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The addiction epidemic driven by fentanyl that has cost more than 100,000 American lives in each of the past two years is affecting communities of all kinds across the country in different ways.
But it is affecting every community.
A virulent new drug called “tranq” – the animal tranquilizer xylazine – which first sprang up in Puerto Rico in the 2000s, has taken over in places like Philadelphia, and, like other drugs, has been mixed with fentanyl.
Tranq often causes rotting open wounds on users and has led to the amputation of limbs. CNN’s Elle Reeve, Samantha Guff and Deborah Brunswick filed a report from Philadelphia.
Among the biggest problems with tranq is that the animal tranquilizer, which is often used on large animals like horses, is not counteracted by naloxone, also known as Narcan, which has been distributed in communities nationwide as the antidote to opioid overdoses.
Restricting xylazine and possibly making Narcan available over the counter
The US Food and Drug Administration acted last week to restrict the illegal importation of xylazine while attempting to keep it available for use in animals. Tranq is found in all 50 states.
The FDA commissioner also now has authority to put a nasal spray version of naloxone onto shelves in box stores, corner stores and everywhere in between.
Overdoses in schools, among students
In the communities outside Washington, DC, there have been a number of overdose deaths among high school students this year.
Public school officials in Montgomery County, Maryland, called a news conference in January to raise awareness after a 15-year-old girl was found dead of a suspected overdose by her mother.
The early February death of a student in Arlington, Virginia, after he overdosed in the school bathroom has school districts throughout the region on guard. In neighboring Fairfax County, Virginia, there were 30 nonfatal opioid overdoses in the first month of 2023, according to a dashboard maintained by the county.
Most of those nonfatal overdoses were among people over 18, but the county’s opioid task force coordinator, Ellen Volo, told local lawmakers last week that the appearance of opioids in local schools is cause for concern.
A school official told local lawmakers that Narcan has been administered twice so far in this school year.
Versions of this story around the country
In February, CNN reported on a couple arrested in Carrollton, Texas, after 10 juveniles overdosed and three died. Authorities said they traced a deluge of pills known as “M30s” from middle and high schools in the area to one house. M30s are counterfeit synthetic opioids pressed to look like prescription oxycodone.
Back in April, CNN reported on a University of California, Los Angeles study that argued US teens are actually using drugs less frequently, but the drugs are more dangerous.
“One of the big challenges with this increase in youth overdoses that we’re seeing is the scarcity of appropriate treatment options,” Volo testified in Virginia, adding that her office is focused on finding better treatment and abuse education options for adolescents.
When I talked to Emily Bentley, the opioid response coordinator in Alexandria, Virginia, she noted a trend: Overdoses in Alexandria have predominantly been in the region’s growing Hispanic community.
A real-time overdose tracker
Simply identifying a spike of overdoses as it is happening has become a major goal, said Jeff Beeson, the deputy director of the Washington/Baltimore High Intensity Drug Trafficking Area program, one of several dozen such offices set up throughout the country to coordinate community responses to illegal drugs overseen by the Office of National Drug Control Policy with help from the Drug Enforcement Administration.
Beeson’s office has also created ODMAP.org, a real-time overdose mapping application funded by the government to help public safety officials respond to the crisis.
Suburban and rural communities too
A backer of the ODMAP application is Lake Travis Fire Rescue Chief Robert Abbott, who told me there were five nonfatal overdoses in his community outside Austin, Texas, in a little more than 24 hours between Sunday and Monday.
“I can tell you this opioid crisis is present in every demographic that we represent,” Abbott said. “It’s in the affluent areas; it’s in the poorest and the middle-class areas. And it’s often with people who have no experience using narcotics.”
When I spoke with him, he was preparing to testify at the state capitol in Austin in support of a bill that would protect local officials from certain privacy law provisions and require first responders to enter certain information about overdoses into ODMAP.
ODMAP is meant to help local officials identify trends and locate hot spots. That helps first responders be ready and can help law enforcement move to contain the flow of drugs. Note: There is no public-facing version of the application, and privacy restrictions mean the data cannot be shared publicly.
“Maybe a small community or a small subdivision, where initially there have never been ODs, now we’re running four of them, let’s say over a couple of weeks,” Abbott said.
Where overdoses were spiking – at least late last year
It’s hard to believe data from the US Centers for Disease Control and Prevention actually showed a slight decrease in the number of overdose deaths last year. The number is still painfully and tragically high: In the 12-month period ending September 2022, the US government predicted 106,840 drug overdose deaths.
The epidemic is presenting itself in different ways across the country, and most overdoses are nonfatal. A CDC dashboard shows a substantial increase in a number of nonfatal overdoses in states stretching from Georgia up to Pennsylvania, along with a band of spikes in Mississippi, Tennessee and Kentucky and also Washington state.
Volo wants to know more about how a possible FDA decision to make Narcan available over the counter will affect things.
“The big question will be price,” she said in her testimony, noting that a single package of the antidote is $140 or more. “What do we do about that cost? That cost will be a barrier for some people.”