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Unlike fentanyl, there is currently no test strip available to detect xylazine in a drug supply.
Deadly batches of drugs continue to sweep the state of Ohio, but harm reduction advocates tell CityBeat that life-saving steps might not be enough in some recent cases in Cincinnati.
The SOAR Initiative (SOAR stands for Safety, Outreach, Autonomy, Respect) alerts subscribers via text or app about deadly batches of drugs, often laced with unknown amounts of fentanyl. But an alert that went out on Feb. 14 warned drug users about batches of “pink fentanyl” downtown that contain little to no fentanyl and were laced with something else entirely: Xylazine, also known as “tranq-dope.”
"Pinkish chunky/powder. Contains little to no fentanyl; suspected to be veterinary xylazine," the alert read. "Maybe packaged in paper East Cost style, may not."
Xylazine is a non-opioid veterinary tranquilizer meant for sedating animals. It’s a central nervous system depressant that can cause drowsiness, amnesia, slowed breathing, heart rate and blood pressure, and can cause scaly wounds on all parts of the body, known as eschar.
The effect has given the xylazine the “zombie drug” nickname, and coroners in various corners of the country are starting to see more people killed by the drug.
Jessica Collier is a harm reduction and outreach specialist at SOAR. As someone who has dealt with substance abuse disorder herself, Collier said she's seen the up-close affects of xylazine.
“You can snort, smoke and inject and still get these sores anywhere on your body,” Collier told CityBeat. “Wound care is super, super important, but there’s not a lot of places out there that offer it. And this is really nasty in that they’re not able to care for it very well themselves. They really need to get into the hospital, but how many IV drug-users are going to be going to the hospital every day to have a dressing change?”
When left untreated, eschar can lead to amputation of the limbs. Xylazine also poses an increased risk for overdose death because it is not an opioid, meaning the nasal spray naloxone (name brand Narcan) cannot reverse an overdose.
Collier said that unlike fentanyl, there is currently no test strip available to detect xylazine in a drug supply.
“We’re essentially going into this completely blind with no resources,” she said.
Xylazine is most commonly found cut into fentanyl, but it also can appear in party drugs like cocaine. While fentanyl is commonly used to cheaply bulk up a drug supply, Collier isn’t sure why drug distributors would be adding Xylazine to the mix.
“Sometimes I think that they’re just trying to create the perfect drug-user,” Collier said. “Someone who comes as often as stimulants and is sick every day and faithful, like opioids.”
Collier encourages people who think they may use drugs to download the SOAR app or sign up for text message alerts for bad-batch drugs. The service is free and anonymous and meant for everyone, from casual drug-users to those struggling with substance abuse disorder.
Harm Reduction Ohio, an organization that equips people to fight overdose deaths and aggregates overdose data, has forecasted that overdose deaths might actually be on a slight decline in the state.
"At the current pace, overdose deaths in Ohio will fall 5.7% from the record pace of 2021 and drop below 5,000 for the first time since COVID," reads a report published on Harm Reduction Ohio's website.
Harm Reduction Ohio pulls overdose data from coroners all over the state, and investigations into some deaths can take time, meaning it's still too soon to say exactly how many Ohioans died of an overdose in 2022. Data from Harm Reduction Ohio shows that around 5,300 Ohioans died of an overdose in 2021.
The organization offers free online naloxone, shipping Narcan and fentanyl test strips to people who sign up for free.
In overdoses where naloxone does not work, Collier said CPR is the only option to save someone's life.
"All you can do is rescue breaths and CPR until first responders get there," she said. "There isn't much else to do."
Harm Reduction Ohio pulls overdose data from coroners all over the state, and investigations into some deaths can take time, meaning it's still too soon to say exactly how many Ohioans died of an overdose in 2022. Data from Harm Reduction Ohio shows that around 5,300 Ohioans died of an overdose in 2021.
The organization offers free online naloxone, shipping Narcan and fentanyl test strips to people who sign up for free.
In overdoses where naloxone does not work, Collier said CPR is the only option to save someone's life.
"All you can do is rescue breaths and CPR until first responders get there," she said. "There isn't much else to do."
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