What is a central nervous system depressant that can cause drowsiness and amnesia, slow breathing, heart rate, and blood pressure to dangerous levels and is nicknamed “tranc”?
If you said Fentanyl, you would be…wrong! There is a relatively new player out there who is quickly becoming popular on the streets. Xylazine, a non-opioid veterinary tranquilizer, currently has the largest footprint in the Northeast.
From 2015 through 2020 the percentage of overdose deaths directly related to Xylazine went from 2% to 26% in the state of Pennsylvania and was involved in 19% of overdose deaths in Maryland in 2021. Most deaths linked to Xylazine involve additional substances such as cocaine, heroin, benzodiazepines, alcohol, gabapentin, methadone, and prescription opioids. Xylazine is added to heroin to delay the withdrawal symptoms and it is mixed with Fentanyl to lengthen the euphoric effect. Xylazine is NOT an opioid and therefore Narcan/Naloxone does nothing to reverse Xylazine’s effect on breathing. It is still recommended to use Narcan when someone is overdosing because as stated above, this drug is many times mixed with opioids. Xylazine is not a controlled substance and is not approved for human use.
The understanding of addiction has increased tremendously in the last decade. Experimentation, the first stage of addiction, is a voluntary use of drugs without any legal or social consequences and is often accepted and even encouraged. (Have you seen the videos and pictures of spring break!?)
Stage two, referred to as “Regular Use”, is many times the “fork in the road”. Some people can regularly engage in the use of drugs or alcohol that does not develop an addiction. The line between stage two and stage three, high-risk use is a very thin one and is typically defined by continued use of drugs or alcohol despite severe social or legal consequences.
This is the stage where justification occurs. Once one reaches this stage the jump to addiction is a very small one. This stage is the one where people lie, cheat, and steal to feed their habit. Without the drug or alcohol one will have physical symptoms. Nothing is more important than feeding the habit. There is a physical as well as a psychological dependence on the substance of choice.
Signs of Dependence
Physical dependence is when the body adapts to the substance and demands more quantity, or more frequency of it, to avoid physical or mental symptoms if the substance is withheld. This can occur with prescription medications, even if taken as directed. This is why good pain doctors vary the dose and quantity of drugs their patients require when addressing their physical complaints.
Almost all cases of physical dependence has a psychological aspect. Psychological dependence refers to cognitive and emotional aspects of addictive behaviors. Cognitive issues such as inability to concentrate, memory loss, problem-solving and questionable judgment start to manifest. Emotionally one may start to exhibit issues of anxiety, depression, irritability, and restlessness all dependent on if they are taking or not taking their drug of choice.
As hard as it may be at times we must remember people with addiction problems are still people.
As always thank you for making us your lab.