The Office of National Drug Control Policy (ONDCP) released the Fentanyl Adulterated or Associated with Xylazine Response Plan. The non-opioid drug xylazine is an FDA approved sedative and analgesic used in animals, but is not approved for use in humans. However, it is being widely used by people in combination with fentanyl illicitly and is responsible for dire health consequences including fatal overdoses. Because xylazine is not an opioid, the opioid reversal agent, naloxone, is ineffective in treating the overdose of those using fentanyl adulterated with xylazine. ONDCP has therefore declared this drug combination to be an emerging drug threat.

The designation of this emerging threat was made under the authority of the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act of 2018. This act requires the Executive Branch to take action, including drafting this response plan. This plan includes evidence-based prevention, treatment, and supply reduction action steps, establishes goals and performance measures informed by comprehensive data, and describes critically important and urgent next action steps. The response plan concludes with a table of roles assigned to various federal department-level leadership. These roles include Testing; Epidemiology and Comprehensive Data; Evidence-based Prevention, Harm Reduction, and Treatment Implementation and Capacity Building; Source and Supply Information and Intelligence; and Supply Reduction Actions; Regulatory Control and Other Regulatory Options; Basic and Applied Research; and Oversight and Coordination.

For more information, check out HSDL’s In Focus topic on Fentanyl and Opioids.