A dangerous horse tranquilizer is being laced into U.S. street drugs

A MARTÍNEZ, HOST:

We turn now to the deadly mystery of who's lacing xylazine, a dangerous horse tranquilizer, into America's street drug supply. The chemical, often mixed with fentanyl, is turning up all over the country, devastating people with addiction. Jessica (ph) lives in New Castle, Del.

JESSICA: It just eats your skin away. And you just have a hole. And then it leaves a scar.

MARTÍNEZ: Thing is, experts say it's unclear how and why xylazine is spreading so fast. NPR addiction correspondent Brian Mann found this lack of information is part of a wider problem. Brian, how can it be that public health officials and law enforcement don't seem to know where xylazine is coming from?

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BRIAN MANN, BYLINE: Yeah, this really is remarkable, A. And it points to one of the dilemmas of America's addiction overdose epidemic. Everyone agrees that there's a public health crisis underway, 110,000 deaths last year. But from the start, the U.S. hasn't done the most basic thing you do during an epidemic, which is gather good data, you know, fast, accurate information. Intel on what drugs are on the streets, when it's gathered at all, tends to be siloed in law enforcement agencies and disseminated really slowly. I spoke about this with Nabarun Dasgupta, who runs a lab at the University of North Carolina that samples street drugs collected all over the U.S.

NABARUN DASGUPTA: We only find out about what's in the street drug supply when it's too late, when people are either dead or arrested.

MANN: And experts say this lack of information slowed the public health response when fentanyl began to spread. Now xylazine is spreading fast, and many communities still aren't even testing for the drug.

MARTÍNEZ: Why don't government agencies track street drugs and overdoses more accurately?

MANN: Yeah, the experts I've spoken to say this is a legacy of decades of public policy that leaned more toward the drug war, you know, police and law enforcement, rather than public health. Levi Wardell is in recovery from drug and alcohol addiction himself. And he works now as a funeral home director in Cheyenne, Wyo. And in that role, A, he helps families who've lost loved ones to drugs. And he says it's just crazy that officials don't track dangerous drugs and overdoses the way we track other public health threats.

LEVI WARDELL: Do you remember when COVID started happening? On the news, you saw the map. And you saw where places were getting red, where hotspots were. Why would that not be available for this?

MANN: The Biden administration has tried to improve drug data collection. But government officials acknowledge the system is still slow and primitive. Big national solutions like monitoring wastewater for illicit drugs or requiring law enforcement agencies to report new substances that they're detecting, those ideas just haven't gained traction.

MARTÍNEZ: So many people are dying. How are people on the front lines dealing with this lack of information?

MANN: Yeah, people are trying to get creative. Cities and some states are improving their local tracking and their information-sharing systems. And nonprofit groups are doing the best they can. I spoke about this with Sam Rivera, who's with OnPoint. It's a group that runs a harm reduction clinic in New York City.

SAM RIVERA: The way, you know, we have national harm reduction calls once a month or so. And we're always checking in with each other. What's there? What are you finding here? What are you finding there?

MANN: And people I talked to say this kind of communication is helping. But it's a far cry from the kind of real-time national public health data that experts say is needed.

MARTÍNEZ: If better information were available, how would it make a difference?

MANN: Yeah, experts I talked to, A, say that it would be a game changer. First, most basically, you could just warn the public when there are new drug dangers on the streets. Real-time data about overdose clusters could help focus first responder, EMT and harm reduction staffing. And then there's one more thing. You know, public health officials, A, say they expect new synthetic drugs, maybe even more deadly, to keep turning up on the streets. And without any kind of early warning system, the country is likely to get caught off guard again, as we were before with fentanyl and xylazine.

MARTÍNEZ: That's NPR addiction correspondent Brian Mann. Brian, thanks.

MANN: Thank you. Transcript provided by NPR, Copyright NPR.