Tranq, an animal sedative, is spreading through the United States illicit drug supply and is thought to be responsible for the surge in overdose cases. The drug is now posing a new threat in the country's ongoing battle against drug overdoses.
Tranq is appearing more frequently in synthetic opioids, particularly fentanyl, causing deaths and severe side effects. Although most jurisdictions don't routinely test for tranq in postmortem toxicology, the DEA estimates the drug was involved in at least 1,423 overdose deaths in the south and 1,281 in the Northeast in 2021. And while the full nationwide scope of overdose death involving the drug is unknown, surveys show deaths associated with tranq have spread westward across the US.
Tranq, also known as Xylazine or tranq dope, is a sedative used to tranquilize large animals during procedures and diagnostic testing. Initially, the drug was given for household pets, but it's now typically used for large animals like elk, cattle, sheep, and horses. The Food and Drug Administration (FDA) approved the drug in 1960 for animal use, but not humans.
Despite this, the drug has become increasingly common in the US illicit drug supply. It is now sold on the streets, usually mixed with other drugs like heroin, cocaine, alcohol, benzodiazepines, methadone, and fentanyl. According to officials, drug dealers and suppliers lace these drugs with Xylazine because it's powerful, cheap, and easy to get. So, in most cases, those who buy these street drugs may be using tranq dope unknowingly.
Now, drugs like heroin and fentanyl are dangerous enough on their own, but Xylazine is making them even more dangerous. Tranq is a powerful sedative meant for animals and can leave users unconscious for hours.
It also causes more complex and potentially more deadly overdoses. And the worst part is users cannot easily detect its presence in the drug supply. Fentanyl test strips that reliably measure fentanyl in street drugs can’t detect tranq presence.
In legal sales, Xylazine is sold directly through pharmaceutical distributors and online platforms for vets. It comes in solid and liquid form or preloaded syringes, with concentrations that match the weight and size of the species. It is not classified as a controlled substance, but people need a valid prescription from a licensed veterinarian to purchase it.
Those without licenses can still obtain tranq in powder and liquid forms through other online sites. These sites often have no association with the veterinary profession and do not require buyers to prove legitimate needs.
According to the DEA, a kilogram of tranq powder can go for as low as USD 6 to USD 20. At this low price, using tranq to lace other drugs may increase profit margins for drug dealers. And the psychoactive effects may also attract buyers looking for prolonged euphoric effects.
The first cases of Xylazine misuse were reported in Puerto Rico in the early 2000s through DEA reporting and lab analysis. But it's unclear when tranq first appeared in the illicit drug market in Philadelphia. Still, public health officials say that the drug seems to be concentrated in Philadelphia, making it the ground zero for tranq dope in the US.
Its uptick in the city's drug market is primarily due to its ability to enhance the potency and duration of a fentanyl high. This has a substantial effect considering fentanyl ranked first ahead of heroin as the city's opioid of choice.
According to researchers, tranq is in 91% of the fentanyl and heroin supply in Philadelphia, and the prevalence is heading west. Reports have also shown that the state of Michigan had an 87% increase in Xylazine-related deaths between 2019 and 2020. Other affected states include Maryland, Delaware, New Jersey, and New York, all of which have seen an increase in drug overdose deaths in 2021.
Tranq is a central nervous system depressant, so it slows down the process in the body's nerve cells. It causes drowsiness and lowers blood pressure, slows the heart rate and breathing to dangerously low levels. Mixing Xylazine and opioids like fentanyl can induce hours of sleep, making it harder to determine whether the user is experiencing an overdose. The risk of life-threatening overdose is also higher when tranq is mixed with other CNS depressants like benzodiazepines or alcohol.
Besides, tranq is highly addictive and can cause physical and psychological dependence. Regular use of the drug can lead to open wounds and skin ulcers. These wounds may result in dead tissue or necrosis and, eventually, amputation of affected limbs.
That's why it's essential for anyone using tranq to seek help before the addiction worsens. Medical experts provide wound care and emergency services to counter the effects of tranq use.
According to experts, tranq is unsafe for humans, and even a small amount can be deadly. Humans are 10-20 times more sensitive to the drug than animals. And as mentioned earlier, tranq is not an opioid and therefore does not respond to naloxone.
Those who overdose on the drug may need breathing assistance in addition to naloxone. Naloxone is given because Xylazine is often mixed with opioids like fentanyl or heroin.
Tranq use can range from mild to severe and cause fatal and non-fatal overdoses. The following are some of the signs and symptoms of Xylazine use:
Tranq addiction presents a different form of challenge to medical professionals. Experts have raised concerns about the limited treatment for tranquilizer withdrawal for those who want to quit using the drug. According to the experts, some medical examiners have no idea what to look for or what to do if they recognize tranq withdrawal.
They may start to treat opioid withdrawal, but other unpleasant symptoms like agitation, anxiety, restlessness, and sweating start to show. Currently, there aren't any FDA-approved treatments specifically for tranq withdrawal, but there are protocols in development to help ease patients' symptoms.
In response to the influx of tranq overdoses, many government and health agencies are taking action. Local health departments are offering public education programs to help people understand the dangers of using tranq. They advocate for the safe and proper disposal of the drug and harm reduction efforts such as needle-exchange programs.
Medical examiners are also working to increase their understanding of tranq overdose to better recognize and respond to its signs and symptoms. Furthermore, The US House of Representatives is looking into ways to schedule the animal tranquilizer. However, this may hinder efforts to study the drug's effects and find a solution to help patients who are overdosing.
Ketamine is an anesthetic drug that affects the central nervous system by antagonizing the n-methyl-d-aspartate (NMDA) receptor. Like most dissociative anesthetics, ketamine has a high potential for abuse.
Ketamine has hallucinogenic effects. It changes your perception of sounds and sights, makes you feel detached, and makes you feel like you aren’t in control.
Ketamine is FDA-approved for use as a pain reliever for chronic pain and anesthetic. Unfortunately, it is often abused.
Although ketamine has a long-standing reputation as a recreational drug, its FDA-approved version has become popular in its role as an anti-depressant. Additionally, studies have shown its effectiveness in reducing drug and alcohol abuse.
This article discusses ketamine therapy and its benefits under supervised care.
Clinical trials focusing on alcohol and cocaine addiction revealed that patients who were prescribed therapy and ketamine had better results than those who went for therapy minus ketamine treatment.
Patients addicted to cocaine received doses of IV ketamine for five days. Additionally, they went through a 5-week mindfulness relapse prevention therapy. On the other hand, patients struggling with alcohol addiction received a dose of ketamine on their second week of 5-week motivational enhancement therapy sessions.
At the end of the trial, researchers concluded that ketamine treatment played a role in preventing relapse. Researchers argued that ketamine treatment alters how patients’ brains deal with cravings. Additionally, they argued that ketamine motivates individuals to stop abusing drugs and control their behavioral interactions. Ketamine treatment may also improve the outcome of behavioral therapy.
The clinical trials discussed above are not conclusive. There is a need for extensive research on the role of ketamine in addiction treatment.
Note that the use of ketamine in addiction treatment should be under the strict supervision of medical practitioners in clinical settings. Patients should only receive doses of ketamine as and when prescribed by their doctors to avert ketamine abuse.
Medical practitioners can use ketamine to treat depression. Additionally, it can be used as an antidote for suicidal thoughts.
Most treatments for suicidal thoughts, including anti-depressants, talk therapy, electroconvulsive therapy (ECT), and transcranial magnetic stimulation (TMS), take several weeks to be effective. Sometimes, you may have to try multiple treatment options at once to gain relief.
Using ketamine for depression has proved effective. The doses that medical practitioners prescribe in treatment for depression are small.
It is still unclear how ketamine works. However, researchers suggest that it targets NMDA receptors in the brain, binds to the receptors, and consequently increases the amount of glutamate, a neurotransmitter, between the neurons.
The glutamate triggers connections in the AMPA receptors resulting in the release of molecules that allow neurons to communicate across new pathways. This process is called synaptogenesis. Synaptogenesis alters your cognition, mood, and thought patterns, making you less depressed.
Ketamine may also treat symptoms of depression by reducing the signals that take part in inflammation. These signals are often linked to mood disorders. Therefore, ketamine may prevent mood swings by reducing the signals.
Ketamine comes in various forms, including white powder. The FDA-approved form for depression medication is a nasal spray known as esketamine/ Spravato.
Doctors prescribe esketamine to adults who have a major depressive disorder, treatment-resistant depression, or are suicidal.
Patients with treatment-resistant depression get the nasal spray twice weekly for the first four weeks, then once a week from the fifth to the ninth week. If they still need the nasal spray after the ninth week, they will get it once every two weeks.
The other forms of ketamine that are not approved by the FDA include; tablets, IV infusion, or a shot in the arm. IV infusions are done explicitly by doctors. Some doctors may prescribe pills for use at home. However, it is not recommended since ketamine has a high potential for abuse.
The process of IV infusion takes place for approximately 30 minutes. Immediately after the drip ends, you will have the dissociative experience for about 20 minutes. Your doctor will be present during the entire process. The dissociative experience wears off after 20 minutes.
Research shows that most patients appear to be asleep during IV infusion. They neither talk, nor move. Most doctors prefer not to interfere unless the patient specifically asks for something or asks where they are.
After ketamine treatment, patients need to undergo talk therapy. Talk therapy is an essential part of depression treatment. During talk therapy, medical practitioners equip you with the relevant skills to handle your depression. It is practical and empowering for most patients. For those with mild depression, talk therapy may be sufficient.
All drugs have side effects. However, the benefits you will get from using ketamine for depression outweigh the side effects you will experience.
Here are some side effects that you may experience after ketamine infusions:
Usually, dissociation and perception disturbances are noticeable when you get the first infusion but fade away afterward.
Long-term use of ketamine may have additional side effects. Scientists are still researching the issues surrounding ketamine abuse.
The main problem regarding ketamine therapy is addiction. Ketamine shows a lot of promise in treating mental health conditions and addiction. However, ketamine is a highly addictive narcotic, and addicts can still get high off it.
There is a possibility that patients who undergo ketamine therapy may become dependent on it. Long-term use of ketamine may have long-term effects. Patients may develop tolerance or unidentified side effects.
Another concern is the risk of cross-addiction. Cross addiction refers to instances when an addict develops a second addiction, in this case, ketamine addiction.
There is a need for more studies on ketamine treatment to realize its benefits in addiction and depression treatment.
If you are struggling with an addiction, check out treatment addiction programs that you can enroll in. You can also check our blog for resources on addiction and mental health issues.