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Ohio classifies xylazine as controlled substance

 A box containing two bottles of Narcan, the nasal spray helps reverse an opioid overdose.
Karen Kasler
Statehouse News Bureau
Xylazine doesn't respond to the overdose reversal drug naloxone (sometimes known by its brand name Narcan), which makes it uniquely dangerous.

Governor Mike DeWine ordered the Ohio Board of Pharmacy to classify the veterinary sedative xylazine as a Schedule III controlled substance.

It first crossed state authorities’ radar in 2019. That year, the drug showed up in 15 overdose deaths. That number had climbed to 113 for just the first two and a half months of last year.

“No known antidote”

A number of substances show up in the polydrug mixtures that crime labs analyze. Last year, the state added nine substances to the controlled drug schedule. But xylazine is a non-opioid and is uniquely dangerous.

“Naloxone which is commonly used to reverse overdoses associated with opioids is not effective when used with xylazine,” said Erin Reed, a special projects manager at the Ohio Narcotics Intelligence Center. “There’s no known antidote for xylazine when it causes an overdose that’s safe for humans.”

Nine times out of 10, Reed says, xylazine is used with other drugs, so it’s still worthwhile to attempt to try to reverse the overdose.

“Naloxone may still work, and is always recommended to be administered if an overdose is suspected,” she said. “But you may need to administer more than one dose and call emergency departments immediately.”

Detecting its presence

Reed’s organization has been working with local drug toxicologists and chemists to monitor the presence of various drugs in the state.

Right now, xylazine is showing up in 25-30% of the fentanyl mixtures crime labs are analyzing, according to Reed.

“We’ve seen that uptick and it’s that uptick in the presence of xylazine that really caused us to have to take measures immediately in order to protect people from overdoses and try to prevent people from being able to sell xylazine.”

But that number is just an estimate.

“It’s really difficult to measure the presence of a substance in the illicit drug supply before it’s controlled,” Reed says. “Most crime labs do not include, on their reports, uncontrolled drugs.”

The executive order will allow the state to get a better idea of the prevalence of the drug in the state.

“Now that xylazine is controlled, moving forward we’ll start to see that from crime lab reports and we’ll have a clearer idea of exactly how much is here.”