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THE RISK REPORT BY IAN BREMMER
Good
working
relation-
ships with
China and
the U.S. are
critical
HEALTH
A NEW DRUG
EPIDEMIC
There’s a new drug beginning
to spread rapidly through
the street drug supply in the
U.S.: xylazine, an animal
tranquilizer, increasingly used
as a synthetic cutting agent for
opioids like heroin. We recently
published a study, based on
years of research, which found
that xylazine is popping up in
cities all over the country.
Xylazine is almost never
seen by itself. Instead, it is
typically added to drug formula-
tions containing fentanyl, a fam-
ily of powerful opioids made
in underground labs. Over the
past 10 years, synthetically pro-
duced fentanyl—a particularly
addictive drug—has largely
taken over the illicit opioid mar-
ket. Combined with poor quality
controls inherent to clandestine
supply chains, this has ushered
in the deadliest overdose
crisis in recorded history. The
U.S. now has an overdose
death rate more than double
the second highest country
(Estonia) and nearly 20 times
the global average. Consumers
are drawn to fentanyl for its
powerful psychoactive effects.
But fentanyl is very short-
acting, and keeping cravings at
bay can require injecting up to
fi ve or six times per day, rather
than perhaps just two or three
if using heroin. This is where
xylazine comes in: it extends
the effect of fentanyl––or, as
this is often put on the street,
“it gives it legs.” Adding xylazine
to a hit can postpone cravings
and withdrawal symptoms for
twice as long as fentanyl alone.
Its risks are substantial.
As xylazine and other
synthetics spread nationally,
we must use evidence-based
strategies like harm reduction
to counter the most lethal drug
crisis in recorded history.
—Joseph Friedman,
M.D./ Ph.D. candidate at UCLA,
and Philippe Bourgois,
professor at UCLA
