What Should I Know about the Illegal Drug Supply?


Opioids

Opioids are commonly known as “painkillers”. They attach to opioid receptors in brain, which carry messages. The messages that the brain receives are changed, pain is no longer perceived as painful.

  • Opioids can relax the body and relieve symptoms of an illness, an injury, or a surgical procedure

  • Regular use can increase tolerance and dependence

  • After taking opioids repeatedly, the brain adapts to the drug and sensitivity is diminished. This makes it hard to feel pleasure from anything besides the drug

  • Common types:

    • Oxycontin

    • Morphine

    • Dilaudid

    • Percocet

Did you know?

  • About 75% of people in the U.S. who became addicted to street opioids like heroin during the 2000s report that their addiction began with prescription opioid use

  • In most parts of the United States, fentanyl and heroin are cheaper and easier to obtain than prescription opioids

  • Synthetic opioids, including fentanyl, are now the most common drugs involved in drug overdose deaths in the United States


Fentanyl

 

Fentanyl is a powerful synthetic (man-made) opioid that is similar to morphine but is

50 - 100 times more potent

Some quick statistics:

  • 75k+ people died from fentanyl & synthetic opioids in 2023

  • 7/10 fake prescription pills contained a potentially lethal dose of fentanyl

  • 360 million deadly doses of fentanyl were seized by the DEA in 2023

  • 52% of teens are unaware that fentanyl is being added to illicit drugs

Many illicit drug suppliers are now mixing fentanyl with their products. Why? It takes very little to produce a high with fentanyl, making it a cheaper option.

This is especially risky when people taking drugs don’t realize they might contain fentanyl as a cheap but dangerous additive.


Xylazine

Xylazine is increasingly being found in the US illegal drug supply. It is a veterinary (animal) tranquilizer, and not approved for use in humans.

  • Especially dangerous when combined with opioids like fentanyl, most frequently reported in combinations with two or more substances present

  • Its use as an adulterant may increase the profit for illicit drug traffickers, as its psychoactive effects allows them to reduce the amount of fentanyl or heroin used in a mixture

  • It may also attract customers looking for a longer high since xylazine is described as having many of the same effects for users as opioids, but with a longer-lasting effect than fentanyl alone

  • CT has the second highest overdose rates involving xylazine in the US

  • 10% of all overdoses in CT since 2022 have been xylazine related

  • Xylazine-related skin wounds can include:

    • Skin infections

    • Wounds below the skin (abscesses)

    • Open, weeping wounds (skin ulcers)

    Wounds can’t heal if a person continues to use substances and/or doesn’t receive appropriate medical care

Source: DEA


Medetomidine

Similar to xylazine, but considerably more potent, medetomidine is a synthetic alpha-2 adrenoreceptor agonist sedative used in veterinary medicine. It has been found in the illegal drug supply, starting in Philadelphia, since 2024.

  • Medetomidine is not approved for human use and understanding of its clinical effects is based on veterinary literature.

  • In the veterinary literature, the effects of medetomidine include sedation, analgesia, muscle relaxation and anxiolysis (i.e., anti-anxiety).

  • All tested samples that contained medetomidine also contained xylazine and fentanyl.

  • Symptoms include hypotension, bradycardia, and prolonged sedation that is not reversed by naloxone.

  • The duration of sedation provided by medetomidine lasts for 2-3 hours, but sedation can be prolonged with co-administration of opioids.

    Wound Care

    It is not clear if medetomidine causes wounds similar to those associated with xylazine use.

    Medetomidine has been shown to cause vasoconstriction in the veterinary literature, which may have implications for wound healing and wounds associated with drug use.

    Source: Philadelphia Department of Public Health - Health Alert - In Philadelphia, medetomidine, a potent non-opioid veterinary sedative, has been detected in the illicit drug supply. 5/13/2024