Corrections_Today_Spring_2025_Vol.87_No.1

COMMITTEES

Xylazine impact on the opioid epidemic and corrections agencies Healthcare Committee By Harbans Deol, M.D., Randolph Maul, M.D. and Jennifer Urra, M.P.H., R.N.

M ore than sixteen million people globally and over 2.1 million people in the United States alone are in the grip of the opioid epidemic, emphasiz ing the urgency of identifying and prompting treatment of persistent opioid use and misuse (Theisen et al., 2018). More than 120,000 deaths worldwide each year are attributed to opioids (Chang et al., 2018). In the United States, drug overdoses in 2021 were over six times higher than in 1999, and most involve some type of opioid (Centers for Disease Control and Prevention, 2024a). The healthcare costs and psychosocial impacts as sociated with the opioid epidemic have affected every aspect of Ameri can life, inclusive of the policies, processes, and budgets of jails and prison systems. To further complicate mitigation efforts, morbidity and mortality associated with the national opioid epidemic has been exacerbated by the emergence of xylazine as an il licit drug adulterant (United States Drug Enforcement Administration, 2023). In April of 2023, fentanyl laced with xylazine was designated as an emerging threat by President Biden’s Office of National Drug Control Policy (White House

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What is Xylazine? Xylazine, a veterinary sedative, can enhance opioid effects during illicit drug use, but can also cause toxic and potentially fatal side effects. Xylazine was first identi fied in Puerto Rico as an illegal additive in street drugs in the early 2000s, and its use as an adulter ant is now spreading across the country (Friedman et al., 2022). Xylazine, also known as “tranq” on the streets when used solo, is more commonly added to opioids

Office of National Drug Control Policy, 2023a). Dr. Rahul Gupta, Director of the Office of National Drug Control Policy and the speaker for the healthcare luncheon at ACA’s 2024 Fall conference in Nashville, expressed his extreme concern related to the fentanyl xylazine combination for the health of our nation in this first use of the emerging threat designa tion for the Biden administration (White House Office of National Drug Control Policy, 2023a).

Corrections Today | Spring 2025

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