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Bill to Study Xylazine Passes House, Advances in Senate

— Measure does not address scheduling the drug, which is frequently added to fentanyl

Last Updated May 15, 2023
MedpageToday
A photo of Senator Chuck Schumer holding a photo of a bottle of xylazine.

WASHINGTON -- Congress appears to be close to passing a bill requiring the federal government to study the effects of xylazine -- a tranquilizer used in veterinary medicine and commonly known as "tranq" -- on the illicit drug supply.

The House passed the on Thursday by unanimous vote (425-0). A in the Senate sponsored by Sen. Ted Cruz (R-Texas) passed the Senate Science, Commerce, and Transportation Committee Wednesday by voice vote, and is now headed to the floor of the Senate for a full Senate vote.

The measure, sponsored in the House by Rep. Mike Collins (R-Ga.), has 25 cosponsors. It would require the National Institute of Standards and Technology (NIST) to support research related to identifying xylazine, novel synthetic opioids, and other emerging substances of concern.

Specifically, NIST must support basic measurement science and research on the drugs, including graduate and postgraduate research. The bill also reaches beyond the federal government to "convene the private sector, institutions of higher education, nonprofit organizations, federal laboratories, and other federal agencies engaged in the analysis of illicit drugs to develop coordinated strategies and voluntary best practices for the safe handling, transport, and analysis of illicit drugs containing xylazine, novel synthetic opioids, or other emerging substances of concern."

The bill also requires the NIST director to submit a report to the committee 1 year after the bill's enactment, to outline what has been done to implement it.

The congressional action comes a month after the Office of National Drug Control Policy (ONDCP) declared fentanyl adulterated with xylazine to be an "emerging drug threat" requiring immediate action -- the first such designation ever. The declaration requires that the administration develop a plan within 90 days to combat the threat; the ONDCP's plan includes more testing for the drug, more comprehensive data on its spread, and the development of health interventions including those for stabilization, withdrawal management, and addiction treatment.

Xylazine was approved by the FDA for veterinary use in 1932, "but it was never approved for human use," ONDCP director Rahul Gupta, MD, said on a phone call with reporters on April 12, the day of the declaration. "It's been increasingly found in [other] drugs, particularly in fentanyl. The DEA [Drug Enforcement Administration] reports that between 2020 and 2021, forensic identifications of xylazine rose in all four U.S. Census regions, most notably in the South by almost 200% and the West by over 100%. The DEA also reports that xylazine-positive overdose deaths increased more than 1,000% in the South, 750% in the West, and more than 500% in the Midwest, as well as more than 100% in the Northeast."

The bill does not address scheduling xylazine as a controlled substance, something that opioid policy expert Andrew Kolodny, MD, of Brandeis University in Waltham, Massachusetts, said is sorely needed.

Scheduling xylazine nationally will help because it will mean the DEA's scheduling regulations will be enforced for a drug that in its liquid form is currently being diverted from veterinary practices, he explained in a phone interview. "That means it would have to be tracked, and before [a distributor] could send a shipment, they would have to monitor for suspicious orders." If that had been done earlier, "when we started to see an uptick in orders, it could have been stopped."

Correction: This story has been updated to reflect that xylazine is a tranquilizer, not an opioid.

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    Joyce Frieden oversees MedPage Today’s Washington coverage, including stories about Congress, the White House, the Supreme Court, healthcare trade associations, and federal agencies. She has 35 years of experience covering health policy.