Officials say there have been at least two cases of the horse tranquilizer xylazine popping up in New Mexico’s drug market — being found recently in the system of one person after they died and another seeking recovery.
Officials couldn’t say whether the person died from xylazine or from an overdose at all, but the individual also reportedly had fentanyl in their system.
Known on the streets as “tranq,” xylazine has saturated the fentanyl supply in Eastern states over the past several months — leading to bold headlines, law enforcement advisories and alarm bells from local leaders there.
Joshua Swatek, Department of Health harm reduction program manager, said cases of xylazine in New Mexico “appear to be pretty few and far between.”
“It hasn’t infiltrated the supply of substances, like it has in Philadelphia, where the majority of fentanyl has xylazine,” he said.
Those who work in New Mexico’s health care system, recovery centers and harm reduction outreach on the streets are still getting ready with education, supplies and programs, just in case.
Carlos Briano, a Drug Enforcement Administration spokesman, said the tranquilizer started popping up in New Mexico in recent months.
He said drug traffickers use xylazine as an adulterant, buying it at a low price and combining it with fentanyl and cocaine. Briano said the tranquilizer lasts longer than those drugs, making it more attractive to users.
The DEA found that in 2021 xylazine was detected in more than 2,600 overdose deaths across the Northeast and South. For the latter, it represented a staggering 1,127% spike from 2020.
Western states, according to the DEA, found the drug in 38 overdose deaths over that same period. However, the DEA found that xylazine was detected in 163 drug samples in 2021 across the west, a 112% increase over 2020.
Elsewhere, the picture hasn’t been pretty.
In Pennsylvania – one of several places where xylazine has been rampant and associated with horrifically-infected sores – Gov. Josh Shapiro took action to limit access to the drug, which is used widely by veterinarians.
The governors of Ohio and West Virginia have enacted similar measures.
‘It worries us’
Dr. Brandon Warrick, an associate professor in the Department of Emergency Medicine at the University of New Mexico Hospital, confirmed the one death involving fentanyl and xylazine.
He believes there have been, and will be, more.
“It’s here. It worries us. It’s something that we need to watch,” Warrick said.
How that plays out for New Mexico in the long run is unknown. But Warrick doesn’t see the tranquilizer as “the game changer that fentanyl has been” in making treatment difficult and killing hundreds while playing a hand in child abuse cases and drug-related homicides.
He said the UNMH Poison Center has had physicians calling in from across the state with suspicions of xylazine after a patient reported “something was off” in the drug they used.
Warrick compared xylazine and fentanyl — the drug it’s commonly found in — to Tylenol and Advil, which both relieve pain but in different ways. That means Narcan, used to reverse an opioid overdose, doesn’t work on xylazine.
He said another challenge is a lack of testing capabilities for the tranquilizer, as samples have to be sent to a reference lab and results take up to a month.
Some who work in recovery stocked up on xylazine tests.
Paul King-Miller, clinical director at Santa Fe Recovery Center, said they recorded their first positive xylazine test two weeks ago.
He said the person had been reportedly using fentanyl and went to the hospital before entering the facility’s detox. King-Miller said they now test everyone for the drug.
He said the idea of a new drug to tackle as a provider is “sad and frustrating.”
“On some level, all of us who are doing this know fentanyl came pretty quickly and it took over everything,” he said. “… It feels like, ‘Well, there’s just one more thing on the pile,’ and it’s like, ‘Don’t we have enough already?'”
Providers like King-Miller and Barry Ore, program director at Four Corners Detox Recovery Center, said one positive is that information on xylazine has moved quickly from state health officials to their programs.
Although Ore hasn’t recorded a positive test at his center in Gallup, they will be teaching clients about xylazine and how to avoid it.
“It is concerning that the drugs are getting stronger, and that there’s more dangerous cocktails out there,” Ore said. “On the other hand, that’s why we do this work. … These trends are going to get the deserved attention. We have to be proactive and stay ahead of the game.”
Preparation, not panic
Ashley Charzuk, founder of New Mexico Harm Reduction Collaborative, said she hasn’t seen xylazine use among those she helps on a regular basis, providing clean syringes, hygiene supplies or fentanyl test strips.
“It would be naive for us to think that it wasn’t here at all. Or that it’s not like right around the corner – we need to be prepared for it,” she said of xylazine.
Charzuk said she has heard rumors of certain types or batches of drugs having xylazine mixed in but nothing was ever confirmed.
She said her number one goal is letting people know the drug isn’t “going to be the apocalypse” and focusing on wound care. Xylazine users elsewhere have developed wounds that can become necrotic and Charzuk said the risk is heightened for the unhoused and those more exposed to the elements.
Swatek, with the Department of Health, said they will be installing a program for people to have their drugs tested at harm reduction sites statewide. He hopes it would be running by the end of summer.
In the meantime, Swatek is advising on the signs of a xylazine overdose and how to treat it. He said if someone is overdosing and Narcan gets them breathing but not conscious, it may be xylazine — or something else.
Swatek said, in such a case, call 911, monitor the person’s breathing and place them on their side in case they vomit. He said do not keep giving someone Narcan if they resume breathing, even if they are unconscious.
More than anything, he said, panic is not helpful.
“I think it’s good to remain calm and provide factual information to individuals about what’s in the substances and how to respond,” Swatek said. “We have to be real with people, we have to be real with the community. And part of that is not panicking and saying, ‘OK, this is the real risk.'”
