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FACTSHEET: In the ongoing battle against the overdose epidemic, the White House publishes a national response plan to address the emerging threat of fentanyl in combination with xylazine

Earlier this year, the Biden-Harris administration first used executive power to designate xylazine in combination with fentanyl as an emerging threat to the United States

In the ongoing effort to combat the dangerous and deadly combination of xylazine mixed with fentanyl, the White House Office of National Drug Control Policy (ONDCP) today released a national response plan to promote a government-wide response to this threat. to coordinate. Earlier this spring, ONDCP director Dr. Gupta an executive designation authority to designate fentanyl in combination with xylazine as an emerging threat to the United States and to proactively address this dangerous threat.

“Since announcing the emerging drug threat earlier this year, we have worked tirelessly to create the best plan of attack to tackle this dangerous and deadly substance head-on,” said Dr Gupta. “Now, with this National Response Plan, we are launching coordinated government-wide efforts to ensure we use every lever we have to protect public health and safety and save lives. As a physician, I have seen first hand the devastating effects of xylazine in combination with fentanyl. And as drug policy adviser to President Biden, I am focused on finding every resource we have and following best evidence-based practices to meet this new challenge. This will be an all-hands-on-deck effort, but I am confident that together we can take action and eradicate this emerging threat.”

Xylazine has been found in almost every state of the country. The Biden-Harris administration made this designation for the first time in U.S. history because of xylazine’s growing role in overdose deaths across the country, and since the designation data from the Centers for Disease Control and Prevention (CDC) continues to show an increase in xylazine-related overdose deaths. In a new report released last month, the monthly percentage of illicitly manufactured fentanyl deaths with xylazine detected increased by 276% (from 2.9% to 10.9%) between January 2019 and June 2022.

A unique national response plan outlines action steps the federal government will take to address this threat, protect public health and safety, and save lives. This includes both short-term and longer-term action steps to provide immediate relief to communities across the country and support the large-scale efforts needed to eradicate this threat.

The plan released today focuses on six pillars of action:

1. Testing

2. Data Collection

3. Evidence-based prevention, harm reduction and treatment

4. Reduction of the offer

5. Scheduling

6. Research

The plan outlines action steps and key responsibilities for departments and agencies within the federal government, directing them to prepare and submit an implementation report to the White House within 60 days. As required by law in the SUPPORT Act and the Criteria for Designating Evolving and Emerging Drug Threats (Dir. No. 2022-002), the goal of the National Response Plan is to eliminate fentanyl in combination with xylazine as an emerging threat. This requires a 15% reduction (compared to 2022 as the base year) of xylazine-positive drug poisoning deaths in at least three of the four U.S. census regions by 2025.

The Biden-Harris administration has stepped up national response efforts in recent months, including the following actions taken by government agencies. In December, Dr. Gupta provided a listening session with public health and public safety leaders and subject matter experts from several states and territories about trends they see related to xylazine and efforts to address those trends. In January, Dr. Gupta convened the Evolving and Emerging Threats Committee to discuss the rise of xylazine-added fentanyl in the illicit drug supply. In February, the US Food and Drug Administration took action to restrict the illegal importation of xylazine active pharmaceutical ingredients and finished dosage form drugs into the country to address growing public health concerns. In March, the US Drug Enforcement Administration issued a public safety alert to warn the American public about a surge in the trade of fentanyl mixed with xylazine.

Since its designation on April 12, ONDCP has convened federal government departments and agencies to develop and implement the National Response Plan. ONDCP has also met with state and local leaders and subject matter experts, including Drug Free Community beneficiaries, High Intensity Drug Trafficking Areas (HIDTA) beneficiaries, Association of State and Territorial Health Officials, the American Veterinary Medical Association, States Attorneys General, law enforcement leaders, primary care and first responders, individuals with lived experience and more. The National Institute on Drug Abuse (NIDA) also convened healthcare professionals and federal partners to review currently available best practices in xylazine-related testing, treatment and wound care to inform evolving best practices in the field .

While this plan outlines action steps that the federal government will pursue to address the emerging threat, the entire society will have to step up to save lives. The National Response Plan also lists practical steps states and individuals can take to address this problem:

Healthcare providers are encouraged to be alert to signs and symptoms of patient exposure to fentanyl adulterated with xylazine and to provide effective care for overdose and wounds, and to initiate or transfer care to opioid use treatment services wherever these patients are found .

State, county and city health authorities are being encouraged to proactively seek out those believed to be consuming fentanyl adulterated with xylazine to provide mobile, low-cost care before their condition worsens.

Addiction treatment and counselors should consult experts on xylazine detoxification methods to understand emerging practices.

Law enforcement and elected officials must work with their public health counterparts to increase the effectiveness of their efforts to reduce and disrupt the illicit supply chain and crack down on traffickers.

Community-based programs will be among the first to reach out to individuals vulnerable to fentanyl adulterated with xylazine and will be key partners in these efforts.