An animal sedative named xylazine has been identified in five Travis County overdose death cases since May, county officials announced in a press conference Aug. 30.

County Judge Andy Brown was joined by Chief Medical Examiner Dr. J. Keith Pinckard, Health Authority Dr. Desmar Walkes and other community leaders after medical examiners confirmed the first overdose involving xylazine in August.

The first death occurred in the end of May with the other four occurring subsequently, Pinckard said.

What we know

The medical examiner team confirmed the first xylazine overdose death in August.

“We’ve now identified five cases of deaths we were investigating in which xylazine was detected. Four of those cases are finalized as drug-related deaths,” Pinckard said, adding fentanyl was also identified in all five of the cases along with other drugs, such as cocaine and methamphetamine.

Unlike fentanyl, Pinckard said, xylazine—also known as “tranq”— is not an opioid, meaning its effects cannot be reversed with medicines such as naloxone, known by the brand name Narcan, and there is not any available agent to reverse it.

Pinckard said the drug was initially studied to treat high blood pressure but was never approved for human use due to adverse side effects. While it has been used in the veterinary community since 1972, the Department of Justice does not classify it as a controlled substance.

Pinckard said as of March, xylazine had been found in seized fentanyl in nearly every U.S. state. He also reported that:
  • Xylazine is produced inexpensively in China.
  • The drug has been reported to have been used recreationally since the early 2000s, beginning in Puerto Rico.
  • It is now commonly mixed with fentanyl and heroin to enhance the effects of those drugs.
  • It can cause sedation, reduced breathing and skin ulcerations.
Put in perspective

Accidental drug deaths in Travis County more than doubled from 2019 to 2022, Pinckard said, with accidental deaths involving fentanyl increasing more than tenfold.

Based on trends, local health officials predict there could be 481 accidental drug overdose deaths in the county by the end of this year.

“People have been experiencing pain over the last three years or so due to the pandemic,” Walkes said. “In the instance, where you’re dealing with someone [who] is living with a substance use problem, you can see where there’s a change in their ability to deal with life and look to use medications that are not prescribed to them.”

Walkes encouraged anyone who is experiencing a substance use disorder to not use by themselves, to obtain Narcan from local harm reduction sites, and to utilize the 988 or Integral Care crisis hotlines.

Brown also said the county needs more support on the state level. While Brown believes the Texas Legislature and Lt. Gov. Dan Patrick should have pushed for the legalization of fentanyl testing strips during the legislative session, he said, other leaders such as Sen. John Cornyn are leading federal-level efforts to do so as well as legalizing test strips that test for xylazine.

Zooming out

Following the countywide drug overdose public health crisis declaration in May 2022, Austin-area officials secured $2 million in federal funding earlier this year for drug education, outreach and prevention programs.

Earlier this month, Brown said the Travis County Commissioners Court approved $825,000 from the county’s opioid settlement toward these efforts, which includes:
  • $175,000 to buy more Narcan
  • $350,000 for peer recovery support with Communities for Recovery
  • $300,000 for methadone services, or medically assisted treatment
  • $35,000 to help with needle collection
The commissioners also voted to earmark $575,000 of the county’s general fund for future investments to respond to emerging opioid overdose trends and $350,000 to create the Travis County Overdose Emergency Fund.

Quote of note

“Narcan does save lives, but we need to normalize the conversations around the use of drugs, not that ‘stop using drugs’ is the answer for everybody because that’s just not realistic,” said Phil Owen, a Communities for Recovery representative. “They deserve the respect of a human connection because we know that connection saves lives.”