A new street drug is showing up in more fatal Maine overdoses
Law enforcement and public health professionals are seeing evidence of a new street drug in Maine’s largest city, further compounding a deadly opioid epidemic that has raged across the state for years.
Xylazine, a non-opioid tranquilizer also known as “tranq,” is being increasingly mixed into illicit drugs like fentanyl and heroin. The drug was developed to sedate large mammals such as horses and cattle and is not approved for use in humans. In humans, it causes difficulty breathing, dangerously low blood pressure and a slow heart rate, according to the U.S. Centers for Disease Control and Prevention.
People who inject drugs containing xylazine can also develop severe wounds at the injection site, including necrosis — the rotting of human tissue — that may lead to amputation, according to the U.S. Department of Justice’s Drug Enforcement Administration.
The latest sinister street drug harming Mainers with substance use disorder could increase the state’s fatal overdose rate that has only risen in recent years, but a member of the Portland Police Department’s Behavioral Health Unit said expanding access to substance use and mental health care may be the key to breaking the cycle.
In an October 2022 report, the DEA stated people usually unknowingly inject or ingest xylazine when it’s mixed into other illicit drugs. Traffickers can buy the drug from foreign distributors or veterinary pharmaceutical companies, and this practice is happening more because xylazine is cheap and causes long-lasting psychoactive effects.
“Given how murky the [drug] supply is, by the time things get to Maine, no one knows what’s in it,” said William Burns of the Portland Police Department’s Behavioral Health Unit. “There’s very little actual heroin around these days.”
The DEA has seized xylazine and fentanyl mixtures in all but two U.S. states, and the administration’s laboratory system reported that about 23 percent of fentanyl powder and 7 percent of fentanyl pills seized by the DEA in 2022 contained xylazine.
Xylazine was first detected in Maine in 2021.
Xylazine is particularly dangerous because it’s not an opioid, which means it doesn’t respond to Narcan, a nasal spray that can reverse the effects of an overdose. The CDC, however, still recommends Narcan be administered in any suspected drug overdose. This is because xylazine is usually mixed with an opioid, like fentanyl, that will respond to Narcan.
Burns said he fears the mixture of xylazine and other drugs will shift over time until xylazine makes up the majority of the drug mixture rather than being an additive, as it is now. If this happens, Narcan likely won’t be able to save someone overdosing, and Maine will “absolutely see more fatalities,” he said.
Xylazine has been detected in 9 percent, or 25 of the 268 fatal overdoses in Maine so far in 2023, according to the state’s June overdose report. This marks an increase from the 6 percent of overdose deaths xylazine was involved in during all of 2022.
Portland’s overdose rate is up 23 percent over last year, with 311 overdoses so far this year, 31 of which were fatal, Burns said. The rate of fatal overdoses, however, has remained steady, and the vast majority of those fatalities were people who were using drugs alone.
“Because our officers are often first on the scene, our officers are using Narcan over once a week to respond to overdoses,” he said. “It has become a routine part of police work, which is crazy.”
During Gov. Janet Mill’s fifth annual Opioid Response Summit, she announced two initiatives added to her Opioid Response Plan, one of which provides $1 million to purchase and distribute xylazine test strips across the state.
Though xylazine is a new threat to Mainers who use drugs, Burns said there will always be new and increasingly harmful illicit street drugs. What the state needs to combat them all is expanded mental health care and substance use treatment facilities that address the root causes behind drug use.
“When one in eight people with an opioid addiction are able to get treatment, that tells us something,” he said. “I’ve driven people all the way to Wellspring in Bangor from Portland to get people into treatment. We wouldn’t stand for that if it was pediatric cancer or liver disease.”
In Bangor, police are responding to the new threat of xylazine with Narcan and referring people to medical care and social services, according to Sgt. Jason McAmbley of the Bangor Police Department. Officers can also refer people with substance use disorder seeking treatment to the state’s Overdose Prevention Through Intensive Outreach Naloxone and Safety program.
The Bangor department doesn’t document how many people are using xylazine, but McAmbey said it remains concerned about the sales of illegal drugs and local overdoses, regardless of what drugs are being distributed and used.
In Lewiston, police are most commonly seeing xylazine mixed with fentanyl and is never used on its own, said Matthew Cashman, an officer Lewiston Police Department and supervisor for Western Maine Drug Enforcement Agency.
Cashman didn’t have data on local overdoses and how many of those involved xylazine, as testing drugs, especially in a fatal overdose, is left to medical professionals, he said.