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Xylazine emerging as much a threat as fentanyl, heroin

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(The Center Square) – While deaths from fentanyl and heroin have received much attention recently, a North Carolina legislative hearing Wednesday focused on another dangerous drug that is often taken at the same time.

Xylazine is used by veterinarians as an animal tranquilizer. When consumed by humans, often with heroin and fentanyl, xylazine can cause “ghastly” wounds that lead to limb amputations, said Nabarun Dasgupta, a University of North Carolina scientist.

He met Wednesday with the Select Committee on Substance Abuse in the House of Representatives.

The drug can complicate recovery because it causes its own withdrawal symptoms and can delay regaining consciousness after reversal agents such as Narcan are administered after overdoses, said Dasgupta.

Xylazine was invented in Germany about 70 years ago as a drug for high blood pressure, Dasgupsta told the committee.

“It was intended for high blood pressure, but it made people too sleepy for it to be a commercial medication,” he said. “So give it to the animals, to sedate the animals.”

The drug is used worldwide on animals ranging from kittens to wild game in Africa, Dasgupsta said.

About 20 years ago, humans began taking the drug in Puerto Rico and its usage spread to the mainland U.S.

“In the summer of 2020, we started getting calls from clinics all over the state about a huge increase in wounds,” he said.

In January 2021, health officials linked the wounds to xylazine.

“We tested 516 fentanyl samples from around the state and about 41% contained xylazine,” said Dasgupsta.

New research has determined that xylazine is an opioid just like fentanyl and heroin although it is a different type of opioid affecting different receptors in the brain, Dasgupsta said. The dangers with xylazine abuse are wounds, withdrawal and overdose, he added.

“The wounds that people have with xylazine are some of the most gruesome I have seen in 20 years of doing this work,” Dasgupsta said. “But they can be treated if you catch them early. They can be treated like chemical burns instead of abscesses.”

There are unnecessary amputations occurring in North Carolina to treat the wounds, Dasgupsta said.

“We have a lot of misunderstanding about how to handle these wounds on a medical level throughout the state,” he said.

Some substance abuse programs are also denying admission to people with wounds, telling them to heal the wounds first. There is also a misunderstanding about whether Narcan will work to revive people who have taken overdoses.

“We hear all the time from the field that Narcan won’t work on xylazine,” Dasgupsta said.

It does work, he said, but it can take another 45 minutes for a patient to regain consciousness.

His advice to first responders is to watch the person’s breathing.

“If you do that, you’ll see that it is actually working,” Dasgupsta said. “It’s working on the fentanyl part of it and it’s also working on some of the xylazine. It’s just going to take them 45 minutes or so to come back.”

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