What to Know: An ‘Emerging Threat’ in Overdose Crisis

April 13, 2023

Federal officials are warning the public about an emerging threat in the nation’s opioid crisis.

This week, the Drug Enforcement Administration (DEA) reported on the rise of illicit fentanyl spiked with the animal tranquilizer xylazine, a powerful sedative that the FDA has approved for veterinary use. The agency has seized xylazine and fentanyl in 48 of 50 states.

“Xylazine is making the deadliest drug threat our country has ever faced, fentanyl, even deadlier,” said DEA Administrator Anne Milgram.

Here's what you need to know:

• Overdose threat:  Xylazine and fentanyl drug mixtures are especially dangerous. Xylazine is not an opioid, so naloxone does not appear to reverse its effects. Still, Naloxone should be administered if someone is suspected of having a drug poisoning, the DEA noted.
• Concerning trend:  About 23 percent of fentanyl powder and 7 percent of fentanyl pills seized by the DEA contained xylazine.
• Health care advisory:  Xylazine, also known as “Tranq,” is not safe for use in humans. It can result in life-threatening side effects that are similar to those associated with opioid use, the FDA noted in an advisory to health care providers.
  • Repeated exposure to xylazine can lead to severe, necrotic skin ulcerations.
• By the numbers:  More than 107,000 Americans died between August 2021 and August 2022 from drug poisonings. About 66 percent of those deaths involved synthetic opioids like fentanyl, the CDC reports.
• Unknown source:  FDA said it’s investigating the source of xylazine in the illicit drug supply, but it is unclear if the drug is being illegally produced or diverted from the animal drug supply.

Providers and patients should report adverse events related to the drug to the FDA’s MedWatch Adverse Event Reporting program.

Additional information from the FDA and DEA is available online.