What’s In Your Concoction or Cocktail ?

Xylazine

What’s in your cocaine? What’s in your heroin? What’s in your Fentanyl? If you’ve been drinking alcohol, you’re probably not real concerned, as the rationale of consequences is greatly compromised when imbibing alcoholic beverages. If you’re struggling with an addiction, the same sort of thinking is more than likely present. Working with a previous heroin addict years ago, I received her phone call, and she was requesting I bring her clean syringes from the pharmacy, as they were only a few dollars to purchase. When I mentioned my disapproval of supporting her substance use, she said she’d simply go find a used one under the bridge. Of course, with harm reduction a priority within our network, I didn’t hesitate bringing her clean syringes. You see, her addiction had been waning due to her agreement to engage in a buprenorphine/naloxone medication assisted treatment protocol. Her healthy autonomy (ability to make healthy decisions) was returning, partially. This is a step away from the governance of her addiction disorder thinking, similar to those dampened thought processes produced while imbibing low doses of alcohol.

A recent article our chief editor, Bill Seldon shared with us “Lethal scourge hits Bay State” written by Flint McColgan (17 Aug 2022) for the Boston Herald shares information regarding a new substance being added to street drugs. The young lady mentioned earlier was a client when fentanyl was just arriving on the scene as an additive to heroin back in the 2015 area. Our organization VSN was initiated in the 2012 area and up until 2015, we had not experienced any lethal overdoses. A few clients after entering remission for several months to a year had lapsed, overdosed, and died. Their body and mind were ill prepared for the added potency of fentanyl in their now altered street drug market. As much as we have improved our harm reduction approach to include educating clients of potency warnings and have lost no clients since then, I fear the results of this new addition to the mix of street drug use. Xylazine is an animal tranquilizer and is resistant to the effects of naloxone, the drug used to reverse the effects of opioids like fentanyl and heroin. This means that an overdose, when addressed in a timely manner, is easily reversed by administering naloxone (Narcan). This will no longer be the case in the event an overdose is heavily laced with xylazine, respiratory failure is likely to ensue.

Here is the issue I see as most pertinent, the concept of dependence, which many folks suffering substance addiction wish to quell will not be addressed while chasing drugs that do not subside the withdrawal symptoms. A person striving to alleviate opioid withdrawals is going to need more of the mix, because it is not working to alleviate withdrawals. Inadvertently, this will lead to larger doses and inevitably overdosing on one or both substances. Yes, it would be great is we could simply alert addiction disorders to stop engaging in their behaviors and they were able to comply due to such and intense threat. Let’s be practical though and remember the onset of today’s dialogue here. The condition of addiction or intoxication deprives folks of healthy rational decision-making processes. Let’s engage a harm reduction approach as we incite remission, please!