ST. LOUIS — There’s a new, dangerous drug that’s killing people in our community. It’s so new, many people don’t know how to deal with it, or even how to pronounce it. It's called xylazine.
"It's some kind of horse tranquilizer," said Kim Seidel, who lost her son to the drug.
It's getting into the black market. It makes medications like Narcan, used to reverse overdoses, less effective. We spoke with those impacted.
"You can pull up at any gas station and they give it away," said Tim Jones, who has experienced xylazine before.
We talked with parents like Seidel, who buried her son a couple of years ago in St. Louis. Seidel is a registered nurse at Chester Mental Health Center in Chester, Illinois.
"It's affected my family and it can affect any family," said Seidel.
She thought her son Cody was healthy.
She was shocked to see his autopsy report. He died with the animal tranquilizer in his system. It was an overdose of xylazine mixed with fentanyl.
"I was scared, shocked, I didn't know what to do," said Seidel.
"Would you describe this as an epidemic?" asked the I-Team's Paula Vasan.
"Yes," said Sarah Sottile, director of research at Missouri Network, a community center in south St. Louis. "An epidemic of poisoning."
It's something Sottile sees every day during her work at Missouri Network. The nonprofit tests the drugs people bring them so they know what they're taking. Those ingredients are shared with law enforcement and first responders. The goal: to know what drugs are out there.
"In the last year, we weren't really seeing it at all," said Sottile. "In November of 2022, we saw it in 100% of the samples we tested. In Baltimore and Philadelphia, they're seeing it in 80% to 90% of what they had tested as well. So it's nationwide at this point."
"Is this destroying our community?" asked Vasan.
"Yes," said Sottile.
The real spread of this drug is a mystery. That's because xylazine is so new in our illegal drug market, testing and tracking haven’t caught up. So, it often goes unnoticed, according to the National Institute of Drug Abuse, a federal research institute.
The U.S. Food and Drug Administration has warned about the risk of xylazine exposure.
A spokesperson with the Centers for Disease Control and Prevention said xylazine misuse has been reported as early as the 2000s in Puerto Rico. More recently, xylazine has been detected in drug overdose deaths in the U.S., particularly in the Northeast.
"Several states including Connecticut and Pennsylvania reported increases in xylazine-involved overdose deaths; however, the prevalence of xylazine involvement in drug overdose deaths (overdose deaths) has not been extensively studied, particularly in the United States," CDC spokesperson Lenard Courtney said in an email.
The U.S. Drug Enforcement Administration calls it "a growing threat." Drug traffickers are mixing xylazine, an animal sedative, with opioids like fentanyl. Why? To make the high last longer, and up their profit. It also makes the impact even more devastating.
"It cuts off blood supply to the area where it's injected," said Sottile.
It leads to serious wounds. Some are so bad, they expose the bone.
"We're giving out wound care supplies at unprecedented rates," said Sottile.
Tim Jones tells the I-Team he's experienced xylazine. He found out his drugs were laced with it.
"What does it feel like when you use it? What's the impact on you?" asked Vasan.
"Normally takes about 20 minutes, but it's so extreme that you can't even hold your head up. And if you did one more, you die," said Jones. "It's very dangerous."
It's a warning from those who lived through it, and others who've lost someone they loved.
"Don't experiment with things that you have no clue. There's drugs out there that will kill you instantly. And this is one of them," said Seidel.
Even with xylazine, industry experts say naloxone, sold under the brand name Narcan among others, is still seen as the silver bullet. That's because the animal tranquilizer is almost always mixed with fentanyl and other opioids. And Narcan reverses opioid overdoses. Xylazine victims may need more overdose-reversing medication. It's also slower to work, but it could still save a life.
If you or someone you know is struggling with drug addiction, there are resources to help. You can call the Substance Abuse and Mental Health Services Administration's National Helpline: 1-800-662-HELP (4357) or visit findtreatment.gov.
Spokespeople at Missouri Network, also known as MO Network, say they aim to change how the public views substance use disorder. In 2022, Sottile said they helped nearly 3,900 people. “We provide our participants with safe supplies (syringes, smoking kits, safe sex kits), individualized peer support interactions, wound care, HIV/Hep C testing, as well as host prosocial group activities and meetings,” said Sottile. “Of our participants, 78% report using opioids and 26% of our participants are people of color. We partner with other recovery community centers and treatment facilities in the St. Louis region, and are capable of connecting anyone who is seeking rehabilitation with the services that they need.”
The organization has 10 peer support specialists on staff who work with people impacted by substance use disorder at various points in the process of substance use disorder and recovery. “We do not require abstinence for participation in any aspect of our program,” said Sottile.
Participants are also able to anonymously submit small samples of drugs for testing which allows the organization to know what’s in drugs in our community. “This collection and analysis of the drug supply directly allows us to better identify trends and notify physicians, first responders, law enforcement, and users to combat overdose death and keep all involved safer,” said Sottile.
The National Institute on Drug Abuse (NIDA) has this webpage on xylazine research, which provides a detailed summary on the state of the science related to xylazine.
The National Institute of Drug Abuse has advice on how to avoid stigmatizing language when talking about addiction.
Drug overdose is currently not a nationally reportable disease and thus CDC cannot require tracking of xylazine. CDC has been and continues to track the presence and role xylazine plays in drug overdose deaths. Programs like the State Unintentional Drug Overdose Reporting System (SUDORS) (see https://www.cdc.gov/drugoverdose/fatal/sudors.html) provide funding for enhanced toxicology testing for newer drugs such as xylazine, and it is possible that some jurisdictions have increasingly included panels to detect xylazine in overdose deaths. More in-depth information on CDC efforts are provided below.
National mortality data from the National Vital Statistics System (NVSS) are based on death certificate data and ICD-10 cause of death codes. There are no ICD-10 codes for xylazine specific overdoses limiting the ability to track these overdose deaths using NVSS data. However, if xylazine is mentioned as a cause of death, it is captured in the NVSS system but it is not as readily analyzable. CDC is funding states to increase the timeliness and comprehensiveness of reporting fatal overdose through a variety of efforts, including the State Unintentional Drug Overdose Reporting System (SUDORS). SUDORS collects data from 47 states and the District of Columbia and gives us a comprehensive picture of the circumstances and substances (e.g., xylazine) involved in drug overdose deaths. A recent SUDORS report provides information on drug overdose deaths involving xylazine in 2019 (Notes from the Field: Xylazine Detection and Involvement in Drug Overdose Deaths — United States, 2019 | MMWR (cdc.gov). As a result of this publication and similar reports on xylazine, there has been increased awareness of xylazine in the drug supply.
In addition, CDC is also working on a new public-facing dashboard using data from the ToxIC Fentalog Study. The dashboard will feature specific drug combinations that were detected in leftover blood or serum samples taken from patients presenting with a suspected opioid overdose at one of the study sites. Xylazine is included in the panel of 900+ substances that are tested for as part of this work.
Injection of xylazine has been anecdotally associated with severe skin infections (CCENDU Drug Alert: Xylazine (ccsa.ca)). Better surveillance of this issue can help inform treatment.
The following reports on xylazine may be helpful and represent efforts to monitor xylazine by CDC and local health departments.
Other reports on xylazine that may be helpful
Xylazine misuse has been reported as early as the 2000s in Puerto Rico. More recently, xylazine has been detected in drug overdose deaths in the US, particularly in the Northeast. Several states including Connecticut and Pennsylvania reported increases in xylazine-involved overdose deaths; however, the prevalence of xylazine involvement in drug overdose deaths (overdose deaths) has not been extensively studied, particularly in the United States. CDC SUDORS was used to document and describe drug overdose deaths with xylazine detected in 2019 (https://www.cdc.gov/mmwr/volumes/70/wr/mm7037a4.htm).
“In 10 jurisdictions – representing all four US Census Regions – xylazine was increasingly present in overdose deaths, rising from 0.36% of deaths in 2015 to 6.7% in 2020. The highest xylazine prevalence data was observed in Philadelphia, (25.8% of deaths), followed by Maryland (19.3%) and Connecticut (10.2%). Illicitly-manufactured-fentanyls were present in 98.4% of xylazine-present-overdose-deaths…PWID in Philadelphia described xylazine as a sought-after adulterant that lengthens the short duration of fentanyl injections. They also linked it to increased risk of soft tissue infection and naloxone-resistant overdose.” https://www.sciencedirect.com/science/article/pii/S037687162200117X?dgcid=author
Some approaches for reducing the harm caused by xylazine
People using drugs should continue to administer naloxone to overdoses involving opioids but should be aware the symptoms associated with xylazine may persist after naloxone administration. Calling 9-1-1 and seeking medical services is recommended as additional medical treatment may be needed beyond naloxone administration.
Harm reduction services can educate people about the adverse effects of xylazine, its presence in the drug supply, and link people developing skin infections to care.
Maryland enhanced wound care services at SSPs when faced with increased skin infections that coincided with high levels of xylazine in their illicit opioid supply.
Got a tip or a concern? Email KSDK's Senior Investigative Reporter Paula Vasan at email@example.com.