Xylazine increasingly identified in illicitly manufactured fentanyl overdose deaths

From 2019 to 2022, there was a considerable increase in illicitly manufactured fentanyl (IMF)-involved overdose deaths with xylazine detected, according to research published in the June 30 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

Mbabazi Kariisa, Ph.D., from the CDC in Atlanta, and colleagues described IMF-involved overdose deaths with and without xylazine that occurred during January 2019 to June 2022 using data from the CDC State Unintentional Drug Overdose Reporting System.

The researchers found a 276 percent increase, from 2.9 to 10.9 percent, in the monthly percentage of IMF-involved deaths with xylazine detected among 21 jurisdictions, including 20 states and the District of Columbia. Among IMF-involved deaths during January 2021 to June 2022 in 32 jurisdictions, xylazine was detected in more jurisdictions in the Northern U.S. Census Bureau region; across jurisdictions, there was variation in listing detected xylazine as a cause of death.

"Routine toxicology testing for xylazine in suspected overdose cases is critical for accurate surveillance, and further investigation of xylazine's potency and effects on humans is needed to clarify morbidity and overdose risks and to guide prevention and response efforts," the authors write. "Insight into motivations for adding xylazine to IMF products, and whether persons actively seek xylazine, could help anticipate future drug supply changes and tailor prevention and response efforts."

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