Accidental exposure to fentanyl patches can be a significant cause of poisoning in children, leading to serious illness or even death. The U.S. Food and Drug Administration (FDA) urges parents and caregivers to take precautions to ensure the proper storage, use, and disposal of these patches. If a child is suspected of being exposed to a fentanyl patch, immediate medical assistance should be sought by calling 911. Fentanyl patches, marketed under the brand name Duragesic and available in generic form, are prescribed by healthcare professionals for opioid-tolerant patients requiring long-term pain management. The patch is applied to the skin and releases fentanyl over a three-day period. Both new and used patches pose risks to children who may put them in their mouth or attach them to their skin, resulting in slowed breathing and decreased oxygen levels, potentially leading to death. The FDA has continuously warned patients, caregivers, and healthcare professionals about the dangers of accidental exposure to fentanyl patches and emphasizes the importance of proper storage and disposal. The FDA also recommends that patients and caregivers discuss having naloxone readily available. Naloxone is a life-saving medication that can rapidly reverse the effects of opioids, including fentanyl, during an overdose. It can be administered to children and individuals exposed to a fentanyl patch. To minimize the risk of accidental exposure to fentanyl patches, the FDA suggests the following precautions: It is crucial to dispose of used fentanyl patches promptly to prevent accidental exposure. The FDA recommends folding the patch with the sticky sides together and flushing it down the toilet. Patches should not be placed in household trash where they can be easily accessed by children or pets. Fentanyl patches are included in a list of medications that should be flushed down the toilet due to their potential harm if used by individuals for whom they were not prescribed. If a child is exposed to a fentanyl patch, naloxone should be administered if available, and immediate medical help should be sought by calling 911. Early signs of exposure may be challenging to recognize in young children, with drowsiness often being the initial symptom. Other signs include trouble breathing, swelling of the face or throat, agitation, high body temperature, and stiff muscles. It is important for individuals to discuss the benefits of naloxone with their healthcare professionals and learn how to obtain it. Naloxone is a vital tool in reversing opioid overdoses and can be used on people of all ages. However, even if naloxone is administered, emergency medical assistance should still be sought. For any questions regarding fentanyl patches, individuals can consult their healthcare professionals, pharmacists, or contact the FDA’s Division of Drug Information (DDI) by email or phone. Cases of accidental exposure to fentanyl patches or other medications should be reported to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program using the provided online form or by downloading and submitting the reporting form via mail or fax. Report US Food & Drug

The U.S. Drug Enforcement Administration (DEA) has issued a warning about the alarming rise in the trafficking of fentanyl mixed with xylazine, a potent sedative approved for veterinary use by the U.S. Food and Drug Administration. Administrator Milgram of the DEA emphasized that xylazine is making fentanyl, already a deadly drug threat, even more dangerous. The DEA has discovered mixtures of xylazine and fentanyl in 48 out of 50 states, with approximately 23% of fentanyl powder and 7% of fentanyl pills seized by the DEA containing xylazine. The combination of xylazine and fentanyl poses a higher risk of fatal drug poisoning for users. Unlike opioids, xylazine’s effects cannot be reversed by naloxone (Narcan), although it is still recommended to administer naloxone in cases of suspected drug poisoning. Individuals injecting drug mixtures with xylazine may develop severe wounds, including tissue necrosis, which can lead to the need for amputation. According to the CDC, between August 2021 and August 2022, drug poisonings resulted in the deaths of 107,735 Americans, with synthetic opioids like fentanyl being involved in 66% of those cases. The Sinaloa Cartel and Jalisco Cartel in Mexico are primarily responsible for trafficking fentanyl into communities across the United States, often sourcing chemicals from China. The FDA has recently alerted healthcare providers about the risks to patients exposed to xylazine in illicit drugs, emphasizing the need for awareness and vigilance. The DEA issues Public Safety Alerts to inform the public about emerging threats to their safety and health. The previous alert, issued in September 2021, warned about the increased availability and lethality of fentanyl-laced counterfeit prescription pills. In November 2022, the DEA updated the alert, highlighting that six out of ten fentanyl-laced fake prescription pills contain a potentially lethal dose of fentanyl. Report DEA

Xylazine, commonly known as “tranq,” is a drug adulterant that has been detected by the DEA in an increasing number of overdose deaths. While the FDA has only authorized its use in veterinary medicine, illicitly-used xylazine is often found in combination with other substances like fentanyl, cocaine, or heroin, which can significantly raise the risk of fatal overdoses. Although limited research has been conducted on the effects of xylazine, anecdotal reports indicate that users experience symptoms similar to opioids, such as central nervous system depression. These effects include dry mouth, drowsiness, hypertension, respiratory depression, and even coma. Users can develop a physical dependence on xylazine, and withdrawal symptoms can be more severe than those experienced with heroin or methadone, including sharp chest pains and seizures. It’s important to note that naloxone, a medication used to reverse opioid overdose, does not reverse the effects of xylazine because it is not an opioid. Xylazine-positive overdose deaths have been on the rise in all regions of the United States, with staggering increases ranging from 103% to 1,127%. However, since xylazine is not included in the CDC’s reporting of national statistics on fatal overdoses, its prevalence is likely widely underestimated. Currently, xylazine is not listed as a controlled substance under the U.S. Controlled Substances Act. It can be purchased online in powder form from Chinese suppliers for as low as $6-20 per kilogram. Drug traffickers may utilize xylazine as an adulterant to increase their profits, as its psychoactive effects allow them to reduce the amount of fentanyl or heroin used in a mixture. These findings are based on a DEA Joint Intelligence Report from October 2022, as reported by Get Smart About Drugs. View the full report here