Biden Administration Calls Fentanyl Laced With Xylazine 'Emerging Threat,' What Now?

For the first time in history, the Biden administration has declared a substance to be an emerging threat to the country.

What happened: Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy (ONDCP) officially designated fentanyl combined with xylazine as an emerging threat to the United States.

Xylazine is a non-opioid tranquilizer approved by the FDA for veterinary, not human use. This designation comes after a careful review of the impact of xylazine on the opioid crisis, including its growing role in overdose deaths in every region of the United States, the Biden-⁠Harris Administration stated in an official press release.

“As a physician, I am deeply troubled about the devastating impact of the fentanyl-xylazine combination, and as President Biden’s drug policy advisor, I am immensely concerned about what this threat means for the Nation,” Dr. Gupta said on Wednesday. “That’s why the Biden-Harris Administration is using this designation authority for the first time since it passed Congress in 2018. By declaring xylazine combined with fentanyl as an emerging threat, we are being proactive in our approach to saving lives and creating new tools for public health and public safety officials and communities across the Nation. To parents, loved ones, community leaders, and those affected by xylazine use: I want you to know that help is on the way.”

Xylazine in combination with fentanyl, which can only be found illegally, is connected to the rising number of overdose deaths and severe morbidity.

According to the data provided by the FDA from 2020 to 2021, forensic laboratories confirmed xylazine rose in all four U.S. census regions, while xylazine-positive overdose deaths grew by a staggering 1,127% in the South, 750% in the West, 500% in the Midwest, and more than 100% in the Northeast.

According to the press release, national overdose death numbers have flattened or fallen over seven months, but xylazine is making the reversal of opioid overdoses with naloxone more difficult.

What’s next: The Administration is working on publishing a government response with evidence-based prevention, treatment and supply reduction.

Is Focusing On Supply The Best Approach?

The Drug Policy Alliance (DPA), commented on the news, saying the organization is also concerned about the crisis. It confirmed that more public health tools like further research into xylazine and possible antagonists that could reverse xylazine-involved overdoses are urgently needed.

However, Maritza Perez Medina, DPA's director of Federal Affairs cautioned that the focus on supply issues could be counterproductive.

“The Biden Administration must learn from the mistakes of the past and not push more supply-side interdiction policies,” Medina state. “They are incredibly counterproductive and lead to a more unknown and potentially more potent drug supply. Crackdowns on prescription opioids and heroin created the conditions for fentanyl analogs to flourish and overtake the drug supply. And now history is once again repeating itself, with newer, potentially more harmful substances—like xylazine—popping up and already overtaking some markets. Make no mistake, focusing on supply-side interdiction will only dig us deeper into this crisis and inevitably result in more loss of life.”

What About Cannabis?

Meanwhile, the idea of marijuana being a viable alternative to opioids is being discussed. Just this week the Texas House approved medical marijuana as a pain relief alternative to opioids.

Scientists at Indiana University Bloomington have developed CBD-based compounds that could be a potential substitute for naloxone, the only drug currently available to reverse opioid overdoses. CBD-based compounds have been found to reduce fentanyl binding and enhance the effectiveness of naloxone, reported the American Chemical Society.

In January, Oklahoma Attorney General Gentner Drummond (R) said the deadly fentanyl problem could be controlled by seizing illegal cannabis operators.

What is the most efficient way to deal with the illegal cannabis market? How about creating safe, legal, controlled and affordable products? During his 2020 presidential campaign, Biden pledged to decriminalize and reschedule marijuana under the Controlled Substance Act and provide automatic expungement. Until now, the president has failed to fulfill any of those promises.

Will this “emerging threat” compel the administration to undertake cannabis reform as a potential solution? That remains to be seen. 

Photo: Benzinga edit with images by Gage Skidmore via Wikimedia Commons and cottonbro studio via Pexels