Xylazine warning even as ODs and deaths continue to trend lower
There were 42 suspected overdoses in Manchester and Nashua in January, according to data shared by American Medical Response (AMR). Thirty of those occurred in Manchester, 12 in Nashua. Four overdoses were fatal — three in Manchester, one in Nashua.
Despite the recent fatalities, January continued the trend of significantly lower opioid overdoses in both communities — 29% below the rolling 12-month average, Chris Stawasz, regional director of AMR, said in a statement.
"The sustained drops in opioid overdose death percentages are consistent with the statewide death statistics reported in the N.H. Drug Data Update from the Office of the Chief Medical Examiner," Stawasz said.
Manchester and Nashua recorded in 2024 the lowest number of overdoses in a year since the COVID pandemic. There were 710 suspected overdoses in Manchester and Nashua in 2024 — 526 of those occurred in Manchester, 184 in Nashua.
Sixty-six overdoses were fatal in 2024 — 46 in Manchester, 20 in Nashua. Nashua recorded both the lowest number of suspected opioid overdoses and lowest number of suspected opioid deaths in one year since AMR began tracking the data in 2015.
Manchester recorded a 24% drop in suspected opioid overdoses in 2024 compared to 2023, with Nashua down 19%. The Queen City recorded a 21% decrease in suspected opioid deaths in 2024, with Nashua down 49%, compared to the prior year.
"Keep in mind that due to the nature of the opioid epidemic and its clear history of unpredictability, it is always possible that the trend of lower numbers could quickly change," Stawasz said. "It is common to see different varieties of illicit poly substances appear without warning. Many can be highly lethal or require alternative approaches for successful lifesaving treatment."
Stawasz said in the most recent update from the state's the Office of the Chief Medical Examiner, Xylazine and Carfentanil were reported to be both "present and contributory" in over a dozen drugs deaths in New Hampshire last year.
"Increasingly now mixed with illicit fentanyl, xylazine's powerful sedative properties complicate EMS providers treatment of suspected opioid overdoses," Stawasz said. "It is undetectable to medics and Narcan does not reverse its effect. When present, it requires a significant additional and prolonged effort to maintain an effective airway and respiratory status on a victim."
The federal Drug Enforcement Administration (DEA) reports xylazine has been detected in approximately 30% of the fentanyl seized by law enforcement in New Hampshire.
People who inject drug mixtures containing xylazine also can develop severe wounds, including necrosis — the rotting of human tissue — that can lead to amputation, the DEA warned.
On Feb. 12, Congressman Chris Pappas (NH-01) joined a bipartisan group of Senate and House colleagues in reintroducing the Combating Illicit Xylazine Act, which would make xylazine a Schedule III controlled substance while protecting access for veterinarians, farmers, cattlemen, and ranchers who use xylazine to treat large animals.
"As we continue to see xylazine being mixed with fentanyl, heroin, and other deadly drugs, we must take action to crack down on dealers who are cutting drugs with this substance that worsens the life-threatening impacts of fentanyl," Pappas said in statement.
The Combating Illicit Xylazine Act would:
* Schedule xylazine as a Schedule III illicit substance under the Controlled Substances Act;
* Ensure veterinarians, farmers, and ranchers can still use the drug for its intended purpose by creating a clear definition of "ultimate user" — someone lawfully permitted to possess a controlled substance for legitimate use;
* Enable the DEA to track its manufacturing to ensure it is not diverted to the illicit market;
* Require a report on prevalence, risks, and recommendations regarding xylazine.
According to AMR, of the 42 suspected opioid overdoses reported in January in both Manchester and Nashua, 31% occurred in a home or residence, 40% happened in a public building or area and 17% were in vehicles or in a roadway. None occurred in a jail or prison. Five percent occurred in a hotel or motel.
In 10% of the overdoses, a bystander or member of the public administered Narcan before EMS personnel arrived.
In New Hampshire, anyone can seek substance use disorder treatment by accessing the NH Doorway program 24/7. To access the NH Doorway program, call 211 at any time of the day or night, or visit www.thedoorway.nh.gov.
If you believe someone is overdosing, call 911 immediately.
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