Under the frightened eyes of our journalist Jessica Nadeau, a consumer injects a dose of xylazine into her neck, trying to avoid an artery. The xylazine will slow her heart rate and plunge her into a state of sedation that she seeks, like everyone around her in the Kensington neighborhood of Philadelphia. However, this substance was not in the least designed for a human like her, but rather for a horse.
Xylazine is in fact a powerful sedative and analgesic used in veterinary medicine to put large animals such as horses to sleep. In Philadelphia, Pennsylvania, the Kensington neighborhood is teeming with users addicted to this “zombie drug,” plunging them into a state of unconsciousness that can lead to death and causing terrible complications, such as putrid sores on the body. As noted The duty during its recent visit, Philadelphia is grappling with a significant problem of consumption of this drug, which is not an opioid and whose overdose cannot therefore be reversed by an antidote like naloxone.
In 2021, the substance, often mixed with fentanyl or heroin, was found in 90% of drug samples tested by Philadelphia Public Health. Last year, the United States even declared that this mixture constituted an “emerging threat” to the nation.
In Philadelphia, this drug did not enter the market gradually, but rather erupted violently. In a short period of time, it was already causing significant devastation and beyond the capacity of health authorities to stem the phenomenon and take preventive action upstream. In Canada, where xylazine was first identified in 2001, since 2019 we have found an increasing presence of this drug, particularly in British Columbia and Ontario. Montreal is not left out, but xylazine is found there in small quantities and its consumption is stable. However, worryingly, the analyzes carried out by the public health department made it possible to conclude that those who had consumed it had done so without their knowledge, which confirms that xylazine is mixed with other drugs on the walk.
Public health authorities therefore remain alert. Having witnessed from afar the terrible devastation caused by xylazine in the United States allows us to prepare the ground and avoid finding ourselves grappling with a new “crisis” like that of opioids and stimulants, whose prevalence fatal overdoses continue to be of great concern.
Because in parallel with an open drug scene with devastating effects, there is still a more discreet opioid crisis, experienced in the secrecy of homes and fueled by a ballet of medical prescriptions which are sometimes the cause of addiction. leading to deaths. The duty found that although opioid prescriptions are decreasing in number, they are still prescribed in high doses to some patients, many of whom may have entered a cycle of dependence, long after an initial dose prescribed to counter postoperative pain or pain. chronic.
Even though the issue of opioid addiction is no longer the taboo it once was and the practice has changed considerably since the time when it was not suspected that these drugs prescribed in large quantities could become addictive, doctors continue to provide certain of these coveted molecules in too high a volume. To the point where the College of Physicians of Quebec launched this year a surveillance program whose objective is to better detect and supervise the practice of those who prescribe too much and for the wrong reasons. We must salute this responsible initiative which attacks the persistent problem at the source.
How is it still possible that patients released from the operating room for a minor procedure find themselves with a large quantity of opioid pills under the pretext that it is simpler and will avoid unnecessary trips to the doctor’s office? This misuse can constitute the start of the cycle of dependence for certain users, for whom a back pain, toothache or knee pain will insidiously transform into a descent to the bottom of the well. The fight against drug dependence is a societal fight which must prioritize prevention, concerted actions combining strength on the ground and public health measures. It is an excellent idea for doctors to be called upon to further improve their good practices.