A National Action Plan for ‘Tranq’

Response focuses on testing, tracking, treatment, and other harm-reduction strategies

July 11, 2023

The federal government today released a national response plan to combat the rise of illicit fentanyl spiked with the animal tranquilizer xylazine.

The release of the plan today follows an earlier declaration of the sedative, also known as “Tranq,” as an emerging drug threat due to a significant rise in overdoses and severe injuries.

“This will be an all-hands-on-deck effort―but I am confident we can take action together and eradicate this emerging threat,” Dr. Rahul Gupta, the director of the Office of National Drug Control Policy, said in a statement.

Here’s what you need to know:

• A growing threat:  The U.S. Drug Enforcement Administration reports Xylazine overdose deaths are increasing across the U.S., especially in the south and the west regions of the country.
  • Xylazine-positive overdose deaths increased 1,127 percent in the south and more than 100 percent in all other regions during 2021, the DEA reported.
• Plan goal:  The plans seeks to end the threat of fentanyl combined with xylazine. The initial goal is to reduce xylazine-positive drug deaths by 15 percent in at least three of four U.S. census regions by 2025.
• Health concerns:  Xylazine is associated with “significant and rapidly worsening negative health consequences,” including fatal overdoses and deep flesh wounds.
• Key action pillars:  The plan’s key elements including testing, data collection, evidence-based prevention, harm reduction, treatment, supply reduction, scheduling, and research.
• Quotable:  “There is an urgent need to determine the source of xylazine and how to reduce the illicit supply; to develop evidence-based testing and overdose response protocols; and to determine how to treat those who have become dependent on the dangerous fentanyl and xylazine combination,” Dr. Gupta said in a statement.

Health care providers should be on alert for signs and symptoms of patient exposure to fentanyl with xylazine and to provide effective care for overdose and wounds. They also should be mindful to start care for opioid use disorder treatment, the action plan notes.

The national response plan and fact sheet are available to review online.