PHILADELPHIA—Dr. Rahul Gupta, Director of the White House Office of National Drug Control Policy, has announced officially designating fentanyl adulterated or associated with xylazine as an emerging threat to the United States. Xylazine is a non-opioid tranquilizer approved by the Food and Drug Administration (FDA) for veterinary use but not human use.
Over the coming months, the ONDCP is convening an interagency working group to inform the development of the national response plan. The response will include work on xylazine testing, treatment, supportive care protocols, comprehensive data systems (including information on drug sourcing and supply), strategies to reduce the illicit supply of xylazine, and rapid research (such as work on the interactions between xylazine and fentanyl).
In response to this announcement, Health Commissioner Dr. Cheryl Bettigole said “We welcome the prospect of federal resources being brought to a problem causing deep harm to Philadelphians and look forward to working with federal agencies as the response plan rolls out.”
Xylazine has hit Philadelphia particularly hard, causing increased overdose deaths as well as severe wounds that can lead to sepsis and amputation. As a result, the Philadelphia Department of Public Health has been working closely with partners across the city to address this new aspect of the drug overdose epidemic. The department released a health update in December 2022, building off its earlier health alert from March of that year, that amplifies the recent FDA alert highlighting the complications xylazine use brings to overdose response, withdrawal, and wound care. The Health Department has worked with local hospital systems and the Department of Behavioral Health and Intellectual Disability Services to develop practice-based standards for managing xylazine withdrawal, to help prevent people with xylazine dependence from leaving treatment early due to uncontrolled symptoms. In collaboration with the Health Federation of Philadelphia and local experts, we are working to support wound care and to develop best practices for xylazine-associated skin wounds. And the department has updated our overdose response trainings to incorporate the risk of fatal overdose associated with xylazine use and is developing communications for people who use drugs to increase awareness of xylazine. We are continuing to monitor the drug supply with surveillance drug checking and are planning to distribute xylazine test strips once we have them available. We are grateful to have federal partnership on this work and look forward to the advances that a national focus on preventing further harms from xylazine can bring.
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