BENNINGTON — Results from the state Department of Health’s drug overdose report lay out a sad and sadly familiar litany: Overdose deaths rose in 2022, and fentanyl was involved in all but a few of those deaths, often in combination with heroin, cocaine, opioid prescription pills and other drugs.
But there are two more entries on the list of substances that killed Vermonters in 2022 — xylazine and gabapentin. They spell trouble, because they can amplify the effects of fentanyl, a powerful opioid painkiller. Even more troubling: Xylazine does not respond to naloxone (also known as Narcan), the drug used to reverse opioid overdoses.
Xylazine — an animal tranquillizer known by the street name “tranq dope” — was present in 68 of the state’s 237 overdose deaths last year, according to the report. Gabapentin, a prescription medication used to treat nerve pain, figured in another 31 of those deaths.
The National Institutes of Health describes xylazine as “a central nervous system depressant that can cause drowsiness and amnesia, and slow breathing, heart rate and blood pressure to dangerously low levels.” Gabapentin, meanwhile, is an anticonvulsant commonly prescribed to control seizures and nerve pain, such as that experienced with shingles.
Both substances are used to extend the euphoric effects of opioids, such as heroin and fentanyl, according to experts.
Margae Diamond, the executive director of Turning Point Recovery Center of Bennington, said the substance use recovery nonprofit has been expecting increasing use of both drugs.
Some users have taken to testing their drugs of choice for the presence of fentanyl, in an attempt to avoid overdosing; even small doses of fentanyl can kill. Xylazine test strips, however, only show that it’s present — not how much. Users don’t know exactly what they’re getting, even if they test it.
Xylazine also has a gruesome side effect — it causes persistent soft-tissue wounds that can become infected and lead to necrosis and amputation, earning it the nickname “zombie drug.” Turning Point is preparing for its arrival by including wound care supplies in the harm reduction kits it makes available.
A U.S. Drug Enforcement Agency alert earlier this month said that lab tests are turning up xylazine in 23 percent of fentanyl powder and 7 percent of fentanyl pills.
“It’s here,” Diamond said. “It’s coming through Albany and Springfield. It’s increasingly a big part of the supply, which is going to cause other issues. I feel like we’re bracing for another round and having to adapt what we do.”