Food and Drug Administration issued an alert Healthcare workers were warned on Tuesday to be “wary” of animal dr*gs that have been illegally distributed and identified in the event of an overdose.

The drug, xylazine, has been approved by the FDA for use as an animal sedative and analgesic. It is not approved for human use and may cause “serious and life-threatening side effects that appear to be similar to those commonly associated with opioid use.”

In letter to stakeholdersThe FDA concluded that xylazine was most often found in combination with opioids such as fentanyl or h*roin, or sometimes together with stimulants such as methamphetamine or c*caine. The administration warned that people exposed to xylazine “may not be aware” that it is present in their drug supply.

The warning warned that it was “difficult to distinguish” an overdose of xylazine from an overdose of opioids, as some side effects, including respiratory depression, are similar.

Routine toxicology testing also fails to detect xylazine. Other side effects may include hypothermia, hypotension and “severe necrotizing skin ulcers” due to repeated exposure to xylazine via injection.

Despite similar side effects and presentation, xylazine affects the human body differently than opioids.

“Xylazine knocks (people) down in a really broad way,” said Claire Zagorski, paramedic and program director and harm reduction instructor at the Texas Opioid Training Initiative at the University of Texas at Austin. “It lowers brain activity, slows down heart rate, slows down breathing, but opioids have this particular aspect where they can really stop breathing. Xylazine doesn’t work the same way … We don’t see the kind of sudden fatal overdose we’ve seen with fentanyl.

The FDA said it was uncertain whether the side effects of xylazine exposure could be reversed with naloxone, a drug that could reverse opioid overdose, since xylazine is not an opioid.

“(An overdose of xylazine) is almost certainly not reversible with naloxone,” Zagórski said, adding that only one study suggests that naloxone works to reverse such an overdose. The science carried out on chicks in 1984.

Zagórski also warned that fentanyl test strips, which can check illegal substances for the presence of a strong opioid, do not work with xylazine. According to Jeffrey Bratberg, clinical professor at the University of Rhode Island College of Pharmacy, xylazine test strips are under development.

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