The number of Vermonters who fatally overdose on opioids diluted with an animal tranquilizer is rising exponentially, recent state data shows.
One quarter — or 19 out of 77 — of the Vermonters who died from an accidental opioid overdose between January and May had taken opioids mixed with xylazine, a veterinary drug not approved for human use, the Vermont Department of Health told VTDigger.
The total number of opioid-related deaths that involved xylazine over the same period last year was 11 out of 81 cases, or 14%.
The increasing prevalence of xylazine “has introduced a new urgency for people to know and understand what they are using,” said state health department spokesperson Ben Truman, “and importantly, that you can’t really know for sure what is in illicit drugs.”
Vermont health officials sounded the alarm about xylazine in fall 2021 after finding a spike in opioid deaths involving the “emerging” illicit drug. A total of 29 people died in Vermont last year from xylazine-laced opioids. There were only five such deaths in 2020 and six in 2019.
The trend was highlighted in a quarterly newsletter released Monday by the University of Vermont’s Center on Rural Addiction.
Xylazine has become a sought-after “cutting agent,” or dilutant, particularly for the powerful synthetic opioid fentanyl, because it prolongs users’ high, according to research.
The Vermont Department of Health’s latest opioid fatality report shows fentanyl continuing to dominate opioid deaths among state residents. During the first five months of this year, the drug figured in 71 out of 77 overdose deaths.
All 19 xylazine-related deaths among Vermonters so far this year also involved fentanyl.
“It is especially important that to save a life, anyone suspecting an opioid overdose should call 9-1-1, because additional medical assessment will be needed if xylazine is involved,” Truman said.
Xylazine is used on many different animal species to calm them for diagnostic and surgical procedures, to relieve pain or to act as a local anesthetic. In humans, repeated use of the drug can cause skin ulcers and abscesses. It can also slow breathing, heart rate and blood pressure to dangerously low levels.
Taking xylazine with opioids and other depressants, such as alcohol or benzodiazepines, increases the risk of a life-threatening overdose, according to information from the National Institute on Drug Use.
Also, because xylazine is not an opioid, experts say opioid antidotes such as naloxone may not be as effective in reversing overdoses when the animal tranquilizer is present.
Studies show that some people exposed to xylazine are not aware it’s in their drug supply, the national institute said. Xylazine also is not detected by fentanyl test strips that are being distributed in Vermont communities.
The Turning Point Center of Bennington said its clients who have used xylazine reported blacking out for eight to nine hours. Other signs are sores, wounds, infections or “abnormal spots” around the area where they inject drugs.
The recovery center is updating its “harm reduction kits” to include wound treatment supplies, along with Narcan — a brand of the opioid antidote naloxone — and fentanyl test strips, said the center’s interim director, Margae Diamond.
Diamond emphasized that people experiencing these symptoms need immediate medical attention. “Radical Compassion, harm reduction and medical treatment are our only frontline tools right now,” she said.
Overall deaths hold steady
This year’s opioid overdosedeaths have so far tracked a bit lower than those of 2021 — the first time Vermont topped 200 opioid fatalities in a year.
But the new data is still preliminary, said Cynthia Seivwright, director of the state health department’s division of substance use programs, and could increase as pending death certificates are completed.
The total overdose deaths last year, for example, was upped to 215 from the original count of 210 after outstanding death certificates were finalized.
Health officials and recovery professionals recognized a few months into the coronavirus pandemic that the surging opioid deaths were closely tied to the public health emergency, which upended people’s lives with fear, anxiety, depression, stress, isolation and loneliness.
These factors led some people to start using substances as a coping mechanism and caused others who had stopped using to relapse. The health department and Vermont community organizations are also telling people not to use alone, which happened more frequently with social distancing during the pandemic.
“This is an unremitting challenge that we're up against here,” said Ed Baker, co-chair of the Vermont Overdose Prevention Network. “‘Pervasive and formidable’ is putting it mildly.”
Don't miss a thing. Sign up here to get VTDigger's weekly email on Vermont hospitals, health care trends, insurance and state health care policy.
