Rainbows and Xylazine
Rainbows and Xylazine
My diary of the American Southwest and an update on the ever shifting drug supply.
I appreciate everybody sticking around while I was away on a high desert sojourn. Per usual, Tana held down the fort and kept this place from being a ghost town. I’m finally back in frigid and gray Chicago. I’ve done very little lately but post sunny desert landscapes. Like this one:
We go to Arizona a couple times every year while it’s unbearably cold in Chicago. One of the sickest parts of this trip is that we discovered a Great Horned Owl hunts the desert near where we stay. This is an extreme close-up of the owl taken from inside so it’s not the best quality. But atop that branch, to the left of the giant saguaro, you can totally makeout the silouette of its round body and pointy horns.
Being in Arizona during winter means you actually see something other than monotonus dry heat. There was hot sun, chilly clouds, hard rain, hail, and even rainbows. Rain at golden hour was magical.
We turned the corner onto Pima Road and looked left to the golden Arizona sun beaming down on the brown mountains desperate for a cool shower. Whitelight splintered into a vivid rainbow, the complete and full spectrum end to end, ROY G. BIV., bursting out of a Walgreens.
Scientists study rainbows using spectroscopy. When matter interacts with light, a spectrum is produced, allowing scientists to see the material fingerprint stamped on the light. Certain materials produce certain spectra.
The past 10 days I did very little reading and zero writing. I gave my eyes a rest. It’s important to swim up to the surface every once and a while and take a deep breath. It helps to see wider and longer for a change. I often struggle with tunnel vision.
By Sunday Jan 8th I was feeling a bit itchy and I couldn’t help but read Jan Hoffman’s big story in The New York Times on the disaster that is xylazine, a veterinary tranquilizer being mixed into fentanyl, often called “tranq” or “tranq dope.” More and more harm reduction groups are using infrared spectroscopy to analyze the contents of unknown drug samples. Fentanyl, xylazine, Benadryl, all these substances in the drug supply produce a fingerprint that can be analyzed by expensive high-tech machines. These techniques produce much more granular data about the drug supply than test strips, which can only offer a simple yes or no to a drug’s presence.
I find the use of these machines for harm reduction purposes to be quite interesting, subversive even. Most of these technologies were developed for scientific and forensic uses. Private defense and technology companies invented mobile machines like the MX908, marketed to the military and law enforcement for field testing. I’ve seen these machines up close while recording a feature audio story about harm reduction groups using them for drug checking back in 2019. The MX908, a mobile mass spectrometer, has a mode called “drug hunter,” easy for cops to use. They can swipe any empty baggy or paraphernalia for residue and quickly determine what substances are there. Now these high-tech tools of the drug war are being turned on their head. Instead of swiping empty baggies to cite people for possession, the technology is being used for public health and harm reduction, uncovering the unholy chemical slurry being sold on the street, allowing users to know what they’re actually consuming.
The Times’s story on xylazine rightly focused on Philadelphia, where tranq dope has been present for quite sometime. Users there are suffering grave injection wounds, some so bad that limbs are being amputated. The qualitative experience of a combo tranq + fent addiction sounds utterly brutal. At non-heavy doses, heroin produces a sort of twilight sleep, dulling pain without the full loss of consciousness. But when users inject fentanyl + tranq, they go right into full anesthesia that can last hours. They blackout on the street, frozen like statues in uncomfortable positions. They come to feeling the withdrawal of fentanyl while still being loopy off the tranq. Words like “high” and “euphoria” don’t seem quite right when the user isn’t even aware or awake to feel it.
My friend and Narcotica podcast co-host, Philly native Chris Moraff, got hold of some xylazine test strips—they work just like fentanyl test strips—and he began to test old samples from Kensington circa 2017/2018 that tested positive for tranq. It used to be that certain corners off of Kensington Ave. were known for selling tranq dope. If users knew the landscape they could probably avoid those corners. But that doesn’t seem to be the case anymore. Xylazine has saturated the Philly supply and even the most savvy users probably cannot avoid it anymore even if they wanted to. Sorry, the word “want” implies some choice or agency in the matter. There isn’t any. Once people are wired to xylazine, and many may not really know they are, they’ve grown tolerant to it and their body expects it—demands it. If they get a fent bag without tranq they won’t feel “well.” Users tell me the withdrawal from xylazine is pure pain, a “body-rattling anxiety,” as the Times described it.
If you’re a bit newer to the newsletter, you maybe missed that I covered xylazine a while back after a big ethnographic and epidemiological study came out. The researchers analyzed the presence of xylazine in 10 jurisdictions and found, “The highest xylazine prevalence data was observed in Philadelphia, (25.8% of deaths), followed by Maryland (19.3%) and Connecticut (10.2%).” If xylazine keeps spreading West from the East Coast, much like illicit fentanyl has since 2013, the fallout will be horrendous.
Why Xylazine?
Just as people were baffled by fentanyl showing up in the cocaine supply, people are also wondering why the hell xylazine is in the fentanyl supply. Especially given the horrorific side-effects it causes. Xylazine was added to the fentanyl supply to try and counteract the way fentanyl wears off so fast. One solid dose of heroin could last somebody four to six hours. People on heroin could actually sleep soundly through the night. But not with fentanyl. They wake up throughout the night in withdrawal and needing to dose. Fentanyl cuts the time by half or even more. So the suppliers thought they could extend the duration of a fentanyl dose by adding xylazine.
The illicit drug supply continues to feel like a gigantic failed experiment. Illicit manufacturers and suppliers are constantly switching and swapping up formulas, hoping to find the right combination that will maximize their profit. As Amazon knows, profit comes from happy customers who will buy and buy and buy product. It sound hard to believe, but I’ve heard users say they preferred the xylazine + fent combo from pure fent. The xylazine gave the fentanyl “legs,” lengthened the duration between doses. Whatever pleasant “high” the tranq dope creates is certainly canceled out by its gnarly effects, like the death of skin tissue. If you want to see what this looks like, go back and check out the xylazine article I did. The dead tissue reminds me of a Cronenbergian take on grey scale in Game of Thrones. Body horror is real.
I hate to end this post that started with beautiful desert landscapes and rainbows with what is perhaps the grimmest turn yet in America’s overdose crisis. Sorry, that’s kinda what you signed up for.
The clearest solution to this problem is to get as many people out of the illicit market as soon as and by whatever means possible. For a lot of people on the front-lines, they say nothing short of a safe supply of what’s on the street will suffice. And that’s devastating because American drug policy changes at a snails pace. It wasn’t until just recently that the government axed the X-waiver required to prescribe buprenorphine. That’s too little too late. People wired to fentanyl + tranq might not do so well on buprenorphine, partly because fentanyl is stored in fat and it can be quite complicated to start someone on buprenoprhine if they have a week worth of fentanyl stored in their system. And the buprenorphine doesn’t really touch the problem of a xylazine addiction.
Dr. Joseph D’Orazio has worked on these hard cases of fentanyl + tranq addiction and has found that anti-anxiety drugs, benzodiazapines, can do some good treating the acute withdrawal of xylazine. That causes even more problems, because many doctors are dogmatic about not mixing opioids and benzos due to their interaction that may result in respiratory depression. So even if a doctor can get someone the right opioid regiment to treat the opioid addiction, that still leaves the xylazine addiction to deal with. The short way of saying all of this is: It’s a fucking mess. This shift in the drug supply is unprecedented, and it’s going to take unprecedented policy action to get ahead of.
I think I’ll end this here for now. I’m glad to be back here writing for all of you. Thanks for being here and for reading me. I’m excited for another year of writing. There is much to do.
Shot, chaser:
