As xylazine surges, some lawmakers are calling for prison sentences for dealers and people who use the drug • Daily Montanan

Lawmakers in some states are introducing bills to address increasing abuse of xylazine, a cheap animal tranquilizer not intended for human consumption.

Xylazine or “Tranq” can cause fainting and lesions that can sometimes lead to serious infections or amputations and even death. The opioid overdose reversal drug naloxone does not work on xylazine, which drug dealers often find through the dark web and other illegal channels rather than obtaining it from veterinary offices. Although xylazine is not classified as a controlled substance by the federal government, it is also not approved for human use.

Several states – including Indiana, New York, South Carolina, South Dakota, Virginia and Wisconsin – are considering bills. Legislation ranges from classifying xylazine as a controlled substance, to stricter penalties for possession and distribution, to legalizing test strips so people who want to use drugs can make sure they are not infected with xylazine.

Other states – Florida, Ohio, Pennsylvania and West Virginia – have already added xylazine to their lists of controlled substances, resulting in stricter controls on the storage and transportation of the drug for veterinary use.

The accessibility and affordability of xylazine, which can be purchased online from Chinese suppliers for $6 to $20 per kilogram, make it an attractive option for drug traffickers, according to the Federal Drug Enforcement Administration. Xylazine is often used as an adulterant to enhance the psychoactive effects of other drugs such as fentanyl. But many people who take such medications are unaware that xylazine has been added.

Public health experts and harm reduction advocates who work with people who use drugs to help them avoid the worst consequences warn that criminalizing xylazine or classifying it as a controlled substance will increase fear and stigma, associated with the drug only exacerbates and isolates the people who use it, discouraging them from seeking treatment.

“Planning for drugs and making things illegal has never had a significant impact … on the people who actually use drugs or on the amount of drugs that show up in the drug supply,” said Colin Miller, community liaison and social/clinical specialist Research at the University of North Carolina Street Drug Analysis Lab. “Xylazine is like the latest in a long line of these examples.”

Danielle German, an associate professor at the Johns Hopkins Bloomberg School of Public Health, agreed that increasing penalties will do more harm than good, “even if the legislature comes from a good place and wants to help.”

“This increased perception of punishment – we've seen time and time again that this keeps people from the resources that we most want them to have access to,” German said.

State action

Still, several states are taking a tougher approach.

In South Dakota, Republican Gov. Kristi Noem signed a law in February classifying xylazine as a controlled substance, with fines and penalties of up to two years in prison for the use, manufacture and distribution of the drug, while still allowing its use in veterinary medicine is.

A similar bill is pending in South Carolina, where manufacturing or distributing the drug for other than veterinary purposes would make it a felony and up to 10 years in prison. Virginia lawmakers are considering legislation with similar penalties.

In New York State, xylazine would be legally classified as one of the most dangerous controlled substances, which would result in harsher penalties for both possession and distribution.

In Indiana, a bill is moving through the legislature that could criminalize the possession and distribution of xylazine, potentially punishing it with prison time. It would impose higher penalties for repeat offenders. The bill exempts use and distribution for veterinary purposes.

“I fully support other harm reduction pathways, such as (the opioid overdose reversal drug) Narcan and testing strips,” said Republican Rep. Jennifer Meltzer of Indiana, the bill’s author. “I just think we have to take action against the bad actors too. … A criminal impact will hopefully deter people involved with xylazine, or perhaps even people who are just looking for xylazine, from getting the help they need.”

Another bill in Indiana would have legalized test strips for all controlled substances, including xylazine, but it failed in the Senate. Meltzer, one of the bill's co-authors, plans to work with the lead Democratic author of this bill to pass it during the next legislative session.

But in Wisconsin, a bill to legalize xylazine test strips is awaiting the governor's signature.

Distribution of xylazine

According to the DEA, xylazine was first detected in other drugs in Puerto Rico in the early 2000s. The drug is now common in every state, although available research suggests that overdose deaths caused by xylazine are concentrated primarily in the eastern United States, particularly the Northeast.

The University of North Carolina Street Drug Analysis Laboratory tests drug samples sent from more than 150 harm reduction and syringe exchange programs in 35 states and publicly releases those results. Between January 2021 and February 2024, the lab found xylazine in lab-confirmed fentanyl samples from 15 states. Some of the samples analyzed were sent to the lab because people suspected the presence of xylazine, Miller wrote in an email to Stateline.

The states with the highest number of fentanyl samples testing positive for xylazine are North Carolina (148); New York, 148; Michigan, 66; Pennsylvania, 38; and Washington, 20.

However, some harm reduction advocates and health experts argue that too much focus on xylazine could inadvertently lead to other, potentially stronger and more harmful drugs entering the illicit drug trade. They warn that states' actions to curb xylazine use repeat a strategy that has had limited success with substances like fentanyl.

“Because we were overly focused on fentanyl for so long, the criminal drug market responded with a deadlier and more potent substance that adulterated and then dominated the supply,” said Sarah Laurel, founder and executive director of Savage Sisters Recovery, a Philadelphia nonprofit that provides provides free services to people experiencing homelessness and drug use.

Philadelphia is one of the cities hardest hit by the rise in xylazine use. In 2022, the Philadelphia Department of Health found that xylazine was involved in 480, or more than a third, of the 1,413 unintentional overdose deaths. Almost every death in which xylazine was found also involved fentanyl, according to the agency.

“The same thing will happen if we refocus on xylazine. They will simply find a new substance that meets the demand,” Laurel said.

Instead, some advocates say states should focus more on expanding access to substance abuse treatment services and mobile drug-monitoring devices, such as mass spectrometers that can analyze ingredients in a drug mixture.

“You can't say you want people to stop using drugs, and every time I call for a detox bed, there's no bed,” said Alixe Dittmore, housing and emergency shelter development coordinator at the National Harm Reduction Coalition.

“We have incredibly punitive and prohibitive services,” Dittmore said. “You really have to look at it holistically if you're worried about how many people are going to die.”

This story was originally produced by Stateline, which is part of States Newsroom, a nonprofit news outlet that includes the Daily Montanan and is a 501c(3) public charity supported by grants and a coalition of donors.