When two people died recently from drug overdoses about a mile from each other along the Murfreesboro Road corridor, their test results showed the presence of xylazine, a sedative used for horses and cattle.
On a hunch, Metro Nashville police Sgt. Mike Hotz signed into the evidence room, pulled out 120,000 counterfeit pills seized last month and tested them.
They tested positive for acetaminophen — a common binder material — fentanyl and xylazine.
He tested another set of seized pills. They, too, tested positive for the veterinary drug.
"That is a significant quantity of pills that was destined for the streets of Nashville," Hotz said during a Metro Nashville Public Health and Safety Committee meeting Tuesday. "I believe that it's important for the public, as well as our public officials, to understand that, unfortunately in my opinion, xylazine is here, on scene, in Nashville's drug supply."
Hotz tracks and monitors all fatal drug overdoses in the city, and what he and his fellow officers are seeing is startling, he said Tuesday. Almost every time, the drug was working in concert with fentanyl, Hotz said.
The Metro Public Health Department tracks data on all suspected drug overdoses in the city, issuing quarterly reports of their findings.
The department first included xylazine in their 2021 fourth quarter report, where it was found in 2.7% of overdose deaths, about 20 cases, more than doubling the number from 2020.
In 2022, the cases doubled again to 40 fatal overdoses involving xylazine, and cases have remained steady, according to the 2023 fourth quarter report.
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But even with steady numbers, Hotz raised serious concerns. In Pennsylvania and other places where the drug first emerged, officials were not equipped to handle it, which led to skyrocketing mortality rates, Hotz said.
Xylazine can cause severe breathing issues, blood clots, damage to muscles, nerves and kidneys as well as serious open wounds that have at times led to amputation of limbs, Hotz said.
Council member Jordan Huffman, who represents parts of Donelson and Hermitage, noted during the meeting the impact the drug is having in his district.
"I recently had a homeless camp closed in my district and I have seen what xylazine does to the human body firsthand," he said during the Tuesday meeting. "Going in these camps and seeing the decay and loss of limbs is extremely traumatic, not only for those that see it but, my goodness, the people that have to deal with it."
It also can cause people to develop a dual addiction with fentanyl, with which is it commonly paired. Narcan has no impact on reversing the side effects of xylazine.
Huffman asked if there is a treatment for the drug.
"There is nothing approved for human use that reverses a xylazine overdose," Hotz said. "That will need professional medical intervention usually to include significant breathing treatments."
If you or someone you know needs help with addiction, please call the Community Overdose Response Team for help at 615-687-1701. Anyone with information about drug sales in the city is asked to call Crime Stoppers at 615-742-7463.
