5/6/2023 0 Comments Creature street![]() ![]() Soares said calling 911 is also critical, especially with xylazine, "because if the person does not wake up as expected, they're going to need more advanced care." "Profound sedation" worries health providers "If you see anyone who you suspect has an overdose, please give Narcan," said Bill Soares, an emergency room physician and the director of harm reduction services at Baystate Medical Center in Springfield, Massachusetts. Giving Narcan is still critical because xylazine is often mixed with fentanyl, and fentanyl is killing people. ![]() "We don't want to be focused on consciousness - we want to be focused on breathing," Davis said. It may help restart the lungs even if the person doesn't wake up. So Davis and others advise starting rescue breathing after giving the first dose of Narcan. With xylazine, the immediate goal is to make sure the person is getting oxygen into the brain. Squirting naloxone into someone's nose won't reverse a deep xylazine sedation - the rescuer won't see the dramatic wake-up that is more common when giving Narcan after an opioid overdose. They begin by explaining that xylazine is not an opioid. May said she has a strong tolerance for fentanyl, but a few months ago, she started getting something that didn't feel like fentanyl, something that "knocked me out before I could even put my stuff away." A shifting overdose responseĭavis and her colleagues are ramping up the safety messages: Never use alone, always start with a small dose and always carry Narcan.ĭavis is also changing the way they talk about drug overdoses. "It's scary to hear that there's something new going around that could be stronger maybe than what I've had," said May, a woman who stopped by Tapestry's van. Narcan is a brand name of naloxone, an opioid overdose reversal medication. "It correlates with the rise, and it correlates with Narcan not being effective to reverse xylazine," said Amy Davis, the assistant director for rural harm-reduction operations at Tapestry. In Greenfield, Tapestry Health is responding to more overdoses as more tests show the presence of xylazine. Tapestry Health's harm reduction team hands out items such as filters and pipes to people from its mobile unit. That record was broken again in 2021 with more than 107,000 deaths. In one study of 10 cities and states, xylazine was detected in fewer than 1% of overdose deaths in 2015, but in 6.7% in 2020, a year the U.S. ![]() Perhaps the biggest concern is an association with more overdoses and deaths. Whatever its path into the drug supply, the presence of xylazine is triggering warnings in Massachusetts and beyond for many reasons. Dealers also may be using this relatively inexpensive and easy-to-order sedative because of supply chain gaps with other drugs. It may be added to fentanyl or heroin to help extend the effects of an opioid high. There's a lot of speculation about how and why xylazine is on the rise. "Now the sad thing is we're really seeing it all over the state. "We've seen an exponential increase during the pandemic," said Traci Green, who oversees MADDS and directs the Opioid Policy Research Collaborative at Brandeis University. ![]() In Greenfield, that's a big change from last year, when xylazine wasn't a concern. Some areas of the state, including western Massachusetts, are seeing xylazine in 50% to 75% of samples. Data from January to mid-June shows that xylazine was in 28% of drug samples tested by the Massachusetts Drug Supply Data Stream (MADDS), a state-funded network of community drug-checking and advisory groups that uses mass spectrometers to let people know what's in bags or pills purchased on the street. Xylazine surged first in some areas of Puerto Rico and then in Philadelphia, where it was found in 91% of opioid samples last year, the most recent reporting period. Kyle's deep sleep might have been triggered by fentanyl too, but Kyle said one of his buddies used a test strip to check for the opioid and none was detected. (NPR and KHN are using first names in this story for people who use illegal drugs.) "Because if we cook it up and we smoke it, we're falling asleep after." "The past week, we've all been just racking our brains, like 'What is going on?'" he said. He and his friends regularly use cocaine, but lately, they had suspected that something else was in the bag. Kyle rocked backward on his heels at the mention of cocaine. This story was produced in partnership with Kaiser Health News. ![]()
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