White House reveals strategy to halt rise in ‘Tranq Dope’ fatalities.

Amid the dramatic rise in overdose deaths caused by “tranq dope,” or fentanyl laced with animal tranquilizer xylazine, the White House has announced a national response plan to address the crisis.

The plan aims to ensure a 15 percent reduction in xylazine-positive overdose deaths in at least three of four U.S. Census regions by 2025.

“Even as we work to save lives from illicit fentanyl, this administration is hyper-vigilant in reacting to changes in the drug supply, like xylazine,” said Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy, on a July 10 call with reporters.

Dr. Gupta designated fentanyl adulterated with xylazine as an “emerging threat” to the United States on April 12. The move marked the first time an administration had issued such a designation to a substance under the SUPPORT Act of 2018.

Xylazine, a nonopioid sedative used by veterinarians during surgeries, is not approved for human use.

Nevertheless, between January 2019 and June 2022, the monthly percentage of overdose deaths from xylazine-laced fentanyl saw a 276 percent spike across 20 states and the District of Columbia, according to Centers for Disease Control and Prevention (CDC) data released on June 30.

“If we thought fentanyl was dangerous, fentanyl combined with xylazine is even deadlier,” Dr. Gupta said, noting that the latter drug produces several serious side effects.

“Xylazine produces deep flesh wounds in users that require extensive medical intervention,” he said. “The deep skin and soft tissue wounds, abscesses, and tissue necrosis are often independent of injection sites and are challenging to treat, and they carry stigma. As a physician, I’ve never seen wounds this bad at this scale.”

The drug, he noted, also slows the user’s heart rate, resulting in dangerously low blood pressure levels and complicating efforts to reverse the overdose with medications like Narcan.

The administration’s plan to stop the surge focuses on six pillars of action: testing; data collection; evidence-based prevention, harm reduction, and treatment; supply reduction; scheduling, and research.

“Our goal is to get fentanyl combined with xylazine off our streets and out of our communities,” said Neera Tanden, White House domestic policy adviser. “This plan is a key step towards that goal, building on our work to meet our broader goal to tackle the opioid and overdose epidemic.”

Plan of Attack

Dr. Gupta said the administration’s plan was developed over the past three months by various federal agencies and departments, and that implementation would require a “whole of society” effort.

Addressing the first pillar, he said testing for xylazine is already being conducted in communities by local law enforcement officials but not frequently enough “to get a national picture of the threat.”

Government efforts on that front will include standardizing forensic testing practices and developing rapid test strips for use in medical and community settings. Testing for xylazine in other drugs will also be increased.

Other key aspects of the plan include standardizing diagnostic codes and developing a comprehensive epidemiological data system, developing safe and effective p