In April, it was designated an "emerging threat" in the United States. Xylazine, nicknamed "tranq", is wreaking havoc across the Atlantic where it is nicknamed "zombie drug". What for? Simply because those who consume it wander like disarticulated puppets in the streets of the country's big cities... And also, or even especially, because the flesh of its consumers can become necrotic. "Unprecedented" effects, according to the US health authorities, which can be seen above in the photos taken by AFP last September in Philadelphia (United States), but also in many videos that have been circulating for a few weeks on social networks, TikTok in the lead.

Present in 25% of drugs sold

Between 2020 and 2021, the detection of xylazine by the US Drug Enforcement Agency (DEA) increased by almost 200% in the southern United States, and more than 100% in the West. "At the national level, it is present in 25% of drugs sold. Particular attention is paid to the city of Philadelphia, where 90 per cent of the drugs seized are affected. It worries the health authorities because of this particularly rapid proliferation, its relatively low cost and its ease of purchase, "recently explained to the Journal des femmes Dr. Judith Trinquart, addictologist doctor. Thus, in 2022, 26% of overdose deaths in Philadelphia were related to xylazine, which can sometimes be found for $ 6 per kilogram.

"This is the first time in our nation's history that a substance has been designated as an emerging threat," Dr. Rahul Gupta, director of the White House Office of Counter-Narcotics, told a news conference at the time. This level of "emerging threat" has made it possible to release funds to fight this drug and to use funds requested by President Joe Biden from the US Congress in his 2024 budget.

Xylazine, authorized as a veterinary sedative and analgesic since 1972 by the US Food and Drug Administration (FDA), is not approved for use on animals. But the "tranq" has been diverted into injection drugs since the 2000s. It is now available as a clear, colourless solution for injection. On the program: slowing breathing and heart rate to dangerous levels, infections that can lead to limb amputations or sedation effect. Its analgesic properties relieve pain, relax muscles and cause euphoria, hallucinations, stupor states and loss of consciousness. "Xylazine is an adrenergic receptor agonist whose toxicity can cause clinical effects such as respiratory depression and coma, bradycardia, hypotension and hyperglycemia. Ventricular arrhythmias have been reported," ANSES said in a fact sheet.

In less than three months, the government is required to present Congress with an action plan, which will address several areas. Among them: more tests to detect the drug and analyses to better understand where it comes from – especially if it is diverted to the United States or from China – in order to better combat its growing presence on the illegal market.

Medical research is another priority because naloxone, an antidote that can resuscitate a person undergoing an opioid-related overdose (e.g. fentanyl), is not effective against xylazine. According to the FDA, which authorizes the marketing of pharmaceutical products in the United States, between 2010 and 2015, xylazine was detected in 2% of opioid overdose deaths and in 2019, this rate rose to 31%.

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