►
From YouTube: Addiction Recovery Channel: Fentanyl and Xylazine and The Poly-drug Overdose Death Crisis in America
Description
From Ed Baker:
Dr. Joseph D’Orazio, a noted expert, discusses the pharmacology of xylazine, the clinical course and clinical management of overdose, the complications presented by fentanyl/xylazine combination, xylazine wounds and wound care, and the growing prevalence of xylazine in the unregulated drug supply.
Dr. Joseph D'Orazio is an emergency physician, medical toxicologist, and addiction medicine specialist at the Lewis Katz School of Medicine at Temple University. He cares for Temple patients in a variety of settings, including the emergency department, an inpatient consultative service for addiction medicine and toxicology, the TRUST Clinic (an office-based opioid treatment program), and Begin the Turn (Temple's low-barrier access street-side medicine program). Dr. D’Orazio is a medical toxicologist for the Poison Control Center at Children’s Hospital of Philadelphia and is regarded as a regional expert regarding substance use and substance use disorder treatment in Philadelphia.
4/20/2023
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A
Hi
everyone
and
welcome
to
the
addiction,
recovery,
Channel,
I'm,
Ed,
Baker
and
I'm
your
host.
Thank
you
for
sharing
your
time
with
us
today.
Today,
as
our
guest,
we
have
Dr
Joseph
derazion
Dr
dorazio
is
an
Emergency
Physician
Medical
toxicologist
in
addiction,
medicine
specialist
at
the
Lewis
Katz
school
of
medicine
at
Temple
University.
A
He
cares
for
temple
patients
in
a
variety
of
settings,
including
the
emergency
department,
an
Inpatient
consultative
service
for
addiction,
medicine
and
toxicology,
the
trust
Clinic,
an
office-based
opioid
treatment
program
and
begin
the
turn.
Temple's
low
barrier
access,
Street
side,
medicine
program,
Dr
durazio,
is
a
medical
toxicologist
for
the
Poison
Control
Center
at
Children's
Hospital
of
Philadelphia
and
is
regarded
as
a
regional
expert
regarding
substance
use
and
substance
use
disorder,
treatment
in
Philadelphia.
A
Thank
you
doctor
for
being
on
the
show.
Thanks
for
having
me,
you
know,
I
just
like
to
set
the
stage
by
giving
you
some
information
about
what's
happening
in
Vermont
in
Vermont,
since
2010
we've
seen
a
quintupling
of
probably
drug
overdose,
death
2022
was
the
worst
year
ever.
It
seems
like
every
year
is
the
worst
year
ever
in
2022
we
had
confirmed
237
accidental
poly
drug
overdose.
Deaths
was
24
pendings,
so
potentially
261
deaths
in
one
year.
A
That's
one
every
33
hours
in
this
little
state,
93
percent
of
those
deaths
involved,
Fentanyl
and
just
under
30
percent
involved
xylazine,
and
you
know,
you've
done
a
lot
of
research
on
this.
You've
got
boots
on
the
ground
on
this
in
in
Philadelphia
and
I
would
just
like
I'd
like
to
hear
from
you
to
begin
with,
and
then
we
can
zero
in
on
stuff.
But
to
begin
with,
what
is
your
assessment
about?
What's
happening
in
our
country
with
the
unregulated
drug
Supply.
B
You
know
here
in
Philadelphia
we're
seeing
the
same
sort
of
the
same
sort
of
things.
The
numbers
are
sort
of
on
a
higher
scale,
but
you
know
we're
sort
of
a
bigger
big
city,
but
we're
seeing
the
same
same
effects.
Fentanyl
is
the
major
drug.
You
know
more
than
90
percent
of
Overdose
deaths
are
caused
by
fentanyl
here,
and
you
know
more
than
30
percent
of
those
opioid
overdose
deaths
are.
They
are
test
positive
for
xylazine
and
postmortem,
so
they're
being
exposed
to
xylazine.
Also.
A
For
the
viewing,
not
my
viewing
audiences
varied
there's
some,
you
know:
practitioners,
some
recovery,
coaches,
some
people
who
are
using
drugs
families
harm
reductionists.
You
know,
can
you
can
you
explain
to
us?
You
know
what
what
is
what
is
xylazine,
why?
Why
is
it
being
mixed
with
fentanyl?
What
is
going
on.
B
It
has
now
made
it
made
its
way
outside
the
veterinary
supply
or
the
veterinary
supplies
made
it
outside
of
the
veterinary
world
and
is
on
the
streets,
and
so
we
first
started
seeing
xylazine
in
Puerto
Rico
in
the
early
2000s
and
the
first
hint
of
it
being
here
in
the
mainland
was
in
Philadelphia
in
2006.,
and
then
we
saw
a
rapid
increase
in
2018
with
xylodine,
and
so
why
it's
in
there
I
think
is
a
really
good
question
and
I.
Don't
think
we
necessarily
have
that
answer.
B
I
think
there's
a
lot
of
conjecture
about
what
the
reasons
it
could
be
in
there.
You
know
the
word
on
the
street
is
that
it
gives
fentanyl
legs
and
that's
the
that's
the
phrase
that
I
hear
all
the
time.
You
know
that
like
Fenton
was
a
really
short-acting,
opioid
and
xylazine
can
can
provide
like
a
longer
period
of
sedation
associated
with
fentanyl
use,
and
so
there's
not
nearly
as
much
up
and
down
I'm,
not
quite
sure.
That's
necessarily
true,
you
know
and
I'm
not
quite
sure.
A
B
Yeah,
you
know
I
I,
hear
about
this.
A
lot
from
my
patients
that
I'm
taking
care
of
will
say
you
know
a
used
bag
and
it
was
heavy
on
track,
meaning
xylazine
and
I
woke
up
three
or
four
hours
later
I
feel
like
I
got
no
opioid
effect
out
of
it,
and
then
I
was
in
withdrawal
when
I
came
to,
and
certainly
that
goes
to
that
sort
of
the
pharmacokinetic
certainly
worked
there.
The
duration
of
effect
of
xylazine
is
going
to
be
much
longer
than
fentanyl.
B
A
B
You
know,
certainly,
we
have
noticed
a
lot
of
talk
about
xylazine
dependence
and
when
you're,
not
people
are
not
using
xylazine
they're
getting
sick,
but
not
to
my
knowledge,
I'm,
not
quite
sure,
there's
a
lot
of
treatment
going
on
for
like
an
addiction
to
xylazine,
as
in
like
people
have
difficulty
putting
it
down.
You.
A
B
That's
a
good
question,
because
certainly
people
who
are
using
xylazine
will
describe
that.
You
know
it's.
My
withdrawals
is
not
the
same
anymore.
You
know
I
used
to
be
able
just
like
a
couple
days
if
I
were
to
stop
and
go
through
a
withdrawal,
but
now
I'm
having
anxiety
and
restlessness
that
lasts
much
longer
or
that
you
know
ever
since
xylazine
made
it
into
our
supply.
My
withdrawal
just
felt
different,
but
you
know
the
symptoms.
B
Typically,
of
xylazine
withdrawal
are
like
anxiety,
dysphoria
restlessness
and,
as
you
can
see,
that
that's
an
over
those
are
overlapping
symptoms
with
opioid
withdrawal,
and
so
sometimes
it's
really
hard
to
differentiate.
The
two
is
this
just
really
bad
opioid
withdrawal,
or
is
there
really
such
thing
as
xylaxene
withdrawal?
You
know
you
certainly
can't
find
it
in
a
textbook.
There
has
not
really
been
much
research
into
this,
at
least
not
that
I
know
of,
and
certainly
we
need
to
start
looking
into
the
dependence
to
xylazine.
B
But
what
we
have
seen
is
an
ever
increasing
dose
of
fentanyl
in
the
community,
and
so
maybe
a
couple
years
ago
we
were
talking
about
like
a
milligram
of
fentanyl.
Then
it
went
to
two
milligrams
of
fentanyl
per
bag
and
now
we're
dealing
with
five
milligrams
of
fentanyl
per
bag
in
Philadelphia,
and
so
you
know,
some
part
of
me
thinks
that
there
is
xylazine
withdrawal.
There
really
is
a
dependence,
but
another
part
of
me
thinks
that
it
really
just
could
be
due
to
the
you
know.
The
ever
Rising
dose
of
opioid.
A
You
know
a
specific
brand,
a
bag
with
a
specific
brand
I
believe
it
was
turbo
and
that
that
this
particular
brand
included
heroin
and
not
Fentanyl,
and
that
was
selling
for
like
an
increased
price
on
the
street.
Is
that?
Is
there
any
truth
to
that
or
people
looking
to
get
away
from
both
xylazine
and
Fentanyl
and
purchase
heroin.
B
You
know
good
question,
I,
really,
don't
think
you
can
avoid
Fentanyl
and
xylazine
if
you're
consuming
bags
dope
in
Philadelphia.
Right
now,
it
seems,
like
you
know,
greater
than
90
of
the
bags
and
Drug
tracking
programs
have
xylazine
in
them
and
almost
all
of
the
bags
have
fentanyl
in
them
and
if
they
don't
have
fentanyl
it's
either
a
nitazine
like
a
non-fentanyl
synthetic
opioid
or
an
or
a
different
fentanyl
analog,
and
really
finding
heroin
in
Philadelphia
is
like
a
needle
in
a
haystack
I.
B
B
A
reality,
that's
what
I
hear
over
and
over
again
too
it's
a
supply-side
Market.
It
has
nothing
to
do
with
the
end
user.
It
really
has
everything
to
do
with
yeah
the
people
who
are
selling
it.
This
is
what
I
have,
and
this
is
the
where
I
can
make
the
most
money
and
so
I'm
going
to
push
this
out
into
the
streets
and
and
there's
there's
no,
it's
not
your
typical
supply
and
demand.
Market
yeah.
B
B
You
know
I
think
when
I
first
started
understanding
xylazine
a
number
of
years
ago,
I
would
have
said
that
it's
associated
with
intranasal
use,
inhalational
use
and
injection,
but
over
the
years
just
talking
to
people
more
and
more,
it
seems
like
that.
It's
more
associated
with
injection
drug
use,
okay,
and
so-
and
this
is
also
not
just
talking
to
people
who
are
using
substances
but
like
looking
at
the
variation
and
differences
or
geographical
differences.
You
know.
B
Certainly,
we
know
that
on
the
west
coast,
there's
a
lot
more
smoking
a
fentanyl
than
there
is
injection
drug
use
and
talking
to
people
who
are
treating
opioid
use
disorder
on
the
west
coast.
They,
you
know,
they're,
never
seeing
wounds,
and
we
sort
of
have
this
concentrated
group
of
people
in
Philadelphia
that
are
engaging
with
injection
drug
use.
Behavior
that
we're
seeing
the
wounds-
and
it's
not
just
like
someone
who
uses
here
and
there
this
is
typically
a
person
who
is
associated
with
severe
heavy
fentanyl
injection
drug
use.
A
Yeah
and
I
had
I
had
spoken
with
a
few
I
met.
One
young
man
who
had
lost
a
foot
to
amputation.
I
met
a
couple
of
other
young
women
who
had
xylazine
sores,
and
you
know
interesting
and
I'm
happy
to
tell
you
that
the
the
the
two
women
that
I
talked
to
I
had
very
positive
things
to
say
about
the
medical
care
that
they
were
getting
and
specifically
that
they
weren't
they
didn't
feel
like
they
were
judged.
A
B
You
know
they're
just
to
sort
of
speak
to
that.
There
are
some
amazing
groups
that
have
their
boots
on
the
ground
in
Philadelphia
and
Kensington
and
specifically,
prevention
point
is
doing
a
lot
of
wound
care.
Savage
sisters
is
another
non-for-profit,
that's
helping
them.
You
know
there
are
a
lot
of
these
programs
in
Philadelphia
that
are
helping
people
who
are
living
on
the
streets
who
are
engaging
with
injection
drug
use,
in
particular
fentanyl
who
have
these
wounds,
and
you
know
I'm
not
quite
sure
where
we'd
be
without
them.
Yeah.
A
A
B
Like
I
think
xylazina
is
here
to
stay
I
think
it's
only
going
to
get
worse.
I,
don't
think
we
have
seen
the
peak
of
this
disorder
or
this
epidemic
just
yet
I
think,
with
a
recent
switch
from
a
Veterinary
pharmaceutical
Supply
to
an
illicit
powder
Supply
just
like
fentanyl,
the
monetary
you
know,
forces
in
there
are
just
really
gonna
just
point
towards
it's
only
going
to
continue
to
increase.
A
A
A
The
figure
from
October
21
to
October
22,
which
is
the
latest
figure,
was
over
a
hundred
and
seven
thousand
people.
Now
all
of
those
are
not
opioids,
but
unless
I'm
mistaken
more
than
two-thirds
are
it's
upgrade.
It's
around.
70
percent
are
opioids,
so
we're
looking
at
it
like
a
tsunami
of
death
and
all
our
responses
are
inadequate.
A
B
Yeah
I
think
you
know
over
and
over
again
we
focus
politically
on
like
prohibition
right
and
that
just
does
not
seem
to
work
and
the
more
regulations.
The
more
scheduling,
the
more
border
patrol
activity
we
sort
of
concentrate
on.
We
just
keep
seeing
increasing
increasing
number
of
Overdose
deaths,
so
there's
like
the
overdose,
death
crisis
and
I
think
prohibition
is
not
going
to
fix
the
overdose
death
crisis
and
what
we
really
need
is
a
safe,
Supply
or
a
safe
way
for
people
that
are
going
to
use
and
overdose
prevention.
B
Centers
are,
like
you
know,
are
a
great
example
of
a
harm
reduction
manner,
of
preventing
those
overdose
deaths
or
providing
a
safe
Supply,
especially
for
people
with
severe
use
that,
despite
multiple
attempts
at
treatment,
I've
just
had
never
been
able
to
get
into
recovery.
We
want
to
keep
those
people
alive
until
you
know,
better
treatments
are
available
to
help
them
achieve
recovery
and
a
safe
supply
seems
to
be
like
a
step
towards
that
for.
B
I
think
just
simply
a
supply
that
people
a
supply
of
opioids
that
people
can
use
that
they
know
know
the
dose.
They
know
that
it's
pure,
that
they
know
that
it
is
not
contaminated
with
lots
of
other
substances,
so
people
can
meter
a
dose,
so
they
know
what
they
can
expect
and
so
they're
not
getting.
You
know
randomly
large
doses
and
other
days
really
small
doses,
and
that
you
know
the
the
variability
in
the
supply
and
the
contaminants
in
the
supplies.
B
A
A
A
B
Yeah
I
think
I
just
wish.
We
were
able
to
sort
of
keep
this
in
a
medical
conversation
and
take
the
overdose
prevention
sites
out
of
a
political
conversation
and
but
unfortunately,
there
this
is
like
hungry,
controversial
sort
of
stuff,
and
so
it
gets
highly
politicized,
but
certainly
from
like
a
science,
research
and
medical
treatment
perspective.
You
know
it
reduces.
You
know
the
needles
on
the
street,
it
reduces.
You
know
open-air
use
where
people
are
just
on
the
side
of
this
on
the
sidewalk
using
and
everyone
is
there
to
see
it.
B
A
A
You
know
worthy
of
being
paid
attention
to,
and
you
know
getting
to
know
each
other.
This
relationship,
you
know
offered
to
them
it's
a
safe
place
and
this
this
particular
population
that
we're
talking
about-
and
you
know
better
than
I-
do
because
you
work
with
them
every
Wednesday,
the
the
probably
the
most
unsafe
population
in
America,
besides
being
unhoused
and
unfed
they're
addicted
to
drugs
that
are
contaminated
with
poison
I,
don't
think
you
can
get
more
at
risk
than
that
now.
A
A
It
seems
to
be
the
epitome
of
meeting
someone
where
they
are
and
that
you
can't
you
can't
fake
that
and
for
this
population,
and
many
of
them
have
been
persecuted,
prosecuted,
stigmatized,
punished,
rejected
traumatized.
This
particular
population,
the
harm
reduction
world,
is
probably
the
only
place
they
can
engage
and
it's
overdose
prevention,
centers
and
we
have.
We
have
home
reduction
centers
in
Vermont.
A
B
Yeah
I
just
want
to
Echo
those
those
thoughts
there
Ed,
and
you
know
this
is
why
I
really
I
really
like
the
term
comprehensive
user
engagement
site.
That
was
a
that's
somewhere
along
the
evolution
of
the
the
name.
We've
we've
landed
on
overdose
prevention
sites,
but
really
overdose
prevention
sites
can
be
so
much
more
than
just
preventing
an
overdose
yeah.
You
know,
if
you
add
Medical,
Care
and
Recovery
Services
to
a
site
like
that.
B
I'm
I
show
up
there
and
I
meet
Joe
and
I
say
you
know
like
and
Joe
was
there
and
nice
to
me
and
doesn't
treat
me
in
a
stigmatized
manner
and
I
get
I,
create
a
relationship,
and
then
you
know
in
due
time
when
I'm
ready
for
Recovery
I
now
have
I,
have
the
trust
of
Joe
to
help
me
get
into
recovery
and
if
it
all
is
engaged
there,
people
know
where
to
go
for
that
care.
So
yeah.
A
People
can
come
in,
you
know,
can
can
get
a
couple
of
other
needs
met
can
feel
safe
and
even
even
if
they're,
just
going
there
for
that
I
just
want
a
cup
of
coffee
and
I
want
a
haircut,
fine,
you
know,
and
and
if
that's
why
you're
coming
come
and
let's
engage
you
because
you
may
come
here
for
other
more
profound
reasons
going
forward.
So,
yes,
like
wound
care,
HIV.
A
Yeah,
you
know
so
I'm
just
really
glad
we're
on
the
same
page
and
the
more
we
can
hear
people
like
you,
you
know
speaking
out
about
this,
the
more
likely
we
are
to
to
turn
this
corner
at
some
point.
What
do
you
do?
You
have
any
opinion
about
the
reluctance
there
seems
to
be
it's
it's
lessening.
Now
there
are
more.
We
seem
to
be
reaching
like
a
little
bit
of
a
Tipping
Point,
where
you'll
hear
more
and
more
people.
Speaking
out,
you
know
calling
out
for
change.
A
A
Comprehensive
user
engagement
sites
you'll
hear
more
and
more
people
about
speaking
out,
but
what
do
you
think
it
is
that
keeps
us
people
with
scientific
Minds
people
with
medical
Minds
people
with
with
wealths
of
experience?
What
is
keeping
them
the
the
majority
of
them
silent,
I,
don't
understand
it.
B
You
know
when
HIV,
when
we
first
just
first
discovered
what
HIV
was
and
started
treatment
for
HIV
I
think
we
ran
into
a
lot
of
the
same
sort
of
stigma.
We
see
here
with
opioid
use
disorder
and
it
took
generations
to
get
to
the
point
where
we
are
now
and
yeah
losing
that
stigma
supporting
research
and
treating
it
just
like
any
other
infection
or
disorder,
as
has
been
really
important
for
getting
HIV
to
the
point
today,
where
you
know
you're
living
with
HIV,
it's
not
a
death
sentence
has
been
really
amazing
and
I.
A
A
You
know
to
ways
other
than
abstinence
based,
namely
harm
reduction,
and
what
opened
my
mind
was
the
reality
of
death
mounting
death
within
a
population
of
people
that
couldn't
just
just
achieve
abstinence.
They
were
going
to
continue
to
use
and
as
a
result
of
stigma,
driving
them
away
from
Health,
Care,
Systems
and
addiction,
driving
them
toward
drug
use.
They
were
dying
left
and
right.
How
can
one
adhere
to
an
abstinence-based
Dogma
when,
when,
when
that
is
reality
and
I've
talked
to
other
people?
B
A
B
Know
this
is
going
to
be
their
burden.
You
know
the
HIV
of
their
generation.
You
know
this
is
the.
This
is
the
biggest
crisis
of
their
of
their
lifetime
and
the
The
Horizon
looks
good
because
a
lot
of
medical
students
I
engage
with
understand
this
and
are
not
that
there's
a
new
wave
of
doctors
coming
up
that
are
treating
people
non-stigmatized
ways,
they're
learning
at
a
very
early
stage
in
their
career,
to
meet
people
where
they're
at
and
be
patient-centered
and
I.
Think
I've
got
a
lot
of
optimism.
A
That's
that's
beautiful
to
hear
I
know
the
American
Society
of
addiction,
medicine
for
a
long
time
has
been
kind
of
leading
the
way.
I
know
that
there
are
programs
with
addiction,
psychiatrists
addiction,
there's
certifications
in
addiction,
there's
certainly
a
growing
field.
Do
you
do
any
of
that
work
at
your
at
your
University
in
Philadelphia,
Temple.
A
B
And
then
I
and
I
work
at
at
Lewis
cat
school
of
medicine
at
Temple
and
I
engage
with
a
with
a
lot
of
medical
students
in
through
addiction,
medicine,
interest
group
and
there's
lots
of
interest
and
there's
lots
of
you
know
the
next
generation
of
trying
of
students
trying
to
get
involved
and
to
find
a
cure.
Yeah.
A
You
know
recently
that
you
mentioned
that
is
interesting,
because
recently
norovalkov
had
a
Blog
very
recently
like
last
week
about
a
cure
for
addiction
and
it
involved.
You
know
ultrasonic
brain
waves
and
different
types
of
brain
treatments
that
were
really
I,
mean
something
that
I
had
never
ever
thought
of.
So
apparently
there's
a
tremendous
amount
of
funding
going
into
into
into
research.
At
this
point,.
B
Yeah
there
is
a
lot
of
funding
grant
funding
out
there
for
addiction,
research,
you
know
and
boy.
We
need
it,
because
the
options
for
treatment
right
now
are
so
limited,
and
for
so
many
people,
buprenorphine
and
methadone,
just
don't
work
for
them
and
we
need
to
have
alternative
options
for
people.
We've
talked
about
safe
Supply,
but
I
think
there
are
treatments
out
there.
There's
medications
out
there
that
we
need
to
work
on
to
help
treat
dependents,
withdrawal
and
then
addiction.
A
And
I
know
there's
research
going
into
that,
but
along
those
lines,
I
know
that
there
is
a
like
an
antidote
for
xylazine
overdose
in
in
in
animals,
but
that
antidote
or
overdose
reversal
drug
has
has
not
I,
don't
think
it's
been
tested
on
humans.
Is
there
any
any
hope
that
in
the
future,
we
might
have
a
an
overdose
reversal
for
xylazine
that
that
that
that
humans
can
use.
B
You
know
there
certainly
is
a
medication
that
is
used
for
reversal
of
xylazine
in
the
veterinary,
World
medications
and
tipism
is
all
but
I.
Think
probably
the
bigger
question
is:
do
we
need
a
reversal
agent?
You
know
just
like
we
have
a
reversal
agent
for
benzodiazepines,
which
is
flamazonil.
It's
not
a
medication
that
we
use
regularly
and
actually
there's
significant
harm
that
is
associated
with
that
drug.
If
you're
giving
it
to
someone
who
has
benzodiazepine
dependence,
but
the
way
I
look
at
xylazine
is
you
know
it's
not
causing
a
significant?
B
It's
not
causing
a
significant
number
of
Overdose
deaths
and
we're
certainly
only
seeing
it
with
opioids
and
opioids
are
really
the
major
cause
of
overdose
death
and
actually,
after
reversing
opioids.
If
a
patient
remains
sedate
from
xylazine,
they
usually
do
pretty
well
with
just
supportive
care,
and
so,
if
it's
you
know
someone
in
the
field
managing
this
overdose
or
someone
coming
to
the
emergency
department,
it's
typically
really
just
some
supportive
care
of
managing
their
Airway
and
even
from
the
data
from
overdose
overdoses
that
are
associated
with
xylazine.
A
You
know,
and
when
you
mention
that
again,
what
comes
to
my
mind
immediately
is
overdose
prevention
centers,
because
with
xylazine
I
I
believe
it's
called
hypoxia
there's
a
blunted
response
to
hypoxia.
In
other
words,
the
person
stops
breathing
and
they
don't
really
care
they're,
not
even
aware
of
it.
It's
not
it's
not.
As
with
an
opioid
the
mechanism
that
causes
you
to
breathe
shuts
down
and
you
just
stop
breathing
with
xylazine.
You
want
to
keep
breathing
something
gets
in
the
way
of
your
breathing
and
you're
so
sedated
that
you
don't
do
anything
about
it.
A
So
it
seems
that
in
an
overdose
prevention
center,
people
in
overdose
prevention,
centers
could
be
very
quickly
trained
on
how
to
position
a
body
to
keep
air
waves,
Airways,
open
and
and
perhaps
Save
a
Life,
whereas
people
on
the
street
with
Narcan,
you
know,
may
not
may
not
know
about
this
and
getting
the
information
out
to
them.
I
think
is
going
to
take
a
while,
but
I
also
think
we
need
to
get
this
information
out
to
to
people
who
are
using
drugs.
You
know
on
the
street.
B
Xylazine
does
not
cause
respiratory
depression
in
the
sense
like
it
opioids
do
where
they
slow
the
respiratory
rate
down.
You
know
what
xylazine
does
is
very
similar
to
what
benzodiazepines
or
alcohol
in
large
quantities
would
do.
It
would
the
sedative
it
puts
you
to
sleep,
and
if
your
Airway
is
occluded
or
you
vomit
and
there's
vomit
in
your
mouth,
and
you
can't
clear
your
Airway,
you
don't
wake
up
to
clear
your
Airway,
like
you
would
like
with
someone
with
a
Sleep
Apnea.
B
A
Yeah,
you
know
so
I
mean
getting
all
this
information
out
and
that's
part
of
what
this
interview
will
do.
This
information
will
get
out.
People
will
share
this
widely
and
and
you're.
You
know,
information,
that's
potentially
life-saving,
you
know
will
will
be
disseminated.
So
that's
the
purpose
of
the
addiction,
recovery,
Channel
and
I
know
from
your.
You
know,
generosity
with
your
time
that
that
it's
your
purpose
too.
You
know,
if
you
get
this
word
out
there
to
help
people
to
really
understand
what
what
we
can
do
about
this,
because
we're
we're
in
this
together.
A
B
You
know
I
think
we
sort
of
you
know
with
some
new
information
out
that
from
ondcp
that
xylazine
they're
working
towards
scheduling,
xylazine
and
you
know,
they've
announced
that
is
the
the
combination
of
xylazine
and
Fentanyl-
is
an
emerging
drug
threat.
I
think
it's
going
to
be
super
helpful
in
spurring
on
some
research
to
make
sure
everyone's
aware
that
this
is
a
dangerous
drug
and
that
we
need
to
understand
a
lot
more
about
it.
But
I.
You
know
my
concerns.
A
Yeah
I
I,
sadly
agree
with.
You
I
think
that
Dr
Gupta
at
the
RX
Summit
made
this
announcement
and
he
also
from
what
I've
heard
implied
that
resources
would
become
available,
but
the
definition
of
resources
and
the
definition
of
resources
for
what
what
was
left
a
little
foggy.
So
we
know
no
one
really
knows
right
now,
but
yeah
criminalization,
as
we've
seen
since
the
Inception
of
the
War
on
Drugs
does
exactly
the
opposite
of
anything.
Anyone
would
want
to
accomplish.
You
know
and
I
I
agree
with
you
on
that.
A
So
thank
you
and
you
know
I
love
your
enthusiasm.
You
know
about
the
medical
profession
and
the
way
the
medical
profession
is
moving
forward.
I
love
your
enthusiasm
about
like
committing
to
this.
Even
if
it
takes
Generations
we're
not
we're
not
going
to
give
up
we're
not
going
away
we're
not
going
to
stop
we're
not
going
to
stop
loving
people,
we're
not
going
to
stop
being
here
for
people
who
need
us.
So
thank
you.
A
B
A
Having
me
Ed
yeah
to
my
to
my
audience,
there's
going
to
be
a
screen
lingering
now
with
two
one
one,
two
one
one
is
the
helpline
in
Vermont.
If
you
call
2-1-1
and
hit
prompt
five
you'll
get
in
touch
with
a
real
person
who
will
give
you
information
on
a
harm
reduction,
Services,
Treatment,
Services,
Recovery,
Center,
Services,
a
wide,
very
wide
range
of
services
and
I
want
everyone
to
know
that
I
would
never
ever
recommend
something.
A
I
hadn't
tried
and
I
called
them
today,
I
called
2-1-1
today
and
I
I
I,
I,
I
I,
was
put
in
touch
with
a
person
and
I
asked
all
the
questions.
I
wanted
to
ask
about
harm
reduction,
about
syringe
Supply,
about
wound,
kits
about
fentanyl
test
strips
and
I
was
treated
with
the
utmost
respect.
The
utmost
dignity.
I
didn't
even
feel
a
whiff
of
stigma
coming
toward
me,
so
this
is
a
safe
number
for
you
to
call
two
one
one.