Administration responds to growing crisis of xylazine-positive overdose deaths

WASHINGTON — In a historic move, The White House Office of National Drug Control Policy (ONDCP) has designated the combination of fentanyl and xylazine as an emerging threat to the United States. Xylazine, a non-opioid tranquilizer approved by the FDA for veterinary use, is being sold illicitly and is associated with significant negative health consequences, including fatal overdoses and severe morbidity.

Xylazine’s role has been growing in overdose deaths in every region of the United States. Between 2020 and 2021, forensic laboratory identifications of xylazine rose in all four U.S. census regions, with the most significant increases in the South (193%) and the West (112%). Xylazine-positive overdose deaths increased by more than 1,000% in the South and more than 500% in the Midwest.

Director Dr. Rahul Gupta’s designation is based on the Emerging Threats Criteria used by ONDCP to judge when the novel use of a substance should be considered an emerging threat to the nation. These criteria focus on geographic presence and impact, measured by metrics such as overdoses in the course of a year.

In response to the designation, the Administration will publish a national response that includes evidence-based prevention, treatment, and supply reduction. ONDCP is forming an interagency group that will come up with ways to provide xylazine testing, comprehensive data systems, and strategies to reduce the illicit supply of xylazine, along with rapid research.

This week, the White House also said it will ramp up sanctions targeting drug traffickers, along with methods to prevent the sale and manufacture of fentanyl.

The Substance Abuse and Mental Health Services Administration has previously warned doctors about the alarming challenges posed by xylazine, and the FDA has taken action on illegal imports. This is the first time the White House has designated an “emerging” threat since Congress granted them this authority in 2018.