Canada’s highly toxic illicit drug supply is worsening with the emergence of xylazine, a dangerous and unpredictable animal tranquillizer that’s putting drug users’ lives at risk in alarming new ways, and advocates are calling for more to be done to address the issue.
The severely potent veterinary sedative, known on the street as “tranq dope” or “zombie drug,” is being cut with opioids like fentanyl to prolong their effects, but can also cause hours-long blackouts and horrific, painful wounds that can lead to amputation.
“It puts people in sort of blackout states, people are at really high risk of walking into traffic because they don’t really know what’s going on,” said Matt Johnson, a drug user and harm reduction worker at the Parkdale Queen West Community Health Centre in Toronto.
“We have definitely seen people get brain injuries from having these mild overdoses again and again and again. We’ve had people who have died from a mix of fentanyl and xylazine.”
Xylazine is typically used as a sedative in large farm animals such as horses, but the tranquillizer is not approved for use in humans in Canada and its long-term effects on human health are unknown.
“It can cause respiratory depression, it can lower your blood pressure, it can actually lower your heart rate,” said Dr. Shovita Padhi, Toronto’s associate medical officer of health.
“And when you have xylazine present with opioids such as fentanyl, this actually greatly increases the risk for fatal overdoses.”
A new report from Health Canada shows the rapid spread of xylazine across the country during the past few years, with a growing number of street drug samples seized by law enforcement agencies testing positive for the tranquillizer — overwhelmingly in Ontario.
In 2018, there were just five samples of xylazine analyzed by Health Canada’s Drug Analysis Service, which tests tens of thousands of drugs apprehended by the Canada Border Services Agency, the Correctional Service of Canada and police forces each year.
By 2019, that number grew to 205. Last year alone there were 1,350.
“This is a changing and ongoing dynamic emergency here, not the same thing that it was five years ago, not the same thing that was even two years ago,” said Karen Ward, a harm reduction advocate for drug users in Vancouver’s Downtown Eastside.
“The supply is changing so quickly and it can only get worse, it’s only going to get more chaotic.”
Xylazine ‘doesn’t respond’ to life-saving naloxone
To make a bad situation worse, one of the best overdose prevention tools available — the life-saving overdose-reversal medication naloxone — is rendered completely ineffective against xylazine, meaning attempts to revive people can be futile.
“There’s a significant amount about xylazine that we don’t know because it is a veterinary drug, so it hasn’t been used or tested in humans. We don’t really know what it does to people long-term necessarily,” said Johnson.
“Xylazine also doesn’t respond to naloxone because it’s not an opioid.”
The short-term effects of the drug are devastating: knocking users out for hours on end, leaving them vulnerable to robbery, physical harm and sexual abuse, and worsening the effects of opioid withdrawal due to long stretches of time spent unconscious.
“People are waking up with no idea where they are, they’re disoriented and they don’t know what they’ve used,” said Ward. “People are being robbed, people are passing out here and there, and it’s putting them at risk in many, many ways.”
Nicole Luongo, the systems change co-ordinator for the Canadian Drug Policy Coalition, a policy advocacy group made up of about 50 organizations, said xylazine is being added to the illicit supply as a way to make drugs such as fentanyl even more potent.
“The assumption is that it’s being used as an adulterant, a relatively cheap kind of way to bulk up drugs,” she said. “It’s probably quite unlikely that people are actually specifically seeking out xylazine to consume.”
Ward said xylazine is used as a way to extend the “half-life” of drugs like fentanyl, which has a shorter high than opioids like heroin, but it leads to users waking up severely disoriented and experiencing withdrawal because of the length of time they were unconscious.
“It’s not an opioid, so when they come out of it they’re dope sick as much as they were before,” she said. “So that’s really, really a vicious cycle.”
But the long-term effects of xylazine use are even more horrific.
“Longer-term, people get these really serious infected wounds that can go necrotic, that are themselves a serious problem,” said Johnson.
“In some places where they have xylazine worse than we do, people have had amputations because of these wounds.”
WATCH | How a dangerous animal tranquillizer is showing up in Manitoba’s drug supply:
‘Bold moves’ needed to ensure safer drug supply
Advocates say more needs to be done to address the growing toxicity of Canada’s illicit drug supply in order to protect users and save lives, and while they are glad to see Health Canada raising awareness about xylazine, action is needed to ensure a safer supply.
“I appreciate the Health Canada warnings, but we need more than warnings about a toxic drug supply. We need to address the toxic drug supply,” said Johnson.
“We’re not treating it with the urgency that it deserves, we’re not acting as if thousands of people’s loved ones have passed away. We need to stop tiptoeing around this and make some really bold moves.”
Luongo said the emergence of xylazine is the effect of “prohibitionist drug policies” and shows the extent to which the supply chain is fragmented, because regardless of how they enter the country, drugs like fentanyl change hands many times before they hit the street.
“New drugs are continuously being added to the illegal supply, because under a regime of prohibition, we are always going to see [organized crime] looking to maximize profit,” she said.
“The addition of new drugs is just a response to a variety of factors that are all rooted in the prevention of a legally regulated drug supply being available.”
There were a total of 3,556 suspected opioid overdose deaths in the first half of last year, according to the latest federal government data — which equates to approximately 20 deaths per day, compared with eight deaths per day in 2016 and 12 per day in 2018.
And from January 2016 to June 2022, there were a total of 32,632 apparent opioid-related deaths in Canada.
Health Canada said in a statement to CBC News xylazine has been detected in some opioid-related deaths and it is currently examining its risks, to determine if further regulatory action is needed.
“We need an urgent response immediately,” said Ward, in Vancouver’s Downtown Eastside.
“We’re sleepwalking all over the place here. We have really yet to respond in a real way. And we need to, right? We need to because it’s going to get worse. How horrible is that to say?”
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