Xylazine isn’t approved for humans, but is used to sedate horses (Photo by Getty Images)

Travis County officials held a press conference today alerting the community that five people have died since May from drug overdoses related to xylazine, which causes overdoses Narcan can’t reverse. In all cases, fentanyl was also present in the autopsy.

Xylazine, also known as tranq, is not an opiate like fentanyl, but a sedative. It was initially studied for treating high blood pressure, but never approved for human use, Travis County Chief Medical Examiner J. Keith Pinckard said. It is currently used by veterinarians as a tranquilizer for large animals like horses, and causes sedation, analgesia, euphoria, and physical dependence and withdrawal symptoms like the fentanyl and heroin it is commonly cut into as an adulterant. The White House Office of National Drug Control Policy declared xylazine an emerging threat in April of this year.

Crucially, overdose reversal drugs like naloxone, brand name Narcan, do not work on xylazine because it’s not an opioid. “In fact, there is not any available agent to reverse the effects of xylazine,” said Pinckard. Plus, “its duration is longer, so it’s thought to enhance the effect of the fentanyl and heroin that it is part of.” However, officials noted that it’s still important to use naloxone if you come upon someone you think is overdosing, and to administer CPR.

Fentanyl is already 50 times stronger than heroin, and has increased Travis County’s accidental overdose deaths more than tenfold between 2019-2022. Fentanyl went from being involved in 12% of drug deaths in 2019 to 59% in 2022, and in 2022, all accidental drug deaths in people 20 years old and younger involved fentanyl. The vast majority (92%) of overdose deaths involve multiple drugs, noted Pickard – the five that involved xylazine this summer included other recreational drugs like methamphetamine, cocaine, and mirtazapine.

“We’re here today to particularly speak to those in our community who are living with substance use disorder, and ask them to not use by themselves,” said Health Authority Dr. Desmar Walkes. She also urged people to get free Narcan from the N.I.C.E Project’s several vending machines around town, or by calling Integral Care or going to harm reduction community partner orgs like the Texas Harm Reduction Alliance. Commissioner Ann Howard urged parents, teachers, and coaches, “Now is the time to talk to your kids about your concern for their drug use.” Walkes noted that xylazine is not a federally defined controlled substance, which means it’s easily available: “We’re going to see much more profound overdose events, and they’re much harder to treat. I urge anybody who is watching to not use alone.”

Travis County Judge Andy Brown ended the presser calling on state leaders to fund medically assisted treatment programs and bring forth legalization of fentanyl and xylazine test strips in a special session. Last session, despite bipartisan support from Gov. Greg Abbott and other Republicans, the fentanyl test strip bill failed. Now, Sen. John Cornyn is proposing another version of the same legislation. (Though test strips are still considered a controlled substance in Texas, they can be ordered online.) As for getting people into treatment, aside from locally funded programs, Brown continued, “the people who are sitting on a ton of money right now that, frankly, don’t know what to do with it, is the state of Texas. They can make a real difference in this by funding more medically assisted treatment.”