Top 5 Takeaways

1. Emerging Substance: Xylazine, a veterinary tranquilizer, is increasingly found in drug overdose deaths in Connecticut.
2. Combination with Fentanyl: Nearly all xylazine-positive deaths also involved fentanyl, highlighting a dangerous combination.
3. Demographics: Xylazine-associated deaths predominantly occurred among males (80.9%) and non-Hispanic White persons (74.0%).
4. Routes of Administration: Injection was the most common route of administration for xylazine, followed by snorting and smoking.
5. Need for Awareness: Health care professionals need to be aware that xylazine intoxication is not reversed by standard doses of naloxone and may require additional interventions.

Original Article Author and Citation

Corresponding Author

Shobha Thangada, shobha.thangada@ct.gov

Suggested Citation

Thangada S, Clinton HA, Ali S, et al. Notes from the Field: Xylazine, a Veterinary Tranquilizer, Identified as an Emerging Novel Substance in Drug Overdose Deaths — Connecticut, 2019–2020. MMWR Morb Mortal Wkly Rep 2021;70:1303–1304. DOI: http://dx.doi.org/10.15585/mmwr.mm7037a5

Summary

Xylazine, a nonopioid veterinary tranquilizer, has been identified as an emerging substance in drug overdose deaths in Connecticut. The substance, often combined with fentanyl, has been found in an increasing number of overdose cases. Xylazine is not reversed by naloxone, the standard treatment for opioid overdoses, necessitating additional medical interventions. The study highlights the need for increased awareness among healthcare professionals and further research into the effects of xylazine when combined with other drugs.

Methods

The Connecticut Office of the Chief Medical Examiner conducted routine drug screenings for all suspected drug overdose deaths. Xylazine was included in toxicology panels, and specimens were analyzed using liquid chromatography time-of-flight mass spectrometry and liquid chromatography-tandem mass spectrometry. Data from 2019 and January–July 2020 were analyzed to identify the prevalence and characteristics of xylazine-positive overdose deaths.

Discussion

The findings indicate a rising prevalence of xylazine-involved overdose deaths, particularly in combination with fentanyl. The demographic data show that the majority of xylazine-associated deaths occurred among males and non-Hispanic White persons. The study underscores the importance of healthcare professionals being aware of the limitations of naloxone in treating xylazine intoxication and the need for additional supportive measures. Further research is needed to understand the interactions between xylazine and other illicit drugs and to develop effective treatment protocols.

Conclusion

The study highlights the emerging threat of xylazine in drug overdose deaths and the need for increased awareness and research. Healthcare professionals should be prepared for cases of xylazine intoxication and consider additional interventions beyond naloxone. Collaboration with other states and enhanced surveillance efforts are crucial for tracking and addressing this growing issue.

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