Biotech company BTNX reported shipping out xylazine test strips at the end of March, and Cabell County health officials said while it could take time to get the test strips, they are working on educating those at risk of exposure to the dangers.
Xylazine, an animal sedative approved by the U.S. Food and Drug Administration for veterinary use, has been reported being mixed with the opioid drug fentanyl. The U.S. Drug Enforcement Administration released a public alert in March citing a “sharp increase” in trafficked fentanyl containing xylazine.
In the alert, DEA Administrator Anne Milgram said the DEA Laboratory System reported “in 2022 approximately 23% of fentanyl powder and 7% of fentanyl pills seized by the DEA contained xylazine.”
Cabell-Huntington Health Department CEO and Health Officer Dr. Michael Kilkenny said the health department is aware of xylazine in the community, and toxicology reports from the West Virginia Chief Medical Examiner’s Office showed xylazine detected in some overdose deaths as early as 2020.
“We don’t know the extent of it’s contamination or inclusion in the drug supply in this area because this area is not primarily supplied by the same illicit markets that are supplying Philadelphia and Baltimore and the areas where this is higher, but we do know that it’s spreading from the Northeast westward and we are aware that there is clear evidence that it has been and is in our area,” Kilkenny said.
Kilkenny said the health department also knows xylazine is in the area by talking with individuals who are injection drug users and also use the department’s Harm Reduction Program. Kilkenny said very few people have reported knowing xylazine is or could be in their substances, and department staff are working to raise awareness of the dangers caused by xylazine.
Because they are so new to the market, Kilkenny said the Cabell-Huntington Health Department does not have the xylazine test strips now, but it will explore options to purchase the strips. Expected to cost about $2 per test strip, the department will explore grant opportunities and other funding sources to get the test strips in the future.
While $2 may seem cheap, Kilkenny said the cost of strips to allow injection drug users in Huntington and Cabell County to test frequently would be significant.
“To adequately distribute test strips across what is actually a pretty large population of injection drug users so that they can test frequently the supply of drug that they’re getting, that’s a very expensive preposition,” he said. “Safety and saved lives are worth those kinds of intervention, but there are limits to what we can do and the timing of when we can do it.”
Xylazine injection can lead to severe wounds, including necrosis, or rotting human tissue, and because it is not an opioid, the opioid effect reversing medicine naloxone is not effective.
Despite not working for xylazine, Kilkenny said the health department is working with local health care providers to encourage them to still naloxone for overdoses to reverse opioid effects and educate staff on dealing with the complications of injecting xylazine.
“So (naloxone) is still very useful in an overdose but the person may require a longer respiratory support and other emergency response, so we’re making sure that our emergency responders and our clinicians are aware of the drug,” he said. “We’re making sure that our surgeons and other clinicians are aware of the drug in the area and in regards to wound care, to keep abreast of the most recent developments in taking care of it.”
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