Staff with a nonprofit in Albuquerque say they’ve seen a recent rise in the use of a dangerous animal tranquilizer as an adulterant in street drugs in New Mexico, and it brings a host of potential issues to an already deadly epidemic.
While xylazine, sometimes called tranq, is regularly used in veterinary offices as a sedative and pain reliever in animals, the FDA says in humans it can have several dangerous side-effects including extremely low blood pressure, sedation, severe withdrawal, and wounds that can become necrotic, which is rotting human flesh.
Ashley Charzuk with the New Mexico Harm Reduction Collaborative said her organization saw a sudden increase in the drug's presence starting in mid-May.
She says the tranquilizer is being used as an adulterant, or cutting agent, in other drugs.
“ We never see xylazine by itself, or at least hardly ever, and here in New Mexico we’ve never seen it alone,” she said.
When drug dealers or wholesalers are trying to maximize profits, they will cut the main drug of choice with a bulking product to increase yield. They will then add another drug, in this case xylazine, to increase the now weaker product’s potency.
In New Mexico, Charzuk says xylazine has only shown up in a brown powder sold as fentanyl powder or heroin, even though the powder contains no actual heroin.
“We usually get around five to seven samples of that specific powder, like that brown powder,” she said, “and I know that from the last quarter, three out of seven samples had xylazine”
That's a nearly 43% positive test rate.
Charzuk says the New Mexico Department of Health first confirmed the drug's presence in the state in samples taken in February, though it wasn’t announced until later. The delay was caused by an error, where the positive test for Xylazine was missed by the harm reduction collaborative. In response to the positive test, the DOH distributed xylazine testing strips to harm reduction programs and community health offices statewide. They're also providing additional training and resources.
Usually people are unaware the tranquilizer is in their supply of drugs, which can cause them to unexpectedly pass into a deep sleep from which they cannot be woken. This is an especially dangerous problem for people living on the streets.
“They often will wake up and maybe they've been robbed, or maybe they’ve been assaulted, or they’ve fallen asleep in an area that is in direct sunlight and they’ve got extreme burns,” she said.
Because of the tranquilizer's strong sedative effects, it can complicate overdose reversal. Even after receiving a dose of Narcan, people will still be asleep. In those cases, Charzuk says the best thing to do is not to rush to another dose of Narcan, but to confirm the victim is breathing, and if not, to perform rescue breathing, and put them in the recovery position.
“Which means on their side with their leg crooked and their arm crooked, so that way they cannot turn over onto their stomach and they cannot turn over onto their back,” she said.
Xylazine constricts the blood vessels, known as vasoconstriction, which contributes to the wounds for which the drug is so infamous.
Charzuk says the wounds don’t necessarily appear at injection sites, like traditional abscesses associated with intravenous drug usage. Instead, they often appear “downwind” of the injection, often where a small scrape might be.
“You add vasoconstriction to that, the healing process is now going to be much longer,” she said. “It’s going to be much more difficult for oxygen to get to the wound, and for white blood cells to get to the wound.”
Dr. Anjali Taneja, the executive director of Casa De Salud, a harm reduction program and medical provider in Albuquerque’s South Valley, said xylazine wounds generally require medical intervention to be properly treated.
“If someone has been taking care of a wound and it’s not getting better, that’s definitely a sign to urgently get care, and if that’s at an outpatient center, or if that’s in an emergency room, I think the access to care is really important,” Taneja said.
Charzuk agrees that the wounds are more difficult to treat, but also says the wounds get such a bad reputation because they tend to be worse on people experiencing homelessness.
She says for people living in houses, who get the right equipment, which her organization provides, to take proper care of the wound, it can heal up well.
But for people living outdoors without access to running water, or proper light, who live in less than sterile situations…“Chances are the wound is going to grow,” Charzuk said, “and it’s going to need some kind of medical help and antibiotics.
Both Charzuk and Taneja say New Mexico is not prepared to deal with another large-scale drug epidemic. Charzuk says while providers and harm reduction advocates knew the drug would make its way to the land of enchantment, most thought there was at least several more months to prepare.
Taneja says more services and a wider range of services are necessary to fight the encroachment of more and more dangerous drugs.
“Our city, county, state government systems have not put enough innovation and infrastructure into best meeting the needs of people who are using drugs,” Taneja said, “and this only multiplies that effect, both for people who are using drugs and for their families.”
According to the U.S. Department of Justice, Xylazine gets into the hands of drug manufacturers, wholesalers, and dealers in both a powder form that comes from China, and a liquid form rerouted from veterinary supply chains
The drug has been spreading across the United States for over a year now according to the DEA.
Organizations such as Bernalillo County’s detox, the CARE campus, Presbyterian Health Group and the Bernalillo County Sheriff’s Office, as well as other official sources, said they were not able to confirm an increase in xylazine, though some of them did confirm they had heard accounts of its increased presence.
But Charzuk says her organization, which does direct harm-reduction work with people using drugs, including mobile outreach to people living on the street, is one of the only places in the state doing the sort of testing that can confirm xylazine’s presence.
“They’re not in a position where they work with actual drug checking, or actual lab confirmations,” she said. “The only reason we have this knowledge is because of the fact that the department of health has a drug checking program that actually allows us to go out into the community, collect substances, get them confirmed.”
Charzuk says her organization provides several drug checking options, Such as collecting samples to send out to the UNC Chapel Hill, for more information on drug testing contact the collaborative or the NMDOH Harm Reduction Team.
Moreover, Charzuk says they have seen growing incidents of xylazine wounds, and more and more reports from people on the streets of drug users falling into a sleep from which they can’t be woken. They were even able to go back and track the drug’s progress moving south from Colorado into northern New Mexico, and then Albuquerque.
Now that xylazine is confirmed to be here, and shows signs of growing, Taneja says we need to invest in ways to keep drug users alive, so we can then get them into recovery.
After all, dead people can’t get sober.
This coverage is supported by the W.K. Kellogg Foundation.
