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Maryland lawmakers are taking action to address the growing role of two veterinary tranquilizers, xylazine and medetomidine, in the state’s overdose crisis. A bipartisan group of legislators is urging the Maryland Department of Health (MDH) to restrict the distribution of these drugs, which have increasingly been found in combination with opioids like fentanyl in local drug samples.
According to the news site Maryland Matters, both tranquilizers have become staples in the illicit drug supply across the mid-Atlantic region, leading to a rise in overdose deaths. Xylazine, in particular, has become a significant concern. In 2021, over a quarter of Maryland’s approximately 2,500 overdose deaths involved xylazine, up from 17% the previous year. The tranquilizer, often referred to as "tranq," is not an opioid, which makes opioid overdose-reversal drugs like naloxone ineffective in treating xylazine overdoses. In fact, users often lose consciousness and experience severe circulatory issues in their limbs, leading to infections and amputations.
Medetomidine, the second tranquilizer, was first detected in Maryland drug samples in 2022. By late 2024, it had been found in more than 8% of samples. The presence of these tranquilizers in the drug supply is a troubling development, as they are not classified as controlled substances under federal law. This leaves states like Maryland with the authority to regulate their distribution at the local level.
While neighboring states like Pennsylvania and Delaware have moved to schedule xylazine as a controlled substance, Maryland officials have been hesitant to take similar action. Chase Cook, a spokesperson for the Maryland Department of Health, has pointed out that scheduling xylazine could have unintended consequences, leading to an increase in the availability of more potent and potentially more dangerous substitutes like medetomidine. He references the experience of Pennsylvania and Delaware, which, after scheduling xylazine, saw a rise in opioid overdoses involving medetomidine, a trend that he describes as following the "iron law of prohibition."
Despite this cautious approach, some Maryland lawmakers are pressing for action. Senators and delegates, including Sen. William Folden and House Minority Whip Jesse Pippy, have sponsored bills aimed at restricting access to the drugs. The proposed legislation would create civil penalties for distributors who supply xylazine or medetomidine without proof of legitimate veterinary use, such as for sedating livestock. The funds from these fines would be directed toward overdose prevention programs in the state.
These efforts have garnered support from the state’s attorney general’s office, but the bills have not yet advanced through the legislative process. As the legislative session nears its end, it remains uncertain whether these proposals will become law. Advocates for stronger regulation argue that Maryland has a moral obligation to take action before more lives are lost to these dangerous substances.
However, some public health advocates caution that banning these drugs could backfire, leading to a cat-and-mouse game in which the illicit drug market simply substitutes one dangerous substance for another. Sarah Laurel, the founder of Savage Sisters Recovery, a harm reduction nonprofit in Philadelphia, has seen firsthand the consequences of such strategies. Her organization has encountered new substances like lidocaine and tetracaine in street drug samples more frequently than fentanyl or xylazine. Laurel argues that regulating xylazine could prompt the criminal drug market to introduce even more dangerous drugs, and she remains firm in her opposition to scheduling the tranquilizer.
As the debate continues, Maryland lawmakers must weigh the risks of regulating these tranquilizers against the urgency of addressing the state’s overdose crisis. The rise of substances like xylazine and medetomidine represents a complex challenge for policymakers and public health officials alike. With overdose deaths on the rise and the stakes higher than ever, Maryland’s approach to controlling the distribution of these drugs will be closely watched by both local and regional stakeholders.
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