Xylazine has recently surfaced as a significant element in the ongoing overdose crisis; however, the precise national impact of overdose fatalities involving xylazine remains unclear. Its presence was first noted in the drug supply of Puerto Rico in the early 2000s. Data from drug seizures across 30 states indicate a surge, with xylazine detection more than doubling between 2019 and 2022.
The Centers for Disease Control and Prevention’s (CDC) State Unintentional Drug Overdose Reporting System (SUDORS) documented a substantial increase. In 20 states and the District of Columbia, the monthly percentage of fentanyl-related overdose deaths where xylazine was detected rose by 276% from January 2019 (2.9%) to June 2022 (10.9%). It’s important to note that these rates can fluctuate considerably from state to state. For instance, a study focusing on fatal overdoses in Michigan revealed that xylazine was present in 4.7% of these cases in 2023.
Early research, however, presents a nuanced perspective on the relationship between xylazine and fatal overdoses. Counterintuitively, initial findings suggest that combining xylazine with opioids does not necessarily increase the odds of a fatal overdose. Research funded by the National Institute on Drug Abuse (NIDA) discovered that individuals who had both xylazine and fentanyl in their systems at the time of an overdose experienced lower rates of heart attack and coma compared to those who tested positive for opioids alone.
This same NIDA study revealed that individuals with xylazine in their system during an opioid overdose were no more likely to die than those who overdosed on opioids without xylazine present. Furthermore, the study showed that individuals exposed to both opioid overdose and xylazine were not more likely to require hospital admission or experience longer hospital stays than those who used opioids without xylazine.
Another study offered additional insights, indicating that individuals with both fentanyl and xylazine in their system at the time of an opioid overdose were no more likely to receive naloxone, the overdose reversal medication. Interestingly, they were also more likely to have a pulse upon the arrival of emergency responders compared to individuals with fentanyl but without xylazine.
NIDA is actively supporting ongoing research to further elucidate these intriguing findings. This includes investigations into how xylazine interacts with fentanyl in the body and whether these initial findings can be substantiated through further research and analysis. Understanding the complex interplay between xylazine and opioids is crucial for developing effective strategies to address the overdose crisis.
