Alaska Health Department issues warning: Fentanyl mixed with xylazine is an emerging drug threat.

In the wake of a noted rise in overdoses in the Mat-Su and Anchorage, Alaska State Troopers issued a public safety warning on the dangers of fentanyl.

The dangers of fentanyl are well-known. In 2022, state health officials warned about it, reminding Alaskans that anything can be laced with fentanyl.

“It’s in everything,” said Jennifer Filley, an Epidemiology Specialist with the State of Alaska Office of Substance Misuse and Addiction Prevention (OSMAP).

Fentanyl is a manufactured opioid, 50-100 times stronger than morphine. Initially developed by pharmaceutical companies, Fentanyl was prescribed for pain management treatment of cancer patients and applied as a patch on the skin. The powerful opioid properties of Fentanyl are added to heroin to increase its potency or disguised as highly potent heroin. As little as 2 milligrams can be lethal.

Because Fentanyl is an opioid, it produces feelings of euphoria, relaxation, confusion, and drowsiness. It is cheaper and easier to obtain than heroin and is frequently used as a cutting agent (substance meant to dilute illegal drugs) or filler for heroin.

Overdose may result in stupor, cold and clammy skin, bluish tint to the skin, coma, and respiratory failure leading to death.

Fentanyl is cheaper and easier to manufacture, making it easy to obtain. It also has a huge profit margin compared with other illegal substances such as cocaine. It is mainly undetected, so users don’t realize they have taken it.

“People need to know that Fentanyl is everywhere-that everything should be thought of as having been contaminated with Fentanyl.” Said Mat-Su Opioid Task Force Chair Michael Carson, who likens Fentanyl to “opioid Roulette.”

Even Alaska Governor Michael Dunleavy has weighed in on fentanyl, saying last year, calling it a “scourge plaguing Alaska.” As previously reported, overdoses in Alaska have risen drastically from 2020-2021 by 71%

Then there is rainbow fentanyl, a particularly troubling form of fentanyl. A rainbow-colored version of the opioid seen in many forms including pills that might look like candy and be attractive to children, teens, and young adults.

And while steps have been taken to address the dangers of fentanyl and making it easier for citizens to get Narcan to help with overdoses, fentanyl is still impacting lives all over the Mat-Su.

Now, a new warning has been issued, alerting people to fentanyl laced with xylazine, an emerging drug threat in the United States.

Xylazine is a non-opioid veterinary tranquilizer not approved for human use that has been added to the illicit opioid supply to prolong drug effects. Known popularly as “tranq” or “tranq-dope.”

While not an opioid, xylazine can cause similar feelings of drowsiness. It also causes lethargy, apnea and death. The real danger is that it can depress breathing, blood pressure, heart rate and body temperature to critical levels. Additionally, xylazine can also exacerbate opioid withdrawal symptoms.

The use of xylazine can additionally result in severe skin wounds and patches of dead and rotting tissue that easily become infected. These wounds are at high risk for infection and typically require medical management.

Xylazine can also cause problems in withdrawal; this can include symptoms such as migraines, high blood pressure, severe anxiety, seizure and death.

Xylazine was first identified in the drug supply on the East Coast but has since spread nationwide, to varying degrees. Recent data from the U.S. Drug Enforcement Administration (DEA) reveals that xylazine identifications increased by 112% in the West and 193% in the South from 2020 – 2021. Approximately 23% of the powder and 7% of the pills the DEA has seized contained xylazine. Xylazine test strips’ accuracy is still being studied, so they are currently not widely distributed, and people who use substances may not be aware that they have been exposed to xylazine.

Because xylazine is a non-opioid, its effects will not be reversed by Narcan. But, because xylazine is so often mixed with opioids, naloxone should be administered in any suspected overdose. In xylazine-involved overdoses, lay responders and emergency personnel should be prepared to provide basic life support measures, along with their standard overdose response interventions.

The Department of Health (DOH) says there are several harm reduction practices can improve the care of patients who use xylazine and suffer an overdose:

Call 911 immediately, administer naloxone, if available, and administer CPR if the person is without a pulseless. If the person is inadequately breathing, administer rescue breaths, roll the person to their side to prevent choking, and wait with them until emergency medical personnel arrive.

Because xylazine can cause severe skin wounds resulting in infection. These wounds are at high risk for infection and typically require medical management. If wound care is needed, provide individuals with the materials they need to take care of their wounds, including individual saline, gauze, wraps, and ointment.

If someone who will be caring for their own wounds is unable to regularly access hand washing, provide gloves and hand sanitizer.

Clean wounds with soap and water, and avoid using alcohol or hydrogen peroxide. Cover wounds with non-adherent dressing, then covered by an absorbent dressing. Keep the wound skin around the wound clean and moisturized using Vitamin A & D ointment.

The DOH also reminds Alaskans that non-prescription drugs can be harmful, concentrated and deadly. One pill can kill, and Alaskans should not take any medication that was not prescribed to them.

Alaskans can obtain the live-saving opioid overdose reversal medication naloxone through Project HOPE. Project HOPE-affiliated organizations can be found at www.opioids.alaska.gov