There are frightening pictures from Philadelphia, which are currently circulating in news programs and social media: people are swaying, limping, almost losing their balance, many have open wounds, rotting spots. Xylazine is to blame, in the scene the drug is called Tranq.

Xylazine is approved as an anesthetic and pain reliever in veterinary medicine and is used on large animals such as horses, cattle or deer. Now the “zombie drug” seems to be flooding the US drug market. It’s been linked to horrific side effects and a growing number of fatal drug overdoses across the country.

Xylazine – how the “zombie drug” works

Xylazine is a chemical (alpha-2 agonist) that inhibits the release of certain messengers and hormones in the body. The “zombie drug” has a calming, analgesic and euphoric effect, explain scientists in the specialist magazine “New England Journal of Medicine”.

The dangerous thing is that breathing, blood pressure, heart rate and body temperature are reduced to critical levels. If overdosed, it can put those affected in a coma-like state, leaving them frozen and defenseless on the street for hours. Loss of consciousness can also occur, which in the worst case can lead to a coma or death.

Deep wounds, some of which expose tendons and bones

In addition, those affected often have open, deep wounds that do not heal. The exact cause is still unclear, but scientists suspect that xylazine affects blood circulation in a way that impairs skin repair. This means that in sufferers, even something as small as a pimple or a needle stick can turn into large wounds of dying tissue. In some cases, tendons and bones are exposed. Unlike other types of drugs, the sores don’t just appear at the injection sites. The US Food and Drug Administration warns that the sites can become infected easily and lead to amputations if left untreated.

Unlike opioids, there is no approved antidote to xylazine.

“Xylazine makes fentanyl, the deadliest drug threat our country has ever known, even deadlier”

According to the FDA, xylazine is primarily used to cut illegal drugs, especially fentanyl. It is designed to enhance the high and pain-relieving effects of fentanyl and prolong the duration of action.

“Xylazine makes fentanyl, the deadliest drug threat our country has ever known, even deadlier,” warns the US Drug Administration (DEA). Fentanyl is around 50 times stronger than heroin and around 100 times stronger than morphine. Because it is also significantly cheaper, it is now very common in the USA. Experts warn that even the smallest amounts – according to the DEA, an amount that fits on the tip of a pencil is enough – can lead to an overdose.

The combination with xylazine is also so dangerous because it is unclear whether and to what extent the drug naloxone used in a fentanyl overdose also works when taken in combination.

According to the US Department of Health and Human Services, the estimated number of overdose deaths involving xylazine increased from 260 in 2018 to 3,480 in 2021. This corresponds to an increase of 1238 percent. Most deaths were reported from Pennsylvania, Maryland, New York and Connecticut. But the “zombie drug” has long since spread further. Fentanyl mixtures with xylazine were confiscated in 48 out of 50 states.

On April 12, a fentanyl mixed with xylazine was classified as a “new threat” in the United States. Experts are working on a plan to combat it.

How common is Xylazine in Germany and Europe?

“Recent seizures have also found new synthetic opioids in mixtures with a new benzodiazepine and the animal tranquilizer xylazine,” says the latest report from the EU drug agency. Problems in this area are “currently still relatively limited”.

Even in Germany, no threat is perceived, said Beate Erbas, head of the Bavarian Academy for Addiction and Health Issues of the “Süddeutsche Zeitung”. In their opinion, this is also due to the fact that fentanyl in Germany, unlike in the USA, does not come from illegal production, but from the legal pharmaceutical trade. “Contaminated mixtures, as observed in the USA, do not play a role in this country – yet.”

That could change, at least according to the EU authority. “This group of substances [stellt] represents a threat that could have a greater impact on health and safety in Europe in the future.”

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