Pennsylvania has issued an order that temporarily schedules the veterinarian drug xylazine as a controlled substance to help protect human health while still allowing animal practitioners to use it.
Acting Secretary of Health Dr. Debra Bogen submitted a notice to temporarily add xylazine to the list of Schedule III drugs under Pennsylvania’s Controlled Substance, Drug, Device, and Cosmetic Act. The notice was published in the Pennsylvania Bulletin on Saturday, June 3.
This order – unlike an April 22 Notice of Intent filing in the same publication – includes a provision to exempt veterinarians and others who use it to treat large farm and zoo animals.
The lack of an exemption in the original draft had caught the attention of the veterinarian industry since a ban would have adversely affected their industry, according to Dr. William Croushore, secretary-treasurer of the Pennsylvania Veterinary Medical Association (PVMA).
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“We appreciate the Shapiro administration’s willingness to collaborate with the veterinary community to safeguard legal xylazine for use in animals,” said Croushore. “This action will preserve a critical veterinary sedative to the benefit of animals, especially livestock, and the farmers and veterinarians who treat these animals every day. Losing this critical medication would have been devastating for livestock farmers and veterinarians, and we are grateful for this solution that preserves legal access for veterinarians.”
In mid-April, Shapiro announced at a press conference in Philadelphia’s Kensington neighborhood, the epicenter of the city’s opioid crisis, that he was directing the state Department of Health to schedule xylazine as a Schedule III controlled substance.
Xylazine, which is also known as “Tranq,” is being used illegally as an addictive adulterant to illegal heroin and fentanyl, and the lethal combo has contributed to the rise in overdose deaths around the country – including hundreds in Philadelphia, according to published reports.
Bogen said in a DOH press release that the executive action will protect the veterinarian industry and other entities that possess the drug legally while providing penalties for those who abuse it.
“This action will protect veterinarians and other legitimate users and manufacturers of xylazine, which is an important medication for animal sedation, while also creating penalties for people who add illicit xylazine to the drug supply that is harming people in our communities,” said Dr. Bogen. “Our focus remains on developing strategies that help connect people with substance use disorder to treatment and other resources.”
Croushore had told LebTown in the May 24 article that the Shapiro administration had two choices to address the illegal use of xylazine. Either issue an executive order or pass a law that makes it a controlled substance. He told LebTown in an email dated June 4 that his organization is still committed to seeing a law passed given the temporary status of the order – which will expire on June 3, 2024.
“Since this is a temporary rule that will have to eventually be made permanent, yes, we would like to see legislation to make it permanent,” wrote Croushore, who practices veterinarian medicine in Somerset County. “We will be working soon to see that a bill is introduced in this session that will do the same thing as the temporary rule. I do not have a timeline other than that … Definitely would like it to be this session, though.”
The DOH press release said people often are exposed to xylazine, knowingly or unknowingly, in combination with other drugs, particularly illicit fentanyl. The release noted that xylazine is a growing issue across Pennsylvania.
In 2017, xylazine contributed to 90 overdose deaths, but in 2021, it contributed to 575 overdose deaths across 30 counties – an increase of over 600 percent in just five years. It’s also becoming increasingly prevalent in Philadelphia – in 2021, the City of Philadelphia reported that 90 percent of street opioid samples tested contained xylazine.
LebTown reported on May 24 that no deaths had occurred in Lebanon County involving xylazine as of early May, but it was noted by the executive director of the county’s commission on drug and alcohol that illegal substances in Philadelphia tend to trickle to other parts of the state. And the county is currently suffering through a surge in fatal overdoses driven by fentanyl. (Croushore told LebTown that xylazine had been detected in humans in his home county.)
Read More: Fentanyl is driving a surge in fatal overdoses in Lebanon County
Last year, the FDA warned that xylazine is not safe for use in humans. Xylazine use may result in skin ulcers and abscesses that drain pus, have decaying tissue and bacterial infections, and which can lead to amputation.
Even though xylazine is not an opioid, an opioid-reversal medication like naloxone should still be administered in instances where signs of an overdose are present because xylazine is most often mixed with an opioid like fentanyl. If xylazine was involved, the person might still appear sedated after their breathing has returned.
A spokesperson with the state’s district attorney’s association said in the DOH release that their organization is grateful that xylazine was being scheduled as a controlled substance.
“There is no legitimate human purpose for its use. Scheduling xylazine will allow law enforcement and prosecutors to investigate and hold drug traffickers seeking to sell it in our communities, often to unsuspecting users, accountable,” said Greg Rowe, spokesperson for the Pennsylvania District Attorneys’ Association.
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