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1 1 (February 2, 2023)

handle is hein.crs/goveklc0001 and id is 1 raw text is: Congressional ____ ~ Research Service Xylazine: Considerations for Federal Control February 2, 2023 Xylazine is a sedative drug used in veterinary medicine. It is not approved or intended for human consumption. Some drug users intentionally consume xylazine in combination with drugs of abuse, such as illicit fentanyl, to strengthen its effects, while other users are unaware that xylazine is sometimes added to illicit opioids as an adulterant. Xylazine is also used in drug-facilitated crimes to induce a state of unconsciousness. The Food and Drug Administration (FDA) and Drug Enforcement Administration (DEA) have issued warnings regarding the risks of humans consuming xylazine, and media reports indicate the substance is worsening addiction and causing physical wounds among those who use illicit opioids. Xylazine is not currently controlled under the Controlled Substances Act (CSA). As Congress weighs the legitimate use of xylazine and the risk it poses to public safety and health, it might consider making it a controlled substance under the CSA, thereby allowing DEA to regulate the substance. The Legitimate Use and Adverse Effects of Xylazine Veterinarians use xylazine on horses and cervidae (e.g., deer, elk) animals as a sedative and pain reliever. According to FDA, it is not safe for use in humans and may result in serious and life-threatening side effects that appear to be similar to those commonly associated with opioid use, making it difficult to distinguish opioid overdoses from xylazine exposure. Xylazine can increase the risk of fatal overdose because it can cause respiratory depression, low blood pressure, and slowed heart rate. Xylazine is not an opioid, and therefore overdose reversal drugs, such as naloxone, do not counteract its effects. According to the Centers for Disease Control and Prevention (CDC) naloxone may be less effective in reversing an opioid-related overdose if illicit opioid substances contain xylazine because xylazine can heighten the sedation and respiratory effects of opioids. Several states have reported increases in xylazine-involved overdose deaths, although the prevalence of xylazine in drug overdose deaths has not been extensively studied. Media reports indicate that xylazine consumption in humans can cause wounds that erupt with a scaly dead tissue that left untreated can lead to the need for amputation. FDA further reports that it is unclear if the xylazine being misused by humans is illicitly manufactured (and therefore unapproved by FDA) or diverted from legitimate medical use. DEA reports increasing xylazine encounters across the United States, most commonly in the Northeast. The substance is frequently found in polydrug mixtures, often in mixtures containing illicit fentanyl. Congressional Research Service https://crsreports.congress.gov IN12086 CRS INSIGHT Prepared for Members and Committees of Congress

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