Governor Newsom is proposing legislation to increase penalties for trafficking of an animal tranquilizer not meant for humans, xylazine, which is emerging to be the next front of the nation’s overdose epidemic.

Xylazine, often called “tranq,” is mixed with illicit drugs and often taken unknowingly, sedating users and causing sometimes severe flesh wounds. Philadelphia’s Kensington Avenue is ground zero of the xylazine crisis, but the tranquilizer has now been identified in overdoses in every region of the country, as the Sun has reported, and the White House this year designated it as an “emerging threat.” 

“Tranq poses a unique and devastating challenge in our fight against the overdose epidemic,” Mr. Newsom said in a statement Tuesday, citing sharp increases in xylazine deaths in the United States, especially in the Northeast.

“Although California is not yet seeing tranq at the same rates as other parts of the country,” he adds, “this legislation will help the state stay ahead and curb dealers and traffickers, while we work to provide treatment and resources for those struggling with addiction and substance abuse.”

Mr. Newsom aims to crack down on the tranquilizer by classifying it “a controlled substance” but exempting legitimate veterinary use, making illicit trafficking of xylazine subject to increased criminal penalties while maintaining veterinarians’ access to the drug for approved use in animals.

In the Northeast, where the xylazine-related deaths far outnumber those on the Coast, doctors are still learning about the drug and treatment options, a clinical psychologist who grew up at Kensington and works with xylazine patients there, Geri-Lynn Utter, tells the Sun

“It’s been a challenge for the medical community and for the mental health community, because we’re out of our comfort area, because we’re trained to work with humans, and to work with drugs that have been used in humans and indicated for humans,” she says. 

“Xylazine was introduced into the illicit drug market as a cutting agent,” she says, with dealers adding it to their drugs “to stretch the fentanyl,” offering them higher profits. 

Doctors are still learning about and theorizing as to what exactly causes the flesh wounds, which in some cases can rot the skin and lead to eventual amputation. Imagery of the wounds is often shown in disturbing TikTok and YouTube videos, dubbing the suffering individuals as “zombies” and raising ethical concerns, as the Sun has reported.

“These wounds appear, regardless of route of administration. So you can be snorting it, or you could be shooting it, and you can still end up with these wounds,” Ms. Utter tells the Sun. 

“Outside of the wounds, the sedative effects are so strong that you may fall asleep with your arm behind your head in a really weird position, and once you fall asleep like that for 12 hours, you have completely cut off the blood flow to that arm,” she adds. “So now you’re dealing with somebody who’s compromised because they’ve lost the use of that arm because of the blood flow.”

From a mental health standpoint, Ms. Utter says she’s observed an intense compulsion in patients to use again.

“The compulsion to use, when you have xylazine on board when you’re taking xylazine or a xylazine-fentanyl mix, seems to be so much more intense than just fentanyl. It’s like there’s really no sense of self-control at all,” she says.

Because xylazine is mixed with opioids, often fentanyl, the protocol to treat patients is to administer Narcan first and then support the patient’s airway, observing sedated patients until they regain consciousness. Because there’s not yet a method to reverse sedation from the xylazine in humans, the process of watching and waiting for patients can overwhelm emergency doctors and use up already-limited time and resources, she says. 

As other states, like California, aim to address emerging threats of xylazine, Ms. Utter says her experiences at ground zero of the crisis indicate that a variety of fields — insurers, medical providers, behavioral health specialists, politicians, legislators, harm reductionists, and law enforcement — need to work together more.

“You have to have everyone on the same page,” she says, and right now, “it’s not that they’re not even on the same page, they’re in a different book, in a different chapter in a different language.”

As different fields work in a silo, she says, “what’s happening is we’re getting siloed, fragmented care.”