GREENFIELD – Of the drug residue samples that Tapestry Health has sent to Brandeis University for testing, roughly half have come back positive for the animal tranquilizer xylazine, a development that is affecting responses to overdoses.
“When responding to an overdose now, it’s not necessarily assumed it’s going to be an opiate, so Narcan may not always work,” explained Amy Davis, assistant director of rural harm reduction operations at Tapestry Health, which provides health care and support services. in the four counties of western Massachusetts. “We have to give Narcan, but we have to focus on breathing.
Xylazine — a sedative used in veterinary medicine — isn’t necessarily a new villain, Davis said, noting reports of it being used in Puerto Rico and Philadelphia. However, in recent months, the region has “really seen an increase” in its presence in the supply of drugs.
The challenge with xylazine, Davis said, is that while it produces similar sedative effects to opioids, it is not an opioid.
“It makes it difficult to reverse an overdose,” Davis said. “A lot of the time, people are looking for that quick awakening, and that’s not necessarily what’s going to happen.”
Xylazine can cause unresponsiveness or decreased consciousness, low blood sugar, low blood pressure, slowed heart rate, and reduced breathing, according to the Massachusetts Drug Supply Data Stream (MADDS), a state-funded collaboration among researchers in Brandeis University, Massachusetts Department of Public Health. and various municipal police departments.
In light of that, Davis and other harm reduction advocates are stressing the importance of administering life-saving breath after administering the overdose reversal drug Narcan, also known as naloxone. They also advise calling 911.
“We’ve been doing more community wound care and making sure people have fresh injection needles … and wound care supplies,” Davis said, explaining that xylazine also puts people at higher risk. for abscesses and other skin wounds.
According to MADDS, 28% of samples sold as fentanyl and heroin between January and June 15 in Massachusetts tested positive for xylazine. This compares to 31% of samples in 2021 and 13% in 2020.
The MADDS study also found that between January and June 15, xylazine was more often present in drugs sold as heroin or fentanyl in parts of western Massachusetts than in the eastern part of the state.
According to the study, which was published in July, samples for testing were provided by harm reduction programs such as Tapestry Health and police departments. Davis said Tapestry ships “drug litter,” or anything with visible residue, such as bags, pot or cotton used for injection.
“I don’t really know why it’s showing up,” Davis said, though they speculated “this is the next wave” in offenders who are used to “cutting” heroin, fentanyl or other drugs. “It’s not just in drug supply – we’re finding it in cocaine.”
Northampton Police Chief Jody Kasper wrote in an email that the department and its officers are aware of the presence of xylazine in the region. “We keep up to date with current trends in illegal substances so we can best respond to medications and for our own safety in the event of exposure,” Kasper wrote.
And while overdoses are also on the rise — in Greenfield, opioid-related overdoses doubled between 2020 and 2021, according to the Department of Public Health — Davis noted that the study doesn’t necessarily link it to xylazine.
Acting Greenfield Police Chief William Gordon said that while his officers have not encountered evidence of it in Greenfield, they are familiar with the substance and are trained to respond to suspected overdoses where xylazine can present life.
In hospitals, Dr. William Soares III, who specializes in emergency medicine at Baystate Health, said emergency rooms at Baystate Franklin Medical Center in Greenfield and Baystate Medical Center in Springfield are seeing more “atypical presentations” of suspected overdose patients.
“They’re sedated for a longer time, or when they have Narcan, they don’t fully wake up,” he explained.
Soares said hospitals do not have the ability to test for xylazine, as it is not included as part of standard urine or drug screens.
“This is true at the patient level. … Xylazine is a white powder,” he said. “There’s no way someone using drugs can tell by looking at it that it can be cut with xylazine.”
Like others, Soares stressed the importance of administering Narcan in suspected opioid overdoses. He said the drugs can be bought without a prescription at any pharmacy.
“Although naloxone does not reverse xylazine, it will reverse (the effects of) fentanyl or opioids,” he said. “That could be just the thing to restore their breathing and help keep them alive, and that’s even more important now.”
Reporter Mary Byrne can be reached at firstname.lastname@example.org or 413-930-4429. Twitter: @MaryEByrne.