I like to keep updated on the latest news related to psychiatry. While I don’t work directly with patients struggling with substance use disorders currently, I think it’s helpful to know what’s going on generally in the addiction field.
In fact, 17.3%, or almost 1 in 5 individuals, in the U.S. struggle with a substance use disorder according to a SAMHSA study in 2022. So whether you work directly with addictions or not, having a general understanding of the latest news is important.
So, what’s the latest?
Rise of the “Zombie drug”
Xylazine, commonly known as “tranq,” has also been referred to as the “zombie drug”. It has both a sedative effect and is also associated with skin ulcerations, which can lead to more severe health complications if left untreated.
This drug is a non-opioid sedative with analgesic and muscle relaxant effects, approved for use as a veterinary tranquilizer but not for use in humans.
Increasing prevalence across the U.S.
Xylazine-positive overdoses have been skyrocketing – a CDC report in 2022 showed an increase of 276% (!) in xylazine-positive overdoses from January 2019 to June 2022.
Some opioid overdose deaths involve xylazine which is not currently classified as a controlled substance – this means the DEA doesn’t currently have the authority to regulate it. There are several legislative efforts working to change this.
What you can do as a provider
With limited testing options, there may be a delay in treating patients and recognizing the contribution of xylazine to the clinical picture. Xylazine is not often included in standard urinary toxicology screens. Additionally, xylazine has a short detection window due to its rapid elimination, further limiting detection.
Some providers who want to test their patients for xylazine, kratom, and other legal but abused medications use Millennium Health’s toxicology labs – they specifically test for all these substances that a standard urine drug screen doesn’t catch.
Education is key
When it comes to harm reduction for xylazine use, making our patients aware of the specific risks associated with the drug is critical.
Chronic xylazine use leads to necrotic skin ulcerations, which can place patients at risk of additional adverse health outcomes. It may also limit patients’ options for outpatient treatment facilities, which are often not equipped to treat these severe wounds.
Have you heard of xylazine before or have you seen an uptick in xylazine-positive overdoses in your area? What do you want to know more about in psychiatry? Hit reply and let me know!
