The tranquilizer Xylazine could move to Northwest, officials say

Xylazine, a common veterinary tranquilizer that is increasingly being mixed with fentanyl in some parts of the U.S., has not significantly infiltrated the drug market on the Kitsap Peninsula, based on available data and anecdotal reports from local providers. But concerns remain that the virus could spread to the state in coming years.

Federal regulators approved the drug, often called tranq, decades ago to sedate large animals such as horses. But the cheap and accessible tranquilizer recently became a common counterfeiter containing fentanyl in some East Coast cities. Combined with an opioid, it can prolong the duration and intensity of intoxication.

According to the National Institute on Drug Abuse, there is limited research on xylazine and its effects on humans. It remains unclear whether it increases the risk of an opioid overdose, but the drug can cause the heart rate to slow to dangerously low and cause gruesome skin sores to form. There is no antidote available for the sedative and it cannot be reversed naloxonean opioid antagonist that has become a crucial harm reduction tool.

Wayne Swanson, director of subacute recovery services at Kitsap Mental Health Services, said providers in Washington state have been talking about xylazine for about a year. It has emerged locally, but like most trends it will likely take off in a more densely populated area first.

“We are aware and preparing for what that could look like, but we are seeing it in small doses,” he said. “It’s not something we’ve seen take off in Kitsap County.”

After first being identified as an adulterant in Puerto Rico two decades ago, xylazine spread to all regions of the US by 2020, according to the US Drug Enforcement Agency. The White House declared last year that fentanyl, laced with xylazine, was an emerging threat

The local effects have been minimal, but the presence of the drug has raised some concerns. Xylazine has so far followed a similar path to fentanyl, which was introduced to the heroin market in the Northeast before eventually spreading south and then, years later, to Washington.

Nationwide, overdose deaths are on the decline and fell nearly 13% between May 2023 and May 2024, according to preliminary data from the Centers for Disease Control. Washington was one of the few states to buck this trend, with a 10% increase.

“We are two to three years behind the national average in terms of cases,” said Nathan Schlicher, an emergency room physician and former president of the Washington State Medical Association who lives in Gig Harbor. “Xylazine is not yet seriously contaminating our supply, but I expect we will see that in the next 12 to 24 months.”

During the second quarter of 2024, the state saw positive xylazine cases more than double compared to the average quarter over the past three years, according to an analysis of preliminary data by the Addictions, Drug and Alcohol Institute at the University of Washington.

Yet the total number of cases remains low. The data showed that only 45 cases were positive for xylazine in that quarter. Nearly all of these cases occurred west of the Cascades, but none occurred in Kitsap or Pierce counties.

“In some East Coast cities, the majority of fentanyl even contains xylazine,” Caleb Banta-Green, researcher and director of the Center for Community-Engaged Drug Education, Epidemiology and Research at the University of Washington, said at a meeting. presentation this month on emerging issues in the state’s drug supply.

“On the West Coast, xylazine came along a little later and has not become as common,” he said. “It kind of arrived at this lower level and stayed there.”

While comprehensive tracking of xylazine is difficult because it is often inconsistently reported, Kitsap officials say they have had few direct interactions. Of the 60 overdose deaths in Kitsap County last year, only two also involved xylazine, said Jeff Wallis of the county medical examiner’s office.

Jolene Kron, clinical director of the Salish Behavioral Health Administrative Services Organization, a state-funded provider serving Kitsap, Clallam and Jefferson counties, said outreach teams saw xylazine last year but found no reports this year.

Sara Marez-Fields, executive director of Bremerton treatment provider Agapè Unlimited, said that while there is increasing positivity for xylazine in Washington, they have not seen this in the population they serve.

“I think xylazine is something we need to be aware of and something we need to prepare for – how we want to address this – (but) the cases right now are extremely low in Washington state,” Dr. Washington Poison Control associate professor Sasha Kaiser said during a presentation this summer. “We have to be aware that these are not crazy cases.”

Conor Wilson is a Murrow News fellow reporting for the Kitsap Sun and Gig Harbor Now, a nonprofit newsroom based in Gig Harbor through a program administered by Washington State University.