MONTICELLO, NY — The U.S. Food and Drug Administration (FDA) has alerted healthcare professionals to a sharp rise in the trafficking of fentanyl mixed with xylazine, a potent tranquilizer used by veterinarians.

Heather Guinan, co-chair of the Medical Pillar of the Sullivan County Drug Task Force, has seen this trend in her work.

“From a clinical standpoint, from descriptions from patients and their experience with use, and then also the presentation that they’re coming into the clinic with, pretty much coincides with what we read in the literature that goes along with xylazine, the effects,” she said at a recent task force meeting. “The high is different, the withdrawal is more significant, and when you couple fentanyl and xylazine together, it’s even more significant.”

Guinan is a nurse practitioner at the Lexington Center, working in Monticello and Liberty.

Xylazine poses an especially dangerous risk because its effects cannot be reversed with Naloxone.  Last year, a 16-month-old in Liberty died from an overdose of a fentanyl and xylazine mixture, according to a grand jury report released last week.

Tim Hunt of the Columbia University School of Social Work noticed another risk posed by xylazine while serving as intervention lead of the HEALing Community Study. “Xylazine stimulant use increase goes hand in hand with an increase in polysubstance abuse,” he said.

Guinan said, “Fentanyl is definitely the predominant opioid that’s out there. Pretty much 99 percent of the toxicology that is done is fentanyl-positive. Xylazine is not consistently being tested for, and there are a lot of limitations with labs, so not every organization is testing for that yet.” 

Guinan is certain of its prevalence in the county, despite the absence of data, the task force hands xylazine strips out to patients. So I will hear back from them whether their product has tested positive for xylazine, and I have patients from both Sullivan and Ulster who have had product that has tested positive. It’s definitely out there. I just don’t think we have a good grasp on the prevalence of it yet, but hopefully soon.”

Fentanyl on its own is one of the deadliest substances known. Two milligrams — the weight of a mosquito — is a fatal dose.

Anne Milgram, administrator for the U.S. Drug Enforcement Administration (DEA), says xylazine, also known as “Tranq,” is “making the deadliest drug threat our country has ever faced, fentanyl, even deadlier,” said administrator. “DEA has seized xylazine and fentanyl mixtures in 48 of 50 states. The DEA Laboratory System is reporting that in 2022 approximately 23 percent of fentanyl powder and 7 percent of fentanyl pills seized by the DEA contained xylazine.”

Still, experts always recommend administering Naloxone if someone might be suffering a drug poisoning, she said.

Source: U.S. Drug Enforcement Administration