ONDCP Designates Fentanyl-Xylazine Combo as Emerging Drug Threat
The Office of National Drug Control Policy (ONDCP) is taking a “heads and tails” approach to the nation’s opioid crisis, Director Rahul Gupta, MD, MPH, MBA, FACP, told Rx Summit attendees on Wednesday morning.
“Heads because it is a disease of the brain,” Dr Gupta said while holding up a large coin. “And tails because drug traffickers need to watch theirs.”
In what he described as a new era for drug trends that requires a new era of drug policy and actions, Dr Gupta announced ONDCP’s latest move: The combination of fentanyl and xylazine has been designated as an emerging drug threat to the United States.
>> READ official announcement from ONDCP
“[The designation] could not have come at a more critical time,” Dr Gupta said. “Xylazine is not safe for human consumption, and it has potentially deadly consequences when used.”
Xylazine, a veterinary sedative, slows breathing and the heart rate, and also lowers blood pressure to dangerous levels in humans. It also complicates opioid overdose reversals with naloxone and has produced extreme flesh wounds, some of which necessitate amputation, Dr Gupta said
“We are seeing xylazine misuse become widely pervasive, and it is present in nearly every state across the country,” Dr Gupta said.
Between 2020 and 2021, forensic lab identifications of xylazine rose in all 4 US census regions, led by the South (193% increase) and the West (112%), according to Drug Enforcement Administration (DEA) data shared in ONDCP’s official announcement. To further illustrate the spread of xylazine misuse, xylazine-positive overdose deaths increased by 1127% in the South, 750% in the West, more than 500% in the Midwest, and more than 100% in the Northeast over the same period, according to DEA data.
With its designation of the fentanyl-xylazine combination as an emerging threat, ONDCP is developing a whole-of-government plan with deliverable actions that is slated to be published in 90 days. ONDCP is prioritizing the following 6 key actions for states and communities to adopt:
- Increasing testing and developing a point-of-care xylazine test;
- Developing a comprehensive data system that is updated regularly and tracks the spread and impact of xylazine at city, county, and state levels;
- Developing treatments;
- Attacking the supply and educating public health and public safety officials about the xylazine supply chain, routes, and methods of distribution;
- Collaborating with Congress to determine an appropriate scheduling action; and
- Developing an antidote for overdoses involving xylazine.
“The bottom line is this: The fentanyl-xylazine combination is an extension of the opioid crisis,” Dr Gupta said. “If you thought fentanyl was dangerous and deadly before, it has become even more lethal and destructive now. We all must act.”
References
Gupta R. Plenary. Presented at Rx and Illicit Drug Summit; April 10-13, 2023; Atlanta, Georgia.
