Potent drug xylazine linked to overdoses in Sarasota

Law enforcement and health providers are sounding the alarm on xylazine, a potent animal sedative that's been showing up in opioids and other drugs in Tampa Bay.

Driving the news: Florida Attorney General Ashley Moody and Sarasota County Sheriff Kurt Hoffman held a news conference last week to warn Floridians about the dangers of the drug and its prevalence in Sarasota.

Why it matters: It's making overdose and drug-related cases harder to treat across the state — putting a bigger strain on the nation's opioid crisis.

How it works: Xylazine can be lethal when mixed with heroin or fentanyl, and causes nasty wounds and sores that can result in amputations. Since it's not an opioid, the sedative resists common overdose reversal treatments such as naloxone.

• Some are injecting the drug unwittingly, while others seek out the sedative to lengthen the high of traditional opioids, Axios Philadelphia's Isaac Avilucea reports.
• Law enforcement agencies have dubbed it the "zombie drug" and say it's sometimes called "tranq."

The big picture: Authorities have seized xylazine-fentanyl mixtures in 48 states, according to the U.S. Drug Enforcement Administration. Of all the fentanyl powder seized by the DEA last year, 23% contained xylazine, the agency said.

• At the end of February, the FDA announced new restrictions on the import of xylazine to ensure it's not diverted for illegal use.

Zoom in: More than 230 Floridians have died after using the drug, with more than 30 of them in Sarasota, Moody said.

• Sarasota has the third-largest increase in xylazine deaths in the state, she said.
• The county's drug lab has detected xylazine in more than 150 of the drugs it tested this year, Hoffman said.

What they're saying: Jeremy Lund, a clinical toxicologist and emergency medical pharmacist at Sarasota Memorial Hospital, and Miami doctor David Serota, who specializes in infectious disease and addiction medicine, said they've both noticed changes in their cases over the last six months that are likely linked to xylazine.

• "​​From the medical standpoint, it's really bad, and I don't know what to do about it yet, but we're trying to figure out what the best wound care is," Serota said.
• Scott Coon, an assistant professor with the University of South Florida's health college pharmacy and a clinical pharmacist with Tampa General Medical Group, said the drug is "one of the major concerns on the horizon," likening it to "where we were at with fentanyl a decade ago."

What we're watching: Congress is moving to designate xylazine a controlled substance, which would better allow authorities to track it and prosecute traffickers.

Yes, but: Some medical professionals are advocating for harm reduction, rather than the tactics law enforcement and legislators are using to combat the spread of xylazine.

• "As we've learned over and over again this is not an issue that you arrest your way out of," Coon said.
• "We've given the DEA quite a few decades to prove the war on drugs can be won. Fundamentally, I think we need to change our position of national consciousness on this issue."

Between the lines: They also had different standpoints on calling xylazine the "zombie drug."

• "I think that if that term is being used to hopefully scare folks from getting into the stuff, it's not necessarily a bad thing," Lund said.

Serota and Coon said more emphasis should be put on reducing barriers to treating opioid addiction and harm reduction.

• "I don't think it does well to address the stigma we're working really hard to minimize so people feel like they have a place in society to get treatment," Coon said. "I would love to see new terms be used."