Use of the Animal Tranquilizer Xylazine Continues to Spread


Plus: Alcohol’s outsized effect on workplace absenteeism, and the increased popularity of nicotine pouches among those trying to quit smoking

By William Wagner

About a year ago in “From the Journals,” we noted the prevalence in Philadelphia of xylazine, a powerful animal tranquilizer. Since then the drug has been emerging elsewhere, leaving an alarming number of overdose fatalities in its wake.

We also look at the havoc wreaked on the U.S. workforce by alcohol misuse, and the rise of nicotine pouches as a substitute for tobacco.

From Drug and Alcohol Dependence:
Troubling New Findings About Xylazine

A UCLA-led study published in Drug and Alcohol Dependence reveals ominous new details about xylazine, a deadly sedative that barely was on the radar in the U.S. just a few years ago. The researchers analyzed 10 jurisdictions (representing all four U.S. census regions) and found that xylazine was involved in 6.7% of all overdose deaths in 2020. That’s a major jump from 2015, when 0.36% of OD fatalities were related to the drug. The hardest-hit pockets were in the Northeast: Philadelphia (25.8% of deaths), Maryland (19.3%) and Connecticut (10.2%). Given the trend line, one can assume the xylazine-related death toll was even greater in 2021.

The spike in xylazine-related deaths is directly linked to the synthetic opioid fentanyl. Xylazine was mixed with fentanyl in 98.4% of the OD deaths reported in the Drug and Alcohol Dependence study. Part of the appeal of xylazine, according to the study, is that it extends the duration of a fentanyl high. The combination of xylazine and fentanyl can be particularly lethal, as it further depresses respiratory functions. Additionally, because xylazine is a sedative, it is resistant to the opioid-OD-reversal medication naloxone. UCLA’s Joseph Friedman, first author of the study, told STAT that xylazine is an “especially noxious contaminant that is spreading through the drug supply.”

From the JAMA Network:
Alcohol’s Impact on Workforce Productivity

The numbers are nothing short of astonishing: Researchers from Washington University School of Medicine in St. Louis say that alcohol use disorder (AUD) contributed to 232 million missed workdays per year from 2015 to 2019. According to their study, Americans with AUD who had full-time jobs—about 9% of the total full-time workforce—missed an average of 32 workdays per year “because of illness, injury, or skipping work,” costing the U.S. economy up to $250 billion annually. The survey data came from 110,000 U.S. adults with full-time jobs.

Given that alcohol use increased during the pandemic, according to several studies, the workforce today likely is even more hobbled by booze. “Alcohol use disorder is a major problem in the United States and a big problem in many workplaces, where it contributes to a significant number of workdays missed,” said Laura J. Bierut, MD, of the Washington University School of Medicine. “The problem likely has worsened during the pandemic, and we need to try to do more to ensure that people can get the help they need to deal with alcohol use disorder. The new data also point to an economic incentive for employers and policymakers to address the issue.”

From Tobacco Control:
Nicotine Pouches Are Gaining Popularity

Nicotine pouches are a relatively new entry on the smoking-cessation scene. To this point, little research has been done on the pouches, which contain no tobacco and are inserted between the lip and the gum. It’s too soon to know how safe a substitute they are for tobacco, but a study out of Rutgers University indicates that they are gaining traction among people who are trying to quit smoking. Of the 1,018 smokers surveyed for the study, 29% were aware of nicotine pouches, 6% had used them and 17% were interested in trying them.

The rising profile of nicotine pouches calls for more to be learned about them, says the Rutgers research team. “This is a really timely issue,” noted Mary Hrywna, PhD, a co-author of the study. “We have now learned from our study that interest will continue to grow in these products, so we will need more independent research on the product itself.”

Photo: Daniel Monteiro