By Gordon Hopkins
New and potentially deadly drugs are increasingly being found in the United States’ supply of illicit street drugs.
When asked if they are prepared for when those drugs show up in the community, local law enforcement agencies responded that they are as prepared as they can be for such an eventuality.
Last year, the DEA (Drug Enforcement Agency) issued a warning about a new class of drugs: synthetic opioids called nitazenes.
In June of 2022, the DEA Washington Division brought local news outlets into their regional laboratory to see and discuss the drugs, which were seen emerge in the region.
Nitazenes, dubbed “Frankenstein” opioids because they are synthetic, are a group of compounds developed in the 1950s as opioid analgesics, but they were never approved to market. As such, they were not well known outside of academic research laboratories until recently.
Nitazenes are not approved for medical use anywhere in the world but are being manufactured for the illicit drug trade.
The DEA warns that nitazenes, which were never approved for medical use, are being sourced from China and being mixed into other drugs. The DEA says these synthetic opioids currently can only be properly identified after a lab test, so people don’t realize they’re buying them until it’s too late.
According to the National Center for Biotechnology Information (NCBI), “A characteristic of nitazenes is their high potency (e.g., hundreds to thousands fold more potent than morphine and other opioids and tenfold more potent than fentanyl). In the past few years, several nitazenes, including ‘designer analogs,’ have been detected in the illicit drug supply and have been implicated in overdose mortality, primarily due to their exceptionally high potency. In the street drug supply, nitazenes are often found mixed with fentanyl or other agents but their presence is not always disclosed to drug buyers, who may not even be familiar with nitazenes. These drugs pose a particular challenge since there is little experience in how to reverse a nitazene overdose or potential drug-drug or drug-alcohol interactions. Public health efforts are needed to better inform street drug consumers, first responders, healthcare professionals, and the general public about these ‘new old drugs’ that are infiltrating the recreational drug supply.”
While there have been no reports of nitazenes in Nebraska, another deadly drug has made its way to the Cornhusker state: Xylazine, better known by its street name, Tranq.
Xylazine is a powerful sedative and pain reliever that the U.S. Food and Drug Administration has approved for veterinary use. According to the DEA, “Xylazine is not safe for use in humans and may result in serious and life-threatening side effects that appear to be similar to those commonly associated with opioid use, making it difficult to distinguish opioid overdoses from Xylazine exposure.”
Tranq was reported in Omaha earlier this year. New street drugs usually hit metro areas first, before making their way to rural areas.
Tranq is also being mixed with other drugs, including cocaine, heroine and fentanyl.
“Xylazine is making the deadliest drug threat our country has ever faced, fentanyl, even deadlier,” said DEA Administrator Anne Milgram. “DEA has seized xylazine and fentanyl mixtures in 48 of 50 States. The DEA Laboratory System is reporting that in 2022 approximately 23% of fentanyl powder and 7% of fentanyl pills seized by the DEA contained xylazine.”
In addition to its lethality, xylazine has a number of other disturbing side-effects. Those who repeatedly use drugs containing xylazine can develop open wounds with dead tissue that, left untreated, may require limb amputation.
Is Local Law Enforcement Ready?
This far, these new drugs have not shown up in rural southeast Nebraska, though most law enforcement agencies acknowledge it is likely only a matter of time.
Jefferson County Sheriff Nick Georgi told FJN, “We have not had any cases or sightings of these drugs withing our communities that we have come across. The Nebraska DHHS (Department of health and Human Services) does an amazing job sending out advisories to use that the DEA issues in regards to these new drug trends.”
Sheriff Georgi said, “We do a great job to prepare our deputies with all these upcoming trends in case they do make an appearance in our community by educating them as much as we can.”
Gage County drug investigator Matthew Ernst said, “Up to this point, we have not seen alot of xylazine and fentanyl problems in Gage County. I am not aware of any xylazine cases and just a few fentanyl cases. I reached out to the NSP Crime Lab to see if they would provide me with any statistics, but they would not release that information. They just referred me to the DEA, which is not much help for understanding local trends.”
“I think the county is fairly well-prepared, but probably not as well as we could be,” said Ernst. “All officers and deputies carry latex gloves and we have transitioned away from mouth to mouth CPR to hands-only CPR, thus reducing the exposure to illegal drugs if they are present on an overdose victim’s lips or mouth.”
“Over the last few years, I believe we have improved each deputy’s awareness and recognition of drug intoxication but we are still lacking in better training for overdose death investigations,” Ernst noted. “But to a certain extent, there is not a lot we can do when people are putting these types of substances into their body. We can only be so well prepared.”
The biggest concern for law enforcement are the inevitable overdoses.
Naloxone, also known by the brand name, Narcan, is a medicine that rapidly reverses an opioid overdose. It can be given as a nasal spray or it can be injected into the muscle, under the skin, or into the veins. Ernst said, “Most, if not all, deputies carry Narcan and so does Beatrice Fire and Rescue.”
Unfortunately, Sheriff Georgi pointed out, “Unlike most fatal opioid overdoses Xylazine is not an opioid so it can not be reversed by Narcan, which our deputies carry on them. So getting medical treatment to anyone who is suffering from a overdose is very important and a top priority. Which in our case here in Jefferson County we have the benefit of a 24/7 ALS ambulance to help with early treatment. So I do think that we are prepared as a county but hope we don’t see these drugs appear in our communities.”
Although Naloxone is not effective against Xylazine, the DEA still recommends administering it to overdose cases because Xylazine is so often mixed with other drugs.
By Gordon Hopkins