An animal tranquilizer is increasingly showing up in illegal opioids around North Carolina, presenting a new risk to people who take the drugs.
Xylazine, also known as Tranq, has raised concerns over wounds that users can develop from the drug, and because the sedative is not an opioid — therefore naloxone, or Narcan, does not reverse its effects.
Colin Miller, a researcher and community liaison with the UNC Opioid Data Lab, joined WFAE's Nick de la Canal to discuss xylazine's presence in North Carolina, and the measures some programs are taking to help test drugs for the sedative.
De la Canal: So the Biden administration said this year that fentanyl mixed with this tranquilizer was an emerging threat in the US. You've been researching this in North Carolina. Has this tranquilizer shown up in drugs here?
Colin Miller: Yes, it certainly has. We've seen samples from all over the state from a number of different counties and different programs within those counties that have tested positive for xylazine and geographically that really stretches from the coast to the mountains in North Carolina.
De la Canal: Is it a large percentage?
Miller: Of the samples that we've tested, and I have to put in a caveat here, people often send us samples that maybe felt a little weird when they use the drugs or, you know, they have some concern about adulterants being present in the drugs. So just as a caveat, our data might skew a little higher than you know, what might be expected if you did a larger study, but out of I believe we're up to 600 some-odd samples. You know, we've had around a quarter of samples in North Carolina of expected fentanyl or heroin coming back positive for xylazine.
De la Canal: And does that worry you?
Miller: It does. It does. I think we're in this sort of new stage where we're beginning to see a lot of adulterants being added to boost the effectiveness or perceived effectiveness of the drugs that are potentially cheaper than fentanyl or heroin.
De la Canal: And in the case of xylazine, can you talk about how it works and what makes it so?
Miller: Yeah, I think there's been a lot of panic about this so I don't want to sound overly stressed out or panicked about this. I think that xylazine is dangerous, but I think fentanyl and fentanyl analogs, that's really the core of what's killing people in the overdose crisis. We have yet to see in the research whether or not xylazine is significantly contributing to someone overdosing. However, it creates its own harms as well. Like, for instance, we're pretty darn sure that it's causing these wounds that people get, which are present as basically ulcers on the skin. Those wounds can take, you know, between one month and I'd say four or five months to heal completely. If under you know the right conditions and if cared for it, everything. If they're not cared for, they can get infected, which can lead to really, really bad consequences, like amputations and things of that nature, potentially death.
De la Canal: You mentioned your lab in Chapel Hill will test drugs that people can send in anonymously to see if it's been cut with something. Certainly, that's a great way for people to check, but I imagine that there are many people who may not know that's an option or may not be willing to wait for results. What can be done for those people?
Miller: Yeah, a lot of programs and health departments are getting money to buy a type of spectrometer known as an FTIR, which is a Fourier transform infrared spectrometer with an FTIR you can typically get somebody results within 10 to 15 minutes of them handing you the sample. So it's a really amazing way to check and for programs that can't afford that, we offer our service. It's not totally perfect as far as getting people results in real-time, but it is going to be able to tell somebody within a week or two what's in the drugs that they have been using.
De la Canal: And do you think there are other measures that should be taken perhaps in addition to getting more testing?
Miller: Yeah, I think that we need to continue to make that full shift into treating substance use disorders as a public health issue and as a medical issue rather than a criminal justice issue. And I think that as long as we have our feet in both worlds, no matter how effective the interventions, they can only be so ineffective when we're talking about dealing with illicit substances that are illegal.
