Responding to the Emerging Threat of Xylazine

A report led by Renee M. Johnson, PhD, MPH, professor in the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health, found that more than a quarter of individuals who died of an overdose in 2021 had traces of xylazine in their system, up from 17.1% in 2020. Xylazine, a veterinary tranquilizer that enhances and extends the effects of opioids, is not reversible with naloxone and is associated with severe skin and soft tissue infections. 

Xylazine use is increasing across the country. According to the Centers for Disease Control and Prevention, overdose deaths involving illicitly manufactured fentanyl and xylazine increased by 276% from January 2019 to June 2022. 

Using data on overdose deaths, the researchers also found that nearly all of the xylazine-positive decedents in Maryland had fentanyl as a cause of death, suggesting that xylazine is being consumed alongside fentanyl.

Working with faculty at the Bloomberg School, Johns Hopkins University, and experts from the Maryland Department of Health, Johnson helped establish a Maryland Xylazine Workgroup, now called the Emerging Drugs Workgroup. With support from the Bloomberg American Health Initiative, the workgroup monitored xylazine use in Maryland, engaged with additional community members and organizations, and assisted local harm reduction programs in developing educational materials and resources about xylazine for people who use drugs.

The workgroup continues to monitor xylazine trends and recently published a report sharing their findings. Along with the Workgroup, Johnson is now focused on disseminating findings and continuing to strengthen the public health response to xylazine.