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Rahul Gupta

In this 2021 file photo, Dr. Rahul Gupta, the director of the White House Office of National Drug Control Policy, walks outside of the White House in Washington, D.C. Last week, the agency named xylazine, a veterinary tranquilizer, as an “emerging threat” when it is mixed with the opioid fentanyl, clearing the way for more efforts to stop the spread of xylazine and develop an antidote.

Alex Brandon

Xylazine is linked to more than 350 deaths in Cook County

A veterinary tranquilizer tied to a wave of overdoses around the U.S. has already led to more than 350 deaths in Cook County in recent years.

A WBEZ review of medical examiner records shows the substance xylazine contributed to at least 161 overdose deaths in Cook County last year — a 46% increase from the previous year. A majority of the victims were Black.

Last week, the White House declared xylazine “an emerging threat to the United States” when combined with the opioid fentanyl, citing a rapid increase in overdose deaths across the country, including the Midwest.

In a statement, Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy, said he is “deeply troubled about the devastating impact of the fentanyl-xylazine combination.”

Xylazine — sometimes referred to as “tranq” — is designed to sedate horses and other farm animals, but it has not been FDA-approved for human use. While the drug is not an opioid, producers of illicit drugs will frequently mix it with opioids, such as fentanyl, to create a potent cocktail that can lead to severe skin ulcers, difficulty breathing and death. All 353 Cook County overdose deaths listing xylazine as a primary cause were also tagged as opioid-related in the medical examiner data.

Xylazine first appeared in the county’s medical examiner records in 2018, when the office recorded a single overdose involving the drug. The number of annual xylazine-involved deaths hovered in the low 30s over the next two years before surging to 110 in 2021.

Last year, the substance was listed as a primary cause in more than 8% of all opioid-related deaths in Cook County, according to medical examiner data. There could be “a nominal increase” in the count of 2022 deaths, as there are still a few outstanding tests from last year, according to Cook County spokesperson Natalia Derevyanny.

It takes time to see the effects of emerging drugs because toxicology tests can take months to process. “The Medical Examiner’s Office closely monitors case outcomes to identify emerging trends,” Derevyanny said in a written statement. “We share this information with law enforcement, public health agencies as well as the general public in order to ensure that proper measures can be taken to minimize the threat to county residents.”

Grouping overdose data by race shows 55% of xylazine deaths involved Black victims. This mirrors a broader trend of African Americans being overrepresented in opioid-related deaths in Cook County. In 2021 and 2022, Black decedents accounted for a majority of opioid overdose deaths in Cook County, where an estimated 22% of residents are African American.

A January report from WTTW found xylazine deaths increasing in Cook County. The report also indicated some scattered cases of overdoses involving the substance in collar counties.

Matt Kiefer is WBEZ’s data editor.

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