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Opioids, particularly fentanyl, are increasingly laced with an animal tranquilizer called xylazine—a drug that public health experts fear will worsen the opioid crisis.
The drug is colloquially called “tranq” and is mostly found in the Northeast—with Philadelphia as the epicenter in this region, Philippe Bourgois, a professor of social medicine and anthropology at UCLA who researches xylazine usage trends, told Healthcare Brew.
Due to a lack of testing, xylazine “will catch the country by surprise as it continues to rapidly spread to new cities,” Bourgois said.
Though xylazine use became prominent in 2015, there’s not much data quantifying how much money health systems have spent to treat patients for its side effects, such as severe skin ulcerations and withdrawal that can put users at risk for seizures.
But just looking at the costs of treating a couple of those common symptoms can show the financial effect on health systems.
Xylazine use symptoms are expensive to treat
A common symptom of xylazine use is pressure ulcers (bed sores), as xylazine often makes users go unconscious for many hours at a time, Bourgois said. Bed sores can be extremely expensive to treat, with severe cases costing an average of $124,327, according to a 2011 New York University study from New York University.
Xylazine dependence can result in such severe skin ulcerations that require amputation. Bourgois said it’s “shocking” how often people are losing limbs as a result of xylazine usage. The economic burden of hospitalizations after amputation is “considerable,” according to a 2018 study from Qatar that estimated the overall per-patient cost for an amputation to be $89,808.
Though xylazine itself is not an opioid, it’s mostly found in conjunction with that class of drugs, and health systems largely bear the costs of treating opioid use disorder because most patients are on Medicaid or are uninsured, according to research from health services firm Premier. The US spends $95.4 billion treating patients with opioid use disorder in emergency rooms every year, according to Premier.
The “simplest, cheapest” intervention health systems can take to mitigate the effects of xylazine is “systematically testing overdose patients in hospitals and coroner departments for xylazine,” Bourgois said.