Administration Has New Plan to Combat Fentanyl-Xylazine Mix

WASHINGTON — The White House unveiled a new plan Tuesday it believes will dramatically slow if not eliminate the growing threat posed by fentanyl laced with xylazine, a potent drug cocktail that has led to a surge in overdose deaths across the country.

The plan, a product of the Office of National Drug Control Policy, directs a number of federal agencies, including the Centers for Disease Control and Prevention, to expand access to testing, prevention and overdose recovery resources.

Another key provision of the plan aims to disrupt the illegal xylazine supply chain, possibly by scheduling it and prosecuting those who manufacture, import, export, sell or distribute the drug.

Those agencies must develop and submit an implementation report to the White House in 60 days. 

The release of the plan, which was previewed during a conference call with reporters on Monday is the first definitive step the White House has taken to address the deadly combination of drugs since declaring it an “emerging threat” in April. 

It also builds on President Joe Biden’s previous efforts to crack down on illegal fentanyl, an extremely potent synthetic opioid which has long been the main driver of overdose deaths in the U.S.

In recent years, xylazine, a cheap veterinary sedative not meant for human consumption, has made its way into the fentanyl supply chain, dramatically compounding the nation’s addiction and overdose crisis, according to the U.S. Drug Enforcement Administration.

There are multiple reasons for this: First, both drugs dramatically decrease respiratory function. Second, overdoses associated with xylazine may be more difficult to identify in clinical settings, as they often appear similar to opioid overdoses and may not be included in routine drug screening tests. 

Third, xylazine has no approved antidote for human use, and as xylazine is not an opioid, naloxone does not reverse its effects. Consequently the presence of xylazine may render naloxone less effective, though health officials say the administration of naloxone can still address the effect of fentanyl on breathing, which may be sufficient to prevent death. 

“If we thought fentanyl was dangerous, fentanyl combined with xylazine is even deadlier,” said Rahul Gupta, director of the White House Office of National Drug Control Policy, during the call with reporters.

A report released last month by the Centers for Disease Control and Prevention found the monthly percentage of illegally manufactured fentanyl-involved deaths with xylazine detected increased 276% (from 2.9% to 10.9%) between January 2019 and June 2022.

Neera Tanden, the White House domestic policy adviser, said Biden wanted a plan that would aggressively expand access to prevention, reduction treatment and recovery support and to target the illicit fentanyl chain.

“Our goal is to get fentanyl combined with xylazine off our streets and out of our communities,” Tanden said.

In the near term, the administration is aiming for a 15% reduction in xylazine-positive drug poisoning deaths by 2025.

As he outlined the six-pillar approach to the plan, Gupta emphasized that the administration expects “to move ahead as quickly as possible” with their implementation.

“Lives are on the line,” he said.

The plan will scale up forensic and postmortem toxicology testing to better gauge the usage of xylazine and speed the creation of new rapid tests to be used in clinical settings.

It also calls for better collection and reporting of data to track xylazine deaths and the spread and impact of fentanyl laced with xylazine across the country.

Next, the administration expects to develop and disseminate best practices for treating patients exposed to xylazine, evaluate overdose reversal strategies and educate health care providers and first responders about treating the severe flesh wounds that result from injecting drug mixtures containing xylazine.

The White House also plans to kick-start new research into how xylazine impacts human behavior and the reasons people use it. Because xylazine is not approved for human consumption, and its use in illicit drugs is fairly new, there is little research on any aspect of its abuse and treatment.

Vice President Kamala Harris will convene state attorneys general next week, with Gupta in attendance, to discuss how they are currently addressing the crisis and what the new plan will mean for those efforts.

You can reach us at [email protected] and follow us on Facebook and Twitter