While partly off the radar for many, the opioid crisis is still unfolding and continuing every day. There are concerns the battle is not being won because one drug or substance just replaces another, each one potentially more dangerous than the previous. Hearst Television’s National Investigative Unit is learning more about a substance, not considered an opioid, being mixed with fentanyl that’s creating a serious problem in the fight against opioids called xylazine. The U.S. Drug Enforcement Administration says the drug is being detected across the country and is making the drugs on the street “even deadlier.”The National Investigative Unit spoke with a harm reduction advocate, doctor and lawmaker about the chemical and is working to reveal what’s being done about the silent xylazine crisis.Sarah Laurel’s journeyOn a below-freezing January morning in Philadelphia, Sarah Laurel loaded up an RV with jackets, hand warmers, blankets, sleeping bags, snacks, wound care kits and even the opioid reversal drug Narcan. Laurel is the founder of Savage Sisters, a nonprofit organization focused on helping those with substance abuse disorder. Packing up her RV is something she and her team do multiple times a week.”Today, we are going to be doing street outreach in Kensington,” Laurel said as she prepared to leave. She then drove the RV 25 minutes northeast to a neighborhood of Philadelphia. Once in Kensington, she handed out supplies to those living on the street. Sarah knows the struggle; she once called the same streets her home. “I’m a person in long-term recovery,” she said. “I’ve experienced being assaulted and a lot of violence.”Now clean and dedicating her time to helping others, Sarah is witness to a new level of danger with street drugs. “Xylazine has entered our drug supply,” Laurel said. “It’s been dominating it.” What is xylazine? Xylazine is a veterinary drug used to sedate large animals. It’s approved by the U.S. Food and Drug Administration only for veterinary use, not human consumption. According to the U.S. Drug Enforcement Administration’s newest National Drug Threat Assessment, 49 states and Washington, D.C., have all reported seizures of xylazine, with Florida, Ohio and Pennsylvania having the highest numbers among the rest. The DEA says law enforcement mainly encounters xylazine in mixtures with fentanyl or other opioids, like heroin, but it has also been seen alone and in mixtures with cocaine and other illicit drugs. In an analysis of the samples that were tested in the report, Xylazine was found in 7.7% of the fentanyl pill samples in 2022 and 5.2% in 2023. Xylazine was found in 24.3% of the fentanyl powder samples in 2022 and 27.3% in 2023. In its newest numbers, the DEA found the substance in a little over one-third of fentanyl powder seized from drug traffickers in 2024.Cartels and traffickers mix xylazine with fentanyl because it’s cheap and easy to buy overseas. It also expands their drug supply and profit.Other substances have been used to ‘cut’ fentanyl before, but this one is different, taking hold faster and deeper.”People like having xylazine in their opioids because it extends the high,” Dr. Olivia Sugarman said. Sugarman is an assistant scientist in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. “It’s potentially associated with higher risk of overdose,” Sugarman said. There is a higher risk for many reasons, including that the overdose-reversing drugs like naloxone, also known by its brand name Narcan, are powerless against xylazine. Other risks include difficulty breathing, low blood pressure, slowed heart rate, and physical wounds. Large open sores that can lead to skin falling off and are prone to infection. In many cases, there are wounds that lead to amputation. Due to limitations, xylazine is also hard to track. The DEA says overdoses associated with xylazine may be more difficult to identify in clinical settings, as they often appear similar to opioid overdoses and may not be included in routine drug screening tests.What’s being done?In most of the U.S., it is legal to purchase and possess xylazine. Hearst’s National Investigative Unit and Television Data Team discovered that only 17 states have policies related to xylazine. The data came from a study published in April 2024 on legal policies and responses to xylazine, which Sugarman co-authored. Hearst Television’s Data Team cross-referenced the study with each state’s laws to update those that have passed and add any additional policies. The policies include those that regulate the use, testing or monitoring of the drug. Of those 17 states, 12 states have policies with penalties relating to xylazine, and eight of them have laws that schedule the drug. Scheduling a drug gives it a classification to then indicate its legality.All but two of the state’s policies were enacted since 2023. Florida established the drug as Schedule I, or having a high potential for abuse and no accepted medical use in treatment, in 2016. Massachusetts’ existing Controlled Substances Act has a Schedule VI category that includes all other prescription drugs not already scheduled.Methodology: Dr. Oliva Sugarman co-authored a study on legal policies and responses to xylazine, which was funded by Bloomberg Philanthropies. Hearst Television’s Data Journalism Team used this study and cross-referenced it with each state’s laws, updating those that have passed. “We need to come in and provide our law enforcement officers with the tools necessary to contain it and to track it,” Rep. Jimmy Panetta said.Panetta is a Congressman serving California’s 19th Congressional District and is working to shut down the xylazine pipeline. He recently proposed the “Combating Illicit Xylazine Act.” If passed, xylazine would become a Schedule III narcotic, a controlled substance.”When you schedule it in class three of the controlled substances act, basically that allows there to be penalties,” Panetta said. “If you’re caught using it for human purposes and selling it for human purposes, you’re going to have penalties of up to 10 years.””We are here to legislate and create laws that actually help people, help our communities, help people who make our communities better,” Panetta said.On the streets, Laurel is helping those in an overdose by administering overdose-reversing drugs and giving rescue breaths. Harm reduction experts and the Centers for Disease Control and Prevention say rescue breaths are helpful for those who have used xylazine. Laurel says rescue breathing helps prevent death by increasing blood and oxygen circulation in the body, keeping the brain and vital organs functioning during a xylazine-related overdose.Concern with legislationSugarman says that while she can’t speak to the effectiveness of policies, she does say more research is needed when addressing the drug supply as a whole.”It is a highly volatile, quickly evolving drug supply. We don’t know what’s in it. People who are using it don’t know what’s in it.” she says, “I think the research needs to move in a direction of how effective is scheduling for particular substances at achieving the public health outcomes we’re looking for?”In Pennsylvania, xylazine is already illegal, but it’s still on the streets. Laurel worries that legislative solutions could just create more problems, putting us further behind in the battle against addiction.”Any legislation prohibiting access to the supply incentivizes the criminal drug market to find more lethal, potent and dangerous unknown substances, which is what has happened,” Laurel said. “I don’t know that we can get ahead of the drug supply, but we can stay current with it.” Laurel said they’re already experiencing the reality that one deadly substance will just replace another. A new chemical called medetomidine is now showing up in street drugs in Kensington. It’s an animal tranquilizer that is more potent than xylazine, legal, and also is resistant to overdose-reversing drugs. This emergence highlights the continuous evolution of the opioid crisis. This story was shot and edited by our Hearst National Investigative Photojournalist Reid Bolton. 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While partly off the radar for many, the opioid crisis is still unfolding and continuing every day. There are concerns the battle is not being won because one drug or substance just replaces another, each one potentially more dangerous than the previous.
Hearst Television’s National Investigative Unit is learning more about a substance, not considered an opioid, being mixed with fentanyl that’s creating a serious problem in the fight against opioids called xylazine.
The U.S. Drug Enforcement Administration says the drug is being detected across the country and is making the drugs on the street “even deadlier.”
The National Investigative Unit spoke with a harm reduction advocate, doctor and lawmaker about the chemical and is working to reveal what’s being done about the silent xylazine crisis.
Sarah Laurel’s journey
On a below-freezing January morning in Philadelphia, Sarah Laurel loaded up an RV with jackets, hand warmers, blankets, sleeping bags, snacks, wound care kits and even the opioid reversal drug Narcan. Laurel is the founder of Savage Sisters, a nonprofit organization focused on helping those with substance abuse disorder. Packing up her RV is something she and her team do multiple times a week.
“Today, we are going to be doing street outreach in Kensington,” Laurel said as she prepared to leave.
She then drove the RV 25 minutes northeast to a neighborhood of Philadelphia. Once in Kensington, she handed out supplies to those living on the street.
Sarah knows the struggle; she once called the same streets her home.
“I’m a person in long-term recovery,” she said. “I’ve experienced being assaulted and a lot of violence.”
Now clean and dedicating her time to helping others, Sarah is witness to a new level of danger with street drugs.
“Xylazine has entered our drug supply,” Laurel said. “It’s been dominating it.”
What is xylazine?
Xylazine is a veterinary drug used to sedate large animals. It’s approved by the U.S. Food and Drug Administration only for veterinary use, not human consumption.
According to the U.S. Drug Enforcement Administration’s newest National Drug Threat Assessment, 49 states and Washington, D.C., have all reported seizures of xylazine, with Florida, Ohio and Pennsylvania having the highest numbers among the rest.
The DEA says law enforcement mainly encounters xylazine in mixtures with fentanyl or other opioids, like heroin, but it has also been seen alone and in mixtures with cocaine and other illicit drugs. In an analysis of the samples that were tested in the report, Xylazine was found in 7.7% of the fentanyl pill samples in 2022 and 5.2% in 2023. Xylazine was found in 24.3% of the fentanyl powder samples in 2022 and 27.3% in 2023. In its newest numbers, the DEA found the substance in a little over one-third of fentanyl powder seized from drug traffickers in 2024.
Cartels and traffickers mix xylazine with fentanyl because it’s cheap and easy to buy overseas. It also expands their drug supply and profit.
Other substances have been used to ‘cut’ fentanyl before, but this one is different, taking hold faster and deeper.
“People like having xylazine in their opioids because it extends the high,” Dr. Olivia Sugarman said.
Sugarman is an assistant scientist in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health.
“It’s potentially associated with higher risk of overdose,” Sugarman said.
There is a higher risk for many reasons, including that the overdose-reversing drugs like naloxone, also known by its brand name Narcan, are powerless against xylazine.
Other risks include difficulty breathing, low blood pressure, slowed heart rate, and physical wounds. Large open sores that can lead to skin falling off and are prone to infection. In many cases, there are wounds that lead to amputation.
Due to limitations, xylazine is also hard to track. The DEA says overdoses associated with xylazine may be more difficult to identify in clinical settings, as they often appear similar to opioid overdoses and may not be included in routine drug screening tests.
What’s being done?
In most of the U.S., it is legal to purchase and possess xylazine. Hearst’s National Investigative Unit and Television Data Team discovered that only 17 states have policies related to xylazine.
The data came from a study published in April 2024 on legal policies and responses to xylazine, which Sugarman co-authored. Hearst Television’s Data Team cross-referenced the study with each state’s laws to update those that have passed and add any additional policies. The policies include those that regulate the use, testing or monitoring of the drug. Of those 17 states, 12 states have policies with penalties relating to xylazine, and eight of them have laws that schedule the drug. Scheduling a drug gives it a classification to then indicate its legality.
All but two of the state’s policies were enacted since 2023. Florida established the drug as Schedule I, or having a high potential for abuse and no accepted medical use in treatment, in 2016. Massachusetts’ existing Controlled Substances Act has a Schedule VI category that includes all other prescription drugs not already scheduled.
Methodology: Dr. Oliva Sugarman co-authored a study on legal policies and responses to xylazine, which was funded by Bloomberg Philanthropies. Hearst Television’s Data Journalism Team used this study and cross-referenced it with each state’s laws, updating those that have passed.
“We need to come in and provide our law enforcement officers with the tools necessary to contain it and to track it,” Rep. Jimmy Panetta said.
Panetta is a Congressman serving California’s 19th Congressional District and is working to shut down the xylazine pipeline. He recently proposed the “Combating Illicit Xylazine Act.” If passed, xylazine would become a Schedule III narcotic, a controlled substance.
“When you schedule it in class three of the controlled substances act, basically that allows there to be penalties,” Panetta said. “If you’re caught using it for human purposes and selling it for human purposes, you’re going to have penalties of up to 10 years.”
“We are here to legislate and create laws that actually help people, help our communities, help people who make our communities better,” Panetta said.
On the streets, Laurel is helping those in an overdose by administering overdose-reversing drugs and giving rescue breaths. Harm reduction experts and the Centers for Disease Control and Prevention say rescue breaths are helpful for those who have used xylazine. Laurel says rescue breathing helps prevent death by increasing blood and oxygen circulation in the body, keeping the brain and vital organs functioning during a xylazine-related overdose.
Concern with legislation
Sugarman says that while she can’t speak to the effectiveness of policies, she does say more research is needed when addressing the drug supply as a whole.
“It is a highly volatile, quickly evolving drug supply. We don’t know what’s in it. People who are using it don’t know what’s in it.” she says, “I think the research needs to move in a direction of how effective is scheduling for particular substances at achieving the public health outcomes we’re looking for?”
In Pennsylvania, xylazine is already illegal, but it’s still on the streets. Laurel worries that legislative solutions could just create more problems, putting us further behind in the battle against addiction.
“Any legislation prohibiting access to the supply incentivizes the criminal drug market to find more lethal, potent and dangerous unknown substances, which is what has happened,” Laurel said. “I don’t know that we can get ahead of the drug supply, but we can stay current with it.”
Laurel said they’re already experiencing the reality that one deadly substance will just replace another. A new chemical called medetomidine is now showing up in street drugs in Kensington. It’s an animal tranquilizer that is more potent than xylazine, legal, and also is resistant to overdose-reversing drugs. This emergence highlights the continuous evolution of the opioid crisis.
This story was shot and edited by our Hearst National Investigative Photojournalist Reid Bolton.
