In Response to House Vote on Xylazine Criminalization, Hundreds of Medical Experts, Scientists, Advocates Call for a Public Health Approach

Today, Congress passed the SUPPORT Act (H.R. 4531), legislation that includes a provision to permanently place the drug xylazine, also known as tranq, on Schedule III of the Controlled Substances Act (CSA). Despite preliminary scientific research showing that placing xylazine on Schedule III of the CSA is not appropriate, the legislation passed in the House and will now go to the Senate.

A group of over 150 public health professionals, scientists and researchers sent a letter to Congress warning that criminalizing xylazine would halt needed research, disrupt medical practices, and fail to prevent overdoses, calling instead for a public health approach guided by research and scientific evidence. Another letter signed by public health, criminal justice, and drug policy organizations including the ACLU, the Leadership Conference on Civil and Human Rights, the National Association of Criminal Defense Lawyers, the National Harm Reduction Coalition, the Sentencing Project, and the Vera Institute for Justice, was also sent to Congress in opposition to placing xylazine on Schedule III of the CSA. In the letter, groups emphasized the need for health-based solutions, noting that previous crackdowns on illicit substances have contributed to the increasingly potent, unpredictable drug supply.

“Instead of hastily criminalizing xylazine as a controlled substance, lawmakers should focus on expanding overdose prevention services, Good Samaritan Laws, access to methadone, buprenorphine, and naloxone, and evidence-based drug education and treatment,” reads the letter. “Additionally, efforts should be made to study and collect data on the presence and distribution of xylazine, expand access to xylazine test strips, and research potential medications that treat xylazine withdrawal and wounds.”

Xylazine, a veterinary drug not approved for use in humans, can increase the risk of an overdose and is increasingly found in the illicit drug supply, though users are often unaware of its presence in their supply. It is frequently found mixed with fentanyl and its analogues, drugs that are already criminalized.

Scheduling xylazine would result in steep criminal penalties that fall disproportionately on people who use drugs and are at the lowest levels of the drug distribution chain. Criminal penalties can result in people being less likely to seek help for problematic drug use and incarceration can increase the risk of overdose.

Jason Beinert, RN, CWCN, a healthcare provider with experience treating patients who have used xylazine:

“As a nurse, I know that we need a robust public health approach to better respond to the unpredictable, potent street drug supply and save lives. Addressing xylazine concerns requires research, education, and public health funding. Effective solutions for xylazine involve informed policies, comprehensive approaches, and frontline public health workers. Scheduling xylazine will create barriers to realizing these needed interventions.”

Alex Krotulski, PhD, Associate Director at the Center for Forensic Science Research and Education (CFSRE):

“History has repeatedly shown that the scheduling of drugs or related substances opens the door for new replacements, those of which are sometimes more potent, more harmful, and more difficult to track. The adulteration of fentanyl with xylazine is occurring deliberately to improve the effects of fentanyl. If xylazine was removed from the drug supply, it would almost certainly be replaced by another drug, possibly a benzodiazepine, which could lead to worse overdose outcomes and health implications.”

Rafael Torruella, PhD, Executive Director of Intercambios in Puerto Rico, where he has provided direct services for people who use xylazine and long advocated for increased research:

“We desperately need more research to better treat xylazine users who are suffering from physical dependence, skin abscesses, and an increased risk of overdose related to the drug. Criminalizing xylazine will obstruct lifesaving public health research and punish those most in need of help. As the bill heads to the Senate, I implore them to heed the advice of experts, reject failed Drug War approaches, and embrace a health approach that will prevent unnecessary deaths.”

Maritza Perez Medina, Director of the Office of Federal Affairs of the Drug Policy Alliance:

“We are deeply concerned and disappointed by the House’s reckless decision to place xylazine on the CSA despite the science not supporting this decision. We know that criminal penalties will fall hardest on people who use drugs who are in desperate need of health treatments, not handcuffs. Placing xylazine on the CSA will inhibit research to find medical solutions for xylazine use. We urge the Senate to reject this approach and instead center science and public health in response to xylazine use.

Sarah Laurel, Executive Director of Savage Sisters in Philadelphia, PA:

“Savage Sisters has been dealing with xylazine for six years. We have witnessed firsthand the lack of urgency in responding to our calls to action. We are asking for updated withdrawal protocols, overdose reversals, and wound care protocols. Scheduling xylazine will have no positive impact on my community or the people we serve. Savage Sisters urges our legislators to avoid political steps that will put an already vulnerable population at greater risk. We need your attention and support for programs and practices that promote healing, education and harm reduction.”

For more information on xylazine and why we need a health approach to the overdose crisis, visit drugpolicy.org/xylazine.

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About the Drug Policy Alliance (DPA) 

The Drug Policy Alliance envisions a just society in which the use and regulation of drugs are grounded in science, compassion, health and human rights, in which people are no longer punished for what they put into their own bodies, and in which the fears, prejudices and punitive prohibitions of today are no more. Our mission is to advance those policies and attitudes that best reduce the harms of both drug use and drug prohibition, and to promote the autonomy of individuals over their minds and bodies. Learn more at drugpolicy.org.