Delaware’s Controlled Substance Advisory Committee voted last week to recommend an emergency regulation to limit the distribution of Xylazine, a tranquilizer increasingly used as an additive in fentanyl and other drugs.
As health care providers and drug users grapple with how to adapt to Xylazine — which has gained attention because of the open sores that result from frequent use — some states are restricting its distribution by classifying it as a Schedule III drug: a designation given to potentially addictive substances with accepted medical uses like codeine and anabolic steroids.
Four states – Florida, Ohio, Pennsylvania and West Virginia – have already moved to classify Xylazine as a controlled substance. Meanwhile, federal lawmakers are also considering a bill that would designate Xylazine a Schedule III controlled substance. Last week, members of Delaware’s Controlled Substance Advisory Committee moved to get ahead of that federal legislation.
The commission noted Xylazine is commonly used as a tranquilizer by farriers — a type of blacksmith who specializes in shoeing horses. Commissioner Herb Von Goerres expressed concern that because farriers aren’t licensed medical professionals, they could be left unaware of the new regulations.
“Would it be prudent to notify some of the horse racing tracks so that it might get back to the farriers that they may have a problem coming up on the horizon," he said, "and will they be given some amnesty to turn the product in?”
Other commissioners argued notifying veterinarians – who supply farriers with Xylazine – would be enough to spread the word.
Though the commission did not directly address the sources of Xylazine used as an additive in illicit drugs, some portion of the supply is likely diverted from veterinary practices or farriers.
Some pharmaceutical suppliers also expressed concern the emergency regulation wouldn’t give them time to adapt. Sarah Everingham, a controlled substance compliance specialist with the healthcare company Cardinal Health – which previously faced lawsuits for its distribution of prescription opioids – asked the Commission to consider delaying implementation of the new rules.
“I wanted to raise that other states are allowing a timeline for compliance," she said, "because since this is going from non-scheduled to scheduled, there are a number of IT changes that need to take place, along with other policies and procedures.”
Meanwhile, pharmacology and harm reduction researchers have objected to scheduling Xylazine on the grounds that it will make it more difficult to study the drug's effects on humans — a critical part of improving the public health response to Xylazine's growing ubiquity.
For now, pharmaceutical companies and other stakeholders have the option to petition the Secretary of State’s office – which oversees the Controlled Substance Advisory Council – to make changes to the regulation.
Delaware Code allows the adoption of regulations on short notice to respond to urgent public health concerns.
The emergency regulation now awaits approval from Secretary of State Jeff Bullock.
