White House National Response Plan Addresses Xylazine, Fentanyl Risk

A statement issued by the White House on July 11, 2023, outlined a national response plan to address the ongoing risk of fentanyl laced with xylazine. As more illicit drug overdoses are linked to xylazine, the White House Office of National Drug Control Policy has designated fentanyl with xylazine as an emerging public health threat.

According to the statement, xylazine has been found in almost every state across the United States. In January 2019, 2.9% of fentanyl-involved overdose deaths were linked to xylazine. By June 2022, fentanyl deaths linked to xylazine rose to 10.9%.

Understanding the growing risk, the Biden–Harris administration identified six pillars of action throughout its national response plan:

• Testing
• Data collection
• Evidence-based prevention, harm reduction, and treatment
• Supply reduction
• Scheduling
• Research

Testing goals include standardizing forensic testing practices, developing new tests for clinical settings, deploying testing in community settings, and targeting those needing testing.

In addition to testing, appropriate data collection can help healthcare providers understand the risks and trends associated with xylazine. Providers should use the proper xylazine ICD codes so health systems can gather relevant information. Additional data collection goals include developing an impact assessment.

Evidence-based prevention, harm reduction, and treatment require a collaborative effort between the public and private sectors to disseminate information. The plan also encourages developing and deploying a treatment framework, including overdose treatments and other harm reduction strategies.

To target and minimize illicit drug supply, the Biden administration recommends strategies for identifying the illegal supply chain, enhancing regulation, and developing interdiction tactics.

Among the recommendations in the plan, healthcare providers are urged to assess patients’ exposure to xylazine and care for patients appropriately.

Beyond efforts by individual healthcare providers, health authorities at the state, county, and city levels should actively seek out individuals who may be using or at risk of using fentanyl adulterated with xylazine to offer care and educate them on harm-reduction strategies.