COLUMBUS, Ohio — Ohio Governor Mike DeWine has signed an executive order directing the State of Ohio Board of Pharmacy to classify xylazine as a Schedule III controlled substance. Xylazine is a central nervous system depressant commonly used in veterinary medicine as a sedative, anesthetic, and muscle relaxant. However, the substance is not approved for human consumption, and it has increasingly been found in the illicit drug supply in Ohio, often mixed with heroin, fentanyl, or new synthetic opioids (NSOs) such as nitazene.
Ohio is one of the first states in the nation to schedule xylazine as a controlled substance drug. The emergency order was prompted by alarming statistics of overdose deaths involving xylazine. According to the Ohio Department of Health, the rate of overdose deaths involving a mixture of xylazine and other drugs has been increasing each year since 2019, with 15 overdose deaths in 2019, 45 in 2020, and 75 in 2021. As of March 14, 2022, the Ohio Department of Health recorded 113 xylazine-involved overdose deaths. Of these 248 unintentional drug overdose deaths, 99.2 percent also involved fentanyl.
When used in combination with an opioid, xylazine may worsen respiratory depression in the event of a drug overdose. Human consumption of xylazine is also known to cause debilitating skin ulcers that cause tissue decay and bacterial infections, which can lead to amputation at higher rates than those who inject other drugs.
The scheduling of xylazine as a Schedule III controlled substance will make the sale and trafficking of xylazine for illicit use a criminal offense. The move will also allow for more robust testing, as many toxicology and crime labs do not test for the presence of uncontrolled substances. Veterinary practices may still administer xylazine to animals but must obtain a Category 3 Terminal Distributor of Dangerous Drugs license by June 30, 2023, to be permitted to order xylazine from a licensed wholesaler.
The emergency order was prompted by intelligence gathered as part of an early detection process developed by the Ohio Narcotics Intelligence Center (ONIC) in partnership with RecoveryOhio, the State of Ohio Board of Pharmacy, and local drug toxicologists and chemists. The early detection process, which includes the proactive collection of reports from Ohio’s criminal justice system and forensic labs, allows ONIC to identify, analyze, and triage information on emerging drugs of abuse that are not controlled substances. In 2022, ONIC intelligence led Governor DeWine and the State of Ohio Board of Pharmacy to add nine emerging dangerous substances to Ohio’s controlled drug schedule.
If you believe you or someone else is in immediate danger of a drug overdose, call 911 immediately. Naloxone should always be administered anytime an overdose is suspected, even if the overdose is believed to be caused by xylazine. Multiple doses of naloxone may be needed to reverse an overdose involving an NSO.
For more information on obtaining free naloxone, visit naloxone.ohio.gov. For more information regarding the emergency scheduling of xylazine by the State of Ohio Board of Pharmacy, visit www.pharmacy.ohio.gov/xylazine.
