The Dangerous Rise of the Drug Xylazine

vial with transparent drug solution in a man's hand

Plus: New study on alcohol–brain disease link; youth misuse of prescription meds; and adolescent blackouts from drinking

By William Wagner

February 9, 2021

The last thing we need is another log on the overdose fire, but here it is. And it sure sounds insidious: a vet tranquilizer called xylazine. Other topics we highlight this week include more research that pinpoints alcohol use disorder (AUD) as a brain disease, statistics on the misuse of prescription psychoactive medications among young adults, and the large number of adolescents who have experienced alcohol-fueled blackouts.

From Injury Prevention:
Fatal ODs and the Vet Tranquilizer Xylazine

Injury Prevention reports that xylazine was part of the polydrug mix in almost a third of fatal overdoses involving heroin and/or fentanyl in Philadelphia in 2019. The vet tranquilizer, known as “tranq” on the street in Philadelphia, has been on the radar for years, but not to this extent. Between 2010 and 2015, according to the journal, xylazine was part of 2% of deaths involving heroin and/or fentanyl. The authors believe opioids such as fentanyl might be more lethal when combined with xylazine. They write, “Xylazine’s association with adverse outcomes in other locations indicates that potential health consequences should also be monitored in the USA. Whenever possible, jurisdictions should consistently test for xylazine.” Here’s hoping that measures are taken to prevent xylazine from coming to a town near you.

From Science Advances:
Scientists: Alcohol Addiction Is Indeed a Brain Disease

Seemingly every day, the medical findings become more definitive: alcohol use disorder (AUD) is a disease of the brain. The latest development? A team of British and Chinese scientists has traced the origins of AUD to a network in the brain that processes danger, specifically the interactions between the medical orbitofrontal cortex (mOFC) and the dorsal periaqueductal gray (dPAG). According to the researchers, when this network doesn’t function properly, a person is more vulnerable to AUD. The team believes its work can translate to better AUD outcomes.

From Family Medicine and Community Health:
Misuse of Prescription Meds by Young Adults

A new study in Family Medicine and Community Health takes a look at substance misuse and the youth of America—and the results are disheartening. Thirty-four percent of U.S. young adults (ages 18 to 25) admitted to misusing prescriptions for psychoactive medications (opioids, stimulants, sedatives and tranquilizers). The data was culled from surveys conducted between 2015 and 2018. For addiction and mental health professionals, the study’s findings present some significant challenges. “There is urgent need to address psychological distress among youth and young adults,” write the study’s authors. “In our study, 11.5% of persons aged 18–25 years reported having serious psychological distress, and this was a strong determinant of misuse of every prescription substance assessed. Increasing patient motivation and establishing a strong collaborative treatment team are key.”

From Addiction:
About Last Night: What Happened?

Bouts of memory loss produced by heavy drinking, otherwise known as blackouts, are widespread among youth. According to a report out of Australia, nearly half of adolescents who drink have experienced a blackout by age 19. Female adolescents are particularly susceptible; they’re three times more likely to have experienced multiple blackouts than their male counterparts. Why is this information important? As the study’s authors note, “Experience of alcohol‐induced memory blackouts in adolescence may be an important risk factor for later harms. …Alcohol‐related blackouts may be associated with later alcohol use disorder.”

Photo: Benjamin Voros