President Joe Biden’s drug czar on Wednesday declared that fentanyl mixed with xylazine, an animal tranquilizer known as “tranq” that has been linked to a rising number of overdose deaths across the U.S., represents an “emerging threat” facing the nation.
The declaration from Dr. Rahul Gupta, the director of the Office of National Drug Control Policy, requires the Biden administration to develop a federal plan to address the crisis. The government must now publish a response plan within 90 days and send implementation guidance to agencies within 120 days, among other steps.
“As the president’s drug policy adviser, I am deeply concerned about what this threat means for the nation,” Gupta told reporters during a briefing call on Tuesday, later adding: “We must act and act now.”
Gupta’s announcement marks the first time a presidential administration has formally labeled an illicit drug an “emerging threat” and then required the federal government to take further action — a legal authority it gained under the SUPPORT Act, a sweeping bill signed into law by former President Donald Trump in 2018.
Research has shown that opioids like fentanyl are increasingly combined with xylazine and sold on the illicit drug market, according to the National Institutes of Health. The spread of xylazine-laced fentanyl has exacerbated the nationwide addiction crisis, ravaging communities and deepening the toll of addiction.
Xylazine is not approved for human use, and ingesting it can cause serious, life-threatening effects, according to the Food and Drug Administration. People who inject it can develop flesh wounds, including blackened, rotting tissue (known as necrosis); if untreated, those injuries may result in amputation, according to the Drug Enforcement Administration.
The powerful tranquilizer was approved by the FDA for veterinary use in 1972. It is typically used on horses, cows, sheep and other nonhuman mammals as a sedative and pain reliever, according to the FDA.
Gupta said the federal government would be mindful that xylazine has “legitimate” uses in the veterinary profession and the agriculture industry while it works on a whole-of-government response that includes evidence-based prevention, treatment and supply reduction.
The federal government has previously sounded the alarm about “tranq” in stark terms. The DEA issued an alert last month warning of a “sharp increase in the trafficking of fentanyl mixed with xylazine.”
“Xylazine is making the deadliest drug threat our country has ever faced, fentanyl, even deadlier,” DEA Administrator Anne Milgram said in a statement March 20. (Because xylazine is not an opioid, overdoses cannot be reversed by the opioid overdose antidote naloxone, better known as Narcan.)
Milgram said the DEA has seized xylazine and fentanyl mixtures in 48 states. Xylazine was detected in about 23% of fentanyl powder and 7% of fentanyl pills the DEA seized last year, she added.
The Centers for Disease Control and Prevention found that 107,735 people in America died from August 2021 to August 2022 from drug poisonings, with 66% of the deaths involving synthetic opioids such as fentanyl.
The federal government has reported that overdose deaths involving xylazine have risen in every region of the country in recent years. From 2020 to 2021, xylazine-linked deaths increased more than 1,000% in the South, 750% in the West and more than 500% in the Midwest, according to a DEA report released last year.