Government response to the ACMD’s advice on xylazine and related compounds
Published 21 March 2024
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This publication is available at https://www.gov.uk/government/publications/response-to-the-acmds-report-on-xylazine-and-related-compounds/government-response-to-the-acmds-advice-on-xylazine-and-related-compounds
Rt Hon Chris Philp MP
Minister of State for Crime, Policing and Fire
2 Marsham Street
London
SW1P 4DF
Professor Owen Bowden-Jones
Chair, Advisory Council on the Misuse of Drugs (ACMD)
Dr David Wood
Chair of xylazine and related substances Working Group, ACMD
C/o 1st Floor
Peel Building
2 Marsham Street
London
SW1P 4DF
21 March 2024
Dear Owen and David,
The government response to the ACMD’s advice on xylazine and related compounds.
I am grateful to the ACMD for their advice on the harms of xylazine, medetomidine and detomidine.
I have set out each recommendation and the government’s response below.
Recommendation 1
Although there is no evidence of intended use of xylazine at this time in the UK, given the acute toxicity of xylazine and the similarity to the enhanced toxicity seen when benzodiazepines are co-used with opioids, xylazine should be added to Class C of the Misuse of Drugs Act 1971.
As xylazine has legitimate use as a veterinary medicine, it should be placed in Schedule 4 Part 1 of the Misuse of Drugs Regulations 2001 (as amended).
Government response
The government accepts this recommendation and intends to introduce legislation to implement it, subject to Parliamentary approval.
Recommendation 2
Information should be provided in an appropriate format to the general public (such as FRANK) and to harm reduction services on the potential that heroin, fentanyl and other illicit drugs may contain xylazine.
This should include information on the potential health effects, including the potential for ulceration associated with the injection of xylazine.
Government response
The government accepts this recommendation.
FRANK is a trusted source of honest and impartial information on drugs, and it receives around 900,000 visits a month. It is regularly updated in response to emerging patterns of use and trends. The Office for Health Improvement and Disparities will update FRANK to include information on xylazine and its effects, including when used with opioids such as heroin or fentanyl.
The DHSC will provide information to harm reduction services, such as drug treatment and rehabilitation services, to increase awareness of the harms of xylazine and the potential for its use as an adulterant in other illicit drugs. UKHSA have confirmed that TOXBASE already includes information on xylazine and fentanyl adulterated with xylazine. UKHSA will keep this under review and update it as necessary.
Recommendation 3
Responsible agencies need to be vigilant and monitor for substances, such as xylazine and related compounds such as detomidine and medetomidine that might be used to augment the opioid market in the UK. This can be done by analysis of seized or submitted drug samples (especially seized heroin and other opioid samples) and analysis of patient toxicology and post mortem samples.
These data can then be collected, collated and monitored by the relevant public health agencies in the UK and reviewed by the newly established Synthetic Opioid Taskforce.
Government response
The government accepts this recommendation.
DHSC, Home Office and law enforcement partners, including the NCA, will continue to monitor the prevalence and harms of xylazine and synthetic opioids, including through analysis of seized or submitted drug samples and patient and post-mortem toxicology. The HMG Synthetic Opioids Taskforce currently oversees and coordinates the government’s strategic response to the threat to the UK posed by synthetic opioids.
Whilst xylazine and related compounds are not opioids, their co-use with opioids can increase the severity and duration of their sedative effects and thus pose a greater risk of harm to drug-users. This data will therefore feed into the ongoing government response to synthetic opioids.
As always, I remain extremely grateful for the expertise and timely reports provided by the ACMD to ensure that we continue to enact the appropriate control for dangerous or otherwise harmful substances.
Yours sincerely,
[Signed]
Rt Hon Chris Philp MP
Minister of State for Crime, Policing and Fire