MADDS Finds Xylazine in 28% of Opioids, Demanding More Proactive Approach to Harm Reduction


Elina Gordon-Halpern


February 12, 2023

On February 2nd, Smith College students packed like sardines into Neilson Library’s Browsing Room, eager to gain potentially life-saving insights from Tapestry Health, a federally funded harm reduction based in Western Massachusetts. In partnership with Smith’s Wellness team, representatives from Tapestry’s Northampton branch led a free training session for Naloxone, also known as Narcan, a drug used to reverse or minimize the effects of an opioid overdose.

Mars Ikeda, a third year Ada Comstock Scholar at Smith, shared their takeaways from the training: “They showed us how to administer Narcan and passed out masks with one-way filters for covid-safe rescue breathing,” Ikeda said, adding that every student attendee was also offered two doses of Narcan, “because sometimes one isn’t enough.”

Over 100 thousand people in the United States died of opioid overdoses between the March of 2021 and that of the following year, the largest number of overdose deaths to ever be recorded in a twelve month period. While figures appear to be decreasing for college students, opioid use is grossly under reported, if the user is even aware of their opioid ingestion, providing potentially misleading information that may portray the opioid epidemic as a less significant concern for students. On the contrary - destigmatizing opioid and broader substance abuse is an important step in achieving student trust and, subsequently, more accurate figures. This starts with campus trainings.

Massachusetts, home to Smith and over one hundred other colleges and universities, has an overdose death rate more than 50% higher than the national average. With such a massive proportion of students compared to the state’s overall population, turning to campus based education may spark hope for addressing the broader Massachusetts opioid epidemic.

Ikeda said that, despite having no prior experience administering Narcan, “I feel like after this training I would know how to help and not hurt.” They noted Tapestry’s breakdown of opioid overdose warning signs as a key source of newfound confidence: “I remember being in New York City seeing people nodding off and not knowing what to do, and after this course I feel like I know what to look for.”

Increases in overdose deaths are due in large part to the increased presence of fentanyl, not only in other opioids but in drugs such as adderall and cocaine, which are popular on college campuses. In June of 2022, however, the Massachusetts Drug Supply Data Stream (MADDS) found xylazine in 28% of opioid samples. Xylazine is an animal tranquilizer with a growing presence in America’s illicit drug supply, and, despite warning signs of slowed breath and loss of consciousness that mirror opioid overdose, it is not impacted by Naloxone.

While certainly a critical and often life-saving tool, Narcan is only retroactive. While harm reduction trainings and resources are absolutely critical, they must evolve alongside sources of harm. Ikeda noted that the information session expanded to other forms of harm reduction, mentioning drug testing kits as a proactive measure. Unfortunately, testing kits are not as easily accessible and are not always 100% reliable, but now, neither is Narcan. It’s time for the harm reduction game to prioritize proactive measures as equally as important as Narcan, and that requires the increased accessibility and reliability of drug testing kits.