IN LATE MAY 2023, at the National Institute of Standards and Technology in Gaithersburg, Maryland, Edward Sisco opened a package of swabs taken from used syringes and empty bags. Sisco, a research chemist, ran the samples through a mass spectrometer, a device about the size of a washing machine, and got back a chemical profile.
Sisco receives these swabs from needle exchanges in Maryland and four other states, to track what drugs people are using. Those drugs range from illicitly manufactured fentanyl, an opioid that has largely replaced heroin; benzodiazepines, a class of drugs used to treat anxiety; and 20 different cutting agents and adulterants, such as caffeine, quinine, and mannitol. The surveillance system, which the federal agency piloted in October 2021, also frequently turn up drugs that are contaminating the illicit drug supply in the U.S. Among these are xylazine, a veterinary sedative that goes by the street name tranq, short for tranquilizer; clickbait headlines sometimes refer to xylazine as a “zombie drug” because it causes necrotizing wounds, skin ulcers and knocks people out. Last year, Sisco found another animal tranquilizer, medetomidine, in a small percentage of samples. Xylazine has never been approved for use in humans, and neither sedative is a typical opioid, which complicates the use of antidotes, such as naloxone, to reverse overdoses.
Hellbound and Down 