Wednesday, February 19, 2025
HomeFamily LawWhat Legal and Public Health Professionals Need to Know – North Carolina...

What Legal and Public Health Professionals Need to Know – North Carolina Criminal Law

The drug xylazine has been in the news recently as a dangerous substance commonly mixed with heroin, fentanyl, and other drugs. Xylazine is not an opioid nor is it currently a controlled substance, which presents unique challenges for legal and public health professionals. This post, co-written by SOG faculty members Kirsten Leloudis and Phil Dixon, examines the legal and public health issues surrounding the drug.

What is Xylazine? Xylazine is a non-opioid sedative or tranquilizer that was first developed in 1962 by the pharmaceutical company Bayer. Xylazine was initially investigated for potential human use as an analgesic, sleeping aid, and anesthetic but was found to have concerning side effects, including severe hypotension and depression of the central nervous system. While xylazine never received approval by the United States Food and Drug Administration (“FDA”) for use in humans, the drug has been approved by the FDA for use in veterinary medicine since 1972. Xylazine in liquid solution form is sold for veterinary use under the trade names Rompun® and AnaSed®. Xylazine may also be referred to by its slang nickname, “tranq.”

Xylazine is typically injected but can also be swallowed or sniffed. Although xylazine can be taken on its own, it is more frequently mixed with fentanyl, heroin, or cocaine. The drug is relatively inexpensive and is often combined with these pricier substances as a low-cost way to increase drug effects or increase dealers’ profits from substances that are typically sold by weight. Because the “cutting” of more expensive drugs with xylazine may occur at the retail level, people who use drugs may be unaware that the substances they have purchased contain xylazine.

Health Risks of Xylazine. Information about xylazine’s toxicity in humans is limited, but law enforcement, health care providers, and public health agencies continue to learn more about its effects through case reports. The United States Centers for Disease Control and Prevention (“CDC”) advises that xylazine can cause sedation, difficulty breathing, dangerously low blood pressure, slowed heart rate, hypothermia, and death. Repeated injection of xylazine is associated with unique soft tissue wounds, characterized in part by necrotic tissue, that may develop away from the injection site. These wounds can easily become infected and, if untreated, may result in limb amputation. Repeated use can also result in xylazine dependence and withdrawal.

Although the effects of xylazine are similar to those caused by opioids, xylazine is not part of the opioid class of drugs. As a result, naloxone—one of public health’s most relied upon tools in responding to the opioid crisis—does not reverse the effects of xylazine. Similarly, medications such as methadone, buprenorphine, and naltrexone that are used for treatment of opioid use disorder may be ineffective for managing the symptoms of xylazine withdrawal.

Note: Although naloxone may be ineffective at reversing the effects of xylazine, the CDC currently recommends administering naloxone in response to any suspected overdose and calling 911. Naloxone is effective for reversing the effects of other drugs that are commonly mixed with and used alongside xylazine and administration of naloxone may help save the life of a person who is overdosing. Since xylazine also causes breathing to slow, CDC currently recommends giving rescue breaths to someone who has used xylazine. Please see the CDC recommendations linked within this post or contact a health care provider, as appropriate, for additional questions on xylazine overdose treatment.

How Big of a Problem is This? According to a 2022 report by the United States Drug Enforcement Agency (“DEA”), the prevalence of xylazine in the nation’s illicit drug supply has skyrocketed since 2020. In 2021, the largest increase in terms of prevalence of the drug (193%) was in the Southern U.S. That region also saw a 1,127% increase in xylazine-positive overdose deaths between 2020 and 2021. The DEA notes in its report that the death count is not complete and likely under-represents the actual number of xylazine-positive overdose deaths. For 2022, the DEA reported that 23% of fentanyl powder and 7% of fentanyl pills seized by the agency contained xylazine.

In February 2023, the FDA issued an import alert for xylazine, which allows for the administrative seizure of the substance. According to the DEA, the drug still manages to enter the country by way of illegal drug trafficking and web-based sales that allow xylazine to be purchased and shipped from another country. The DEA has found that xylazine can be purchased online from China for a price of between $6 and $20 per kilogram without requiring any proof that the buyer intends to use the drug for veterinary purposes.

Testing for Xylazine. Routine drug testing kits and drug screens, such as immunoassay toxicology screens, do not readily detect xylazine. Health care professionals attempting to treat an overdosing patient may therefore not easily discover the presence of the drug, which can result in misdiagnosis as an opioid overdose and consequent ineffective treatment. The FDA has explained that even if appropriate screening methods are used, xylazine can be hard to identify because it has a half-life of only 25 to 30 minutes, which means it is quickly eliminated from the body.

Out in the field, many people using drugs have begun relying on drug testing kits to protect against inadvertent fentanyl consumption and to verify the identity and purity of a drug as a way to avoid accidental overdose. North Carolina removed drug testing kits from the definition of drug paraphernalia in 2019 in recognition of the value of such testing. See G.S. 90-113.22(d). Like with drug screens, most routine drug testing kits do not test for xylazine and will not detect its presence. Testing kits developed specifically for xylazine do exist, but may not yet be widely available in all communities.

Xylazine is Currently Not a Controlled Substance. Xylazine is currently not an illegal controlled substance under North Carolina or federal law. The FDA regulations limit distribution of the drug to licensed veterinarians, but that seems to be it as far as national regulation. 21 C.F.R. 522.2662. There is a bill aiming to change that on the federal level, here. A coalition of 39 state attorneys general, including North Carolina’s, have urged Congress to pass the proposed bill. If passed in its current iteration, the bill would schedule xylazine as a Schedule III controlled substance (including all salts, isomers, and derivatives of the drug). On the state level, some places have acted to criminalize and schedule the substance, but there is no similar legislation pending in North Carolina at the time of this writing. Even if the federal bill were to become law, state officials would lack the ability to enforce such a ban, absent a similar prohibition under state law.

Xylazine is Not an Analogue Controlled Substance. Both federal and state criminal law prohibit the illicit use and distribution of analogue controlled substances—drugs designed to mimic the effects of controlled substances, but which are chemically distinct from actual controlled substances. The state and federal definitions of an analogue controlled substance mirror each other. See G.S. 90-87(5a) and 21 U.S.C. 802(32). Both laws define a controlled substance analogue as a substance chemically similar in structure to an existing Schedule I or II drug and intended for human consumption, which either mimics the effects of one of those types of controlled substances or which is intended to or represented as having such a mimicking effect. Xylazine is an analogue of another drug, clonidine, but that drug is also not an illegal controlled substance (much less a Schedule I or II drug). Clonidine and xylazine belong to a class of drugs known as alpha 2-adrenergic agonists, which are not chemically similar in structure to existing Schedule I or II drugs, even if they may share similar effects. For this reason, it seems unlikely that xylazine would qualify as an analogue controlled substance. Simply put, no provision of current federal or North Carolina criminal law prohibits xylazine as an illegal drug.

Resources. For more information about xylazine, health risks, and federal guidance for legal and public health professionals, please see these materials from the FDA, CDC, DEA, and Substance Abuse and Mental Health Services Administration.

If readers have questions, comments, or concerns for us, we can be reached at [email protected] and [email protected].

Hello, sobat pengemar slot! pernahkah mendengar semboyan “slot demo”? Kalau tidak, bersiaplah jatuh hati sama program ini. slot gaco merupakan mesin slots yang selalu memberi kemenangan. Yup, mesin-mesin ini bisa dikatakan adalah andalannya tuk membawa pulang cuan. but, gimana sih caranya nemuin slot gaco yang benar? Santai Bro and Sis, kita bahas santai saja di tempat ini

Gaming terbaik saat ini satu-satunya berada Indonesia yaitu pasti menyediakan imbal hasil terbesar

Daftarkanlah di:

Informasi mengenai KING SLOT, Segera Daftar Bersama king selot terbaik dan terpercaya no satu di Indonesia. Boleh mendaftar melalui sini king slot serta memberikan hasil kembali yang paling tinggi saat sekarang ini hanyalah KING SLOT atau Raja slot paling gacor, gilak dan gaco saat sekarang di Indonesia melalui program return tinggi di kingselot serta pg king slot

slot demo gacor

slot demo gacor permainan paling top dan garansi imbal balik hasil besar bersama kdwapp.com

akun demo slot gacor

akun demo slot gacor permainan paling top dan garansi imbal balik hasil besar bersama kdwapp.com

akun slot demo gacor

akun slot demo gacor permainan paling top dan garansi imbal balik hasil besar bersama kdwapp.com

akun demo slot pragmatic

akun demo slot pragmatic permainan paling top dan garansi imbal balik hasil besar bersama kdwapp.com

akun slot demo pragmatic

akun slot demo pragmatic permainan paling top dan garansi imbal balik hasil besar bersama kdwapp.com

akun slot demo

akun slot demo permainan paling top dan garansi imbal balik hasil besar bersama kdwapp.com

akun demo slot

akun demo slot permainan paling top dan garansi imbal balik hasil besar bersama kdwapp.com

slot demo gacor

slot demo gacor permainan paling top dan garansi imbal balik hasil besar bersama jebswagstore.com

akun demo slot gacor

akun demo slot gacor permainan paling top dan garansi imbal balik hasil besar bersama jebswagstore.com

akun slot demo gacor

akun slot demo gacor permainan paling top dan garansi imbal balik hasil besar bersama jebswagstore.com

akun demo slot pragmatic

akun demo slot pragmatic permainan paling top dan garansi imbal balik hasil besar bersama jebswagstore.com

akun slot demo pragmatic

akun slot demo pragmatic permainan paling top dan garansi imbal balik hasil besar bersama jebswagstore.com

akun slot demo

akun slot demo permainan paling top dan garansi imbal balik hasil besar bersama jebswagstore.com

akun demo slot

akun demo slot permainan paling top dan garansi imbal balik hasil besar bersama jebswagstore.com

slot demo gacor

slot demo gacor permainan paling top dan garansi imbal balik hasil besar bersama demoslotgacor.pro

akun demo slot gacor

akun demo slot gacor permainan paling top dan garansi imbal balik hasil besar bersama demoslotgacor.pro

akun slot demo gacor

akun slot demo gacor permainan paling top dan garansi imbal balik hasil besar bersama demoslotgacor.pro

akun demo slot pragmatic

akun demo slot pragmatic permainan paling top dan garansi imbal balik hasil besar bersama demoslotgacor.pro

akun slot demo pragmatic

akun slot demo pragmatic permainan paling top dan garansi imbal balik hasil besar bersama demoslotgacor.pro

akun slot demo

akun slot demo permainan paling top dan garansi imbal balik hasil besar bersama demoslotgacor.pro

akun demo slot

akun demo slot permainan paling top dan garansi imbal balik hasil besar bersama demoslotgacor.pro

slot demo gacor

slot demo gacor permainan paling top dan garansi imbal balik hasil besar bersama situsslotterbaru.net

akun demo slot gacor

akun demo slot gacor permainan paling top dan garansi imbal balik hasil besar bersama situsslotterbaru.net

akun slot demo gacor

akun slot demo gacor permainan paling top dan garansi imbal balik hasil besar bersama situsslotterbaru.net

akun demo slot pragmatic

akun demo slot pragmatic permainan paling top dan garansi imbal balik hasil besar bersama situsslotterbaru.net

akun slot demo pragmatic

akun slot demo pragmatic permainan paling top dan garansi imbal balik hasil besar bersama situsslotterbaru.net

akun slot demo

akun slot demo permainan paling top dan garansi imbal balik hasil besar bersama situsslotterbaru.net

akun demo slot

akun demo slot permainan paling top dan garansi imbal balik hasil besar bersama situsslotterbaru.net

situs slot terbaru

situs slot terbaru permainan paling top dan garansi imbal balik hasil besar bersama situsslotterbaru.net

slot terbaru

slot terbaru permainan paling top dan garansi imbal balik hasil besar bersama situsslotterbaru.net

asn88 permainan paling top dan garansi imbal balik hasil besar bersama asn88.net

anjir88 permainan paling top dan garansi imbal balik hasil besar bersama anjir88.asia

albaslot88 permainan paling top dan garansi imbal balik hasil besar bersama albaslot88.asia

air88 permainan paling top dan garansi imbal balik hasil besar bersama air88.bio

air88 permainan paling top dan garansi imbal balik hasil besar bersama air88.asia

vavaslot888 permainan paling top dan garansi imbal balik hasil besar bersama vavaslot888.org

vavaslot888 permainan paling top dan garansi imbal balik hasil besar bersama vavaslot888.net

oborslot888 permainan paling top dan garansi imbal balik hasil besar bersama oborslot888.org

oborslot888 permainan paling top dan garansi imbal balik hasil besar bersama oborslot888.net

duniaslot777 permainan paling top dan garansi imbal balik hasil besar bersama duniaslot777a.org

ayukbet88 permainan paling top dan garansi imbal balik hasil besar bersama ayukbet88.org

ayukbet88 permainan paling top dan garansi imbal balik hasil besar bersama ayukbet88.net

j888slot permainan paling top dan garansi imbal balik hasil besar bersama j888slot.org

klikdewa88 permainan paling top dan garansi imbal balik hasil besar bersama klikdewa88.net

klikdewa88 permainan paling top dan garansi imbal balik hasil besar bersama klikdewa88.com

klikbet777 permainan paling top dan garansi imbal balik hasil besar bersama klikbet777.info

klikbet777 permainan paling top dan garansi imbal balik hasil besar bersama klikbet777.asia

gemoyslot999 permainan paling top dan garansi imbal balik hasil besar bersama gemoyslot999.net

seroja888 permainan paling top dan garansi imbal balik hasil besar bersama seroja888.net

seroja888 permainan paling top dan garansi imbal balik hasil besar bersama seroja888.com

hoka88 permainan paling top dan garansi imbal balik hasil besar bersama hoka88.asia

dutaslot88 permainan paling top dan garansi imbal balik hasil besar bersama dutaslot88.com

buaya88 permainan paling top dan garansi imbal balik hasil besar bersama buaya88.asia

buaya777 permainan paling top dan garansi imbal balik hasil besar bersama buaya777.asia

zonavegas88 permainan paling top dan garansi imbal balik hasil besar bersama zonavegas88.net

tongtoto88 permainan paling top dan garansi imbal balik hasil besar bersama tongtoto88.org

tongtoto88 permainan paling top dan garansi imbal balik hasil besar bersama tongtoto88.net

sista999 permainan paling top dan garansi imbal balik hasil besar bersama sista999.org

mbokslot88 permainan paling top dan garansi imbal balik hasil besar bersama mbokslot88.org

mbokslot88 permainan paling top dan garansi imbal balik hasil besar bersama mbokslot88.net

pg king slot permainan paling top dan garansi imbal balik hasil besar bersama pgkingslot.org

holywing88 permainan paling top dan garansi imbal balik hasil besar bersama holywing88.asia

bolagila88 permainan paling top dan garansi imbal balik hasil besar bersama bolagila88.asia

dewalive88 permainan paling top dan garansi imbal balik hasil besar bersama dewalive88.biz

kputoto888 permainan paling top dan garansi imbal balik hasil besar bersama kputoto888.net

vio777 permainan paling top dan garansi imbal balik hasil besar bersama vio777.asia

nix777 permainan paling top dan garansi imbal balik hasil besar bersama nix777.net

nego88 permainan paling top dan garansi imbal balik hasil besar bersama nego88.net

nego777 permainan paling top dan garansi imbal balik hasil besar bersama nego777.com

marjan899 permainan paling top dan garansi imbal balik hasil besar bersama marjan899.com

marjan888 permainan paling top dan garansi imbal balik hasil besar bersama marjan888.com

gcr88 permainan paling top dan garansi imbal balik hasil besar bersama gcr88.org

bosku77 permainan paling top dan garansi imbal balik hasil besar bersama bosku77.asia

gaco88 permainan paling top dan garansi imbal balik hasil besar bersama gaco88.asia

dijual88 permainan paling top dan garansi imbal balik hasil besar bersama dijual88.com

dijual88 permainan paling top dan garansi imbal balik hasil besar bersama dijual88.net

saritoto88 permainan paling top dan garansi imbal balik hasil besar bersama saritoto88.com

gege888 permainan paling top dan garansi imbal balik hasil besar bersama gege888.net

exa88 permainan paling top dan garansi imbal balik hasil besar bersama exa88.org

dower888 permainan paling top dan garansi imbal balik hasil besar bersama dower888.org

bos888 permainan paling top dan garansi imbal balik hasil besar bersama bos888.info

badabest888 permainan paling top dan garansi imbal balik hasil besar bersama badabest888.com

ayamjago888 permainan paling top dan garansi imbal balik hasil besar bersama ayamjago888.net

vviavi88 permainan paling top dan garansi imbal balik hasil besar bersama vviavi88.com

sydneycuan88 permainan paling top dan garansi imbal balik hasil besar bersama sydneycuan88.com

gotocuan88 permainan paling top dan garansi imbal balik hasil besar bersama gotocuan88.com

bank88 permainan paling top dan garansi imbal balik hasil besar bersama bank88.asia

agenplay888 permainan paling top dan garansi imbal balik hasil besar bersama agenplay888.com

satelittogel88 permainan paling top dan garansi imbal balik hasil besar bersama satelittogel88.net

hiutoto88 permainan paling top dan garansi imbal balik hasil besar bersama hiutoto88.net

hiutoto88 permainan paling top dan garansi imbal balik hasil besar bersama hiutoto88.com

kedai88slot permainan paling top dan garansi imbal balik hasil besar bersama kedai88slot.biz

nova12 permainan paling top dan garansi imbal balik hasil besar bersama nova12.net

piktoto88 permainan paling top dan garansi imbal balik hasil besar bersama piktoto88.net

zeuswin888 permainan paling top dan garansi imbal balik hasil besar bersama zeuswin888.com

zoom88 permainan paling top dan garansi imbal balik hasil besar bersama zoom88.info

asg88 permainan paling top dan garansi imbal balik hasil besar bersama asg88.org

azkabet88 permainan paling top dan garansi imbal balik hasil besar bersama azkabet88.net

becak88 permainan paling top dan garansi imbal balik hasil besar bersama becak88.biz

besitoto88 permainan paling top dan garansi imbal balik hasil besar bersama besitoto88.com

bethoki88 permainan paling top dan garansi imbal balik hasil besar bersama bethoki88.biz

bibit88 permainan paling top dan garansi imbal balik hasil besar bersama bibit88.biz

bibit88 permainan paling top dan garansi imbal balik hasil besar bersama bibit88.info

bolago888 permainan paling top dan garansi imbal balik hasil besar bersama bolago888.net

boswin777 permainan paling top dan garansi imbal balik hasil besar bersama boswin777.biz

cafe88 permainan paling top dan garansi imbal balik hasil besar bersama cafe88.info

cinta88 permainan paling top dan garansi imbal balik hasil besar bersama cinta88.biz

coki888 permainan paling top dan garansi imbal balik hasil besar bersama coki888.com

cumi88 permainan paling top dan garansi imbal balik hasil besar bersama cumi88.com

cumitoto permainan paling top dan garansi imbal balik hasil besar bersama cumitoto.com

darma888 permainan paling top dan garansi imbal balik hasil besar bersama darma888.org

dewagacor888 permainan paling top dan garansi imbal balik hasil besar bersama dewagacor888.net

engkol888 permainan paling top dan garansi imbal balik hasil besar bersama engkol888.info

garasislot88 permainan paling top dan garansi imbal balik hasil besar bersama garasislot88.biz

harumtoto permainan paling top dan garansi imbal balik hasil besar bersama harumtoto.org

indo788 permainan paling top dan garansi imbal balik hasil besar bersama indo788.net

jenitoto permainan paling top dan garansi imbal balik hasil besar bersama jenitoto.com

joker18 permainan paling top dan garansi imbal balik hasil besar bersama joker18.net

juliet88 permainan paling top dan garansi imbal balik hasil besar bersama juliet88.net

jumbototo88 permainan paling top dan garansi imbal balik hasil besar bersama jumbototo88.com

kaostogel88 permainan paling top dan garansi imbal balik hasil besar bersama kaostogel88.net

kaskus88 permainan paling top dan garansi imbal balik hasil besar bersama kaskus88.biz

kawin777 permainan paling top dan garansi imbal balik hasil besar bersama kawin777.biz

kinggacor88 permainan paling top dan garansi imbal balik hasil besar bersama kinggacor88.com

koboislot88 permainan paling top dan garansi imbal balik hasil besar bersama koboislot88.net

kputoto88 permainan paling top dan garansi imbal balik hasil besar bersama kputoto88.net

ribo888 permainan paling top dan garansi imbal balik hasil besar bersama ribo888.biz

kripto888 permainan paling top dan garansi imbal balik hasil besar bersama kripto888.biz

lebah77 permainan paling top dan garansi imbal balik hasil besar bersama lebah77.asia

lebah7777 permainan paling top dan garansi imbal balik hasil besar bersama lebah7777.com

legend888 permainan paling top dan garansi imbal balik hasil besar bersama legend888.info

RELATED ARTICLES
- Advertisment -
Google search engine

Most Popular

Recent Comments