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The Biden administration says fentanyl-xylazine cocktail is a deadly national threat

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WASHINGTON (NPR) — The U.S. government issued a grave new warning Wednesday about a cocktail of illegal street drugs made of fentanyl and xylazine that’s fueling another wave of American overdose deaths.

“I’m deeply concerned about what this threat means for the nation,” said Dr. Rahul Gupta, head of the White House Office of National Drug Control Policy.

Xylazine, known on the street as tranq, was first linked to drug deaths in the Northeast but has since spread rapidly in Southern and Western states.

Speaking with reporters ahead of today’s public announcement, Gupta said the Biden administration will formally notify Congress about the public health threat and will then roll out a plan to combat the crisis over the next 90 days.

“This is the first time in our nation’s history that a substance is being designated as an emerging threat by any administration,” Gupta said.

Gupta has been on the front lines of the opioid-fentanyl epidemic for decades as drug overdoses surged above 100,000 deaths a year. He said the threat that this latest mix of drugs could make things even worse is alarming.

Already, the latest drug data from 2020-2021 shows a stunning increase of fatal overdoses linked to xylazine, with deaths in the South surging more than 1,000%.

Public health experts say frequent xylazine users also suffer terrible wounds when they inject the drug.

“People are often ending up having to have amputations of their limbs, or having deep ulcers, infections or sepsis,” Gupta said.

Public health officials and researchers contacted by NPR said the Biden administration is right to raise the alarm about fentanyl and xylazine.

“I think it’s a tremendous public health risk,” said Dr. Stephanie Ann Deutsch, a pediatrician who treats kids exposed to drugs at the Nemours Children’s Hospital in Delaware.

Deutsch published a paper in December warning other pediatricians about her experience struggling to treat young children sickened by fentanyl and xylazine.

“The children didn’t respond to the traditional antidotes and in general were quite critically ill.”

In the coming months, the Biden administration’s response is expected to include more testing to identify where xylazine is prevalent in the street drug supply.

Gupta also called for increased funding for research to find medical treatments for people affected.

He said it’s also likely the government will consider further regulations for xylazine, which is used legally by veterinarians as an animal tranquilizer.

Gupta said it may also make sense for Congress to increase criminal penalties, as police try to crack down on dealers and gangs adulterating street drugs with xylazine.

Maritza Perez Medina with the Drug Policy Alliance said she worries that growing fears about xylazine and other synthetic drugs will lead to more arrests rather than better treatment.

“We’re really targeting people who could benefit from health services,” Perez Medina told NPR. “That’s my overall concern with the direction the federal government is taking, specifically Congress with criminalizing these emergent substances.”

Synthetic drugs including fentanyl, methamphetamines and now xylazine have become a political flashpoint as drug deaths rise.

With the Biden administration pivoting to battle the xylazine-fentanyl cocktail, experts say they expects to see more deadly synthetic drugs making their way onto American streets.

Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy, speaks at a press conference at the Superior Council of the Judiciary in Bogota, Colombia
Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy, speaks at a press conference at the Superior Council of the Judiciary in Bogota, Colombia. Juancho Torres | Anadolu Agency via Getty Images
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Transcript :

MICHEL MARTIN, HOST:

The U.S. government issued a grave new warning today that illegal street drugs are growing even more deadly. A hundred thousand people are already dying each year from drug overdoses. Now the White House says a synthetic drug cocktail of fentanyl and xylazine is poisoning even more Americans. NPR addiction correspondent Brian Mann has this report.

BRIAN MANN, BYLINE: Dr. Rahul Gupta, the Biden administration’s drug czar, says he’s been hearing for months from experts that this combination of fentanyl and xylazine, often known on the street as tranq, is spreading fast. First seen in overdose cases in the Northeast, it’s now common in the South and West. Speaking with reporters ahead of this morning’s announcement, Gupta said it’s time to act.

(SOUNDBITE OF ARCHIVED RECORDING)

RAHUL GUPTA: This is the first time in our nation’s history that a substance is being designated as an emerging threat by any administration.

MANN: Gupta has been on the front line of the opioid-fentanyl epidemic for decades, as drug overdoses surged above a hundred thousand deaths a year. He says the threat that this latest mix of drugs could make things even worse is alarming.

(SOUNDBITE OF ARCHIVED RECORDING)

GUPTA: I’m deeply concerned about what is – this threat means for the nation.

MANN: Like other synthetic drugs, xylazine is cheap for drug cartels to make. Mixed with fentanyl, it can deepen and prolong the sense of euphoria experienced by drug users. But the human cost is grim. Gupta says federal data showed a 1,000% increase in xylazine-related deaths in the South in a single year, along with big increases in the West and Midwest. Frequent xylazine users also suffer terrible wounds when they inject the drug.

(SOUNDBITE OF ARCHIVED RECORDING)

GUPTA: People are often ending up having to either have amputations of their limbs or having deep ulcers, infection, sepsis and oftentimes are admitted to intensive care units.

MANN: Dr. Stephanie Ann Deutsch is a pediatrician who treats kids exposed to drugs at the Nemours Children’s Hospital in Delaware.

STEPHANIE ANN DEUTSCH: I think it’s a tremendous public health risk.

MANN: Deutsch published a paper in December warning other pediatricians about her experience struggling to treat young children sickened by fentanyl and xylazine.

DEUTSCH: The children didn’t respond to the traditional antidotes and, in general, were quite critically ill.

MANN: According to Dr. Gupta, the White House will inform Congress later today the gravity of this public health crisis and will then roll out a national strategy designed to combat the fentanyl-xylazine mixture over the next 90 days. This plan is expected to include more testing to identify where xylazine is prevalent in the drug supply. Also, more funding for research to find medical treatments for people affected.

It’s also likely the government will further regulate xylazine, which is used legally by veterinarians as an animal tranquilizer. Gupta says it may also make sense for Congress to increase criminal penalties as police try to crack down on drug dealers and gangs pushing this cocktail. This part of the federal response worries Maritza Perez Medina with the Drug Policy Alliance. She says growing fears about xylazine and other synthetic drugs could lead to more arrests rather than better treatment.

MARITZA PEREZ MEDINA: We’re really targeting people who could benefit from health services. So that’s my overall concern with, like, the direction that the federal government is taking, specifically Congress, with, you know, criminalizing these emerging substances.

MANN: Synthetic drugs, including fentanyl, methamphetamines and now xylazine, have become a political flashpoint. With the Biden administration now pivoting to battle the xylazine-fentanyl cocktail, experts say this is a sign of things to come with more and more of these deadly synthetic drugs expected to make their way onto American streets.

Brian Mann, NPR News. Transcript provided by NPR, Copyright NPR.