Animal sedatives linked to US overdoses, calls for increased drug surveillance in San Francisco

“The San Francisco Department of Health is aware that new synthetic drugs, including medetomidine, have been identified in the North American drug market,” a spokesperson for the city's public health department said in an email. “We are working with city departments and nonprofit partners to continue to monitor for new synthetic drugs, prepare supportive care options, including treatment, and respond rapidly in the event of an outbreak.”

Dorsey submitted a similar letter about a year ago, questioning the city's practices for monitoring xylazine and other impurities found in opioids that are more commonly found in the drug supply in other parts of the country.

“As with my previous investigations, my goal is to see how I can educate myself and advance the actions I believe are essential to protecting the lives and health of San Franciscans affected by addiction,” Dorsey wrote in his investigation, “and sustain the signs of progress we are beginning to see in the deadly drug overdose crisis facing San Francisco.”

The San Francisco Office of the Chief Medical Examiner reports each month that a range of substances have been found in recent overdoses, including fentanyl, heroin, methamphetamine, cocaine, xylazine, bromazolam and fluorofentanyl. In November 2023, local health officials also Wastewater Testing The study will look at fentanyl, cocaine, methamphetamine and metabolites of these three substances to gauge trends in drug use and supply in the city.

Concerns about medetomidine Overdose deaths down 3% Data released this month by the Centers for Disease Control and Prevention (CDC) showed cases will fall in 2023 compared with 2022, marking the first nationwide decline since 2018.

However, according to city of San Francisco data, 2023 will be the year with the highest number of drug overdose deaths ever, with 258 people having died of drug overdoses in the city this year alone.

Fentanyl, an opioid about 50 times more potent than heroin, was implicated in the majority of overdose deaths, although only 12 of the overdose deaths in San Francisco this year were linked to xylazine, according to the chief medical examiner.

“We know the majority of overdose deaths are fentanyl-related, and our fixation on this new scary drug that politicians point to misses the point,” said Laura Guzman, executive director of the National Harm Reduction Coalition. “We need to put resources where they're needed most.”

As synthetic drugs become more common across the U.S., efforts to curb plant-based drugs like heroin and cocaine could lead to the development of cheaper, more powerful drugs that people could seek out themselves or be removed from the supply chain, the study suggests.

“Without serious and sustained efforts to address the direct and underlying causes of non-medical opioid use, the intensive supply suppression efforts that have brought us fentanyl will continue to push the market toward more lethal alternatives,” they wrote. 2017 Report Published in the International Drug Policy Journal.

A common concern with sedatives such as xylazine and medetomidine is that they do not respond to medications such as Narcan, which can reverse the effects of an opioid overdose. However, because sedatives are often used in combination with other drugs such as fentanyl, many medical professionals still advise using Narcan if there is a possibility that opioids may be present during an overdose.

“The drug supply continues to be in a very precarious and frightening state because we continue to criminalize new synthetic drugs that keep coming out and there is no safe supply,” Guzman said. “The drug supply is becoming very contaminated and enriched with new synthetic drugs, which is why drug testing is so important.”