiction treatment and disrupt illegal drug supplies.

The government's xylazine plan will be distributed to federal agencies, including the Food and Drug Administration and the Drug Enforcement Administration, which will be tasked with helping implement it.