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Ohio Governor Mike DeWine authorized an emergency classification of xylazine as a controlled three substance on March 29. The use of xylazine with other illicit drugs is increasing in the community, causing overdoses and drug withdrawals to occur in a way not seen before.
What is xylazine?
According to Billy Gordon, a board member of the human rights organization Harm Reduction Ohio, xylazine is a medicine for animals, not humans.
“It’s a veterinary medicine for a variety of different animals. It's used in combination with ketamine for short-term procedures where an animal needs to be sedated, or it's used to get switched over to a longer-term sedation technique, like inhalation,” Gordon said.
The United States Food and Drug Administration and the Drug Enforcement Administration explained that xylazine is solely used in veterinary medicine as a sedative. The FDA has approved the drug for use only in these veterinary purposes, according to the Drug Enforcement Administration, Diversion Control Division, Drug & Chemical Evaluation Section regarding xylazine.
Human use
The Ohio Department of Health explains that, although xylazine is not fit for human use, people are increasingly using the drug in combination with illicit drugs, such as heroin.
A press release from Governor DeWine’s office states why this is an emergency, noting the amount of overdose deaths related to xylazine.
“According to the Ohio Department of Health, overdose deaths involving xylazine have increased each year in Ohio since 2019, with 15 overdose deaths in 2019, 45 in 2020, and 75 in 2021,” the press release reads.
Gordon explained that xylazine seems to be mixed with fentanyl for the most part. DeWine also reported on fentanyl-involved overdose deaths in the March 29 press release.
“Although 2022 mortality data is not yet complete, the Ohio Department of Health recorded 113 xylazine-involved overdose deaths as of March 14, 2022. Of these 248 unintentional drug overdose deaths, 99.2 percent also involved fentanyl,” the governor’s press release reads.
According to Gordon, the duration of fentanyl is shorter than heroin.
“The xylazine is added, as I understand it, to kind of increase the amount of time between how often someone might need to use to stay well,” Gordon said.
Overdoses and response
Due to the intense side effects, Gordon explained that xylazine is changing the nature of overdoses and what some drug withdrawal looks like.
According to Gordon, xylazine gives a sedative effect, so when someone overdoses and responders use naloxone, which has the common brand narcan and is a medicine for treatment of narcotic overdoses, the person is not waking up as readily.
Gordon emphasized that naloxone should still be used on a person who is overdosing for when the drug xylazine is used with fentanyl, but what is really important is to focus on rescue breathing. Between doses of naloxone, one should focus on rescue breathing to help the person who has overdosed.
For up-to-date information about drug use and abuse in the state, visit the Ohio Department of Health’s website.
