The U.S. Drug Enforcement Administration issued an alert Monday warning of a “sharp increase in the trafficking of fentanyl mixed with xylazine,” which is also known as “tranq” or “tranq dope.”

Xylazine has flown under the radar of federal officials because of its status as a veterinary drug. Meaning, it is not a controlled substance and therefore not subject to review by federal authorities.

The United States Food and Drug Administration (FDA) originally approved xylazine in 1972 as a sedative and analgesic for use in veterinary medicine.

Xylazine is a non-opioid agent that’s been linked to a growing number of overdose deaths across the country. As a non-opioid, the drug poses a threat to humans in part because it does not respond to typical revival methods like Narcan.

Leigh Brooks, the medical director of the medically assisted treatment program at Bluestone Primary Care in Princeton, W.Va., has seen firsthand the effects that xylazine and other novel psychoactive substances (NPS) have had on people’s lives.

“I see a positive xylazine test, probably one or two a week and this has been since August of 2022,” Brooks said. “But we do know that some of the side effects that happens, like dry mouth, they get drowsy, at first, an increase in blood pressure and increase in heart rate, then heart rate, lowers blood sugar goes up, patients develop hypothermia, and then they go into respiratory distress. And also at the injection site, they can get necrotic tissue.”

Federal authorities are calling the emergence of fentanyl mixed with xylazine a public safety threat.

Joshua Schrecker is the Senior Director of Clinical Affairs at Aegis Sciences Corporation, a toxicology and medication monitoring laboratory that has been tracking the use of xylazine for years.

“We had the prescription opioid epidemic, and then it became the illicitly manufactured fentanyl epidemic,” Schrecker said. “And now we’re seeing adulteration of illicit opioids, traditional illicit substances, like cocaine, with sort of a hodgepodge, or mixing of drugs.”

The DEA reported 23 percent of fentanyl powder contained xylazine in 2022. Despite this alarming report and many others about the rise of xylazine, federal, state, and local law enforcement do not have the tools necessary to effectively monitor its spread or put prevention measures in place.

On Tuesday, federal lawmakers, including Sens. Shelley Moore Capito and Joe Manchin, introduced the “Combating Illicit Xylazine Act” to classify the drug as a controlled substance, among other measures.

The Combating Illicit Xylazine Act, if passed, would:

Classify its illicit use under Schedule III of the Controlled Substances Act.

Enable the DEA to track its manufacturing to ensure it is not diverted to the illicit market.

Require a report on the prevalence, risks, and recommendations to best regulate the illicit use of xylazine.

Ensuring all salts and isomers of xylazine are covered when restricting its illicit use.

Declaring xylazine an emerging drug threat.

Xylazine is essential in veterinary medicine with large animals. According to Sen. Manchin this legislation would not infringe upon the rights of veterinarians, farmers, cattlemen or ranchers. 

“In the last year, more than 106,000 Americans and 1,400 West Virginians died from drug related overdoses,” Manchin said. “It’s heartbreaking to lose so many of our fellow Americans and West Virginians to this devastating epidemic, and Congress must take meaningful action to address the crisis, which includes the surging threat of the highly dangerous xylazine drug. I’m proud to introduce this bipartisan, bicameral legislation to ensure our law enforcement agencies have the tools they need to monitor and control the spread of illicit xylazine, while ensuring its continued access for veterinary medicine.”