Updates on xylazine regulation in the US and UK

Kelley Detweiler and Peter Weinstein, DVM, MBA, discuss the latest developments surrounding xylazine regulation in the United Kingdom and its implications for the veterinary profession. As the UK prepares to classify xylazine as a controlled substance, they look at the timeline of potential legislative actions in both the UK and the United States.

Transcript:

Kelley Detweiler: If you want to just get a quick, what we call a "sit rep," on what's going on here: the reason the xylazine ban in the United Kingdom is becoming such a hot topic is because, well, xylazine and its crises really started Ground Zero—almost in my backyard in Philadelphia. The United States, as everyone probably remembers, got really hot and heavy on it for a while. It was the biggest thing everyone was talking about as 2023 came to a close. In March, the federal government had legislation passed through Congress, but it was standing still. Meanwhile, the states were off to the races. Florida had already acted, then Ohio, West Virginia, and it just kept going.

But then, all of a sudden, there was nothing. On July 11, 2023, the White House put out the different pillars of what they were going to do. But nothing has really happened at the federal level in the United States. If the US acted, they’d likely make xylazine a Schedule III controlled substance, subject to those penalties, but still protecting licit veterinary use.

While all of that has kind of been "to be continued," the UK has moved forward with their initiative. To give some background, in June 2023, the UK Minister for Crime, Police, and Fire commissioned an Advisory Council on the Misuse of Drugs (ACMD). They were looking for guidance on how to appropriately classify and schedule xylazine under the Misuse of Drugs Act of 1971, which is similar to the Controlled Substances Act in the United States.

As things have continued to get worse in the UK, since xylazine is now an international issue, early in September 2023—right after Labor Day—legislation was laid out in Parliament to ban xylazine as well as 21 other dangerous drugs. This is part of a government cooperative action to prevent drug deaths and crack down on gang-related drug activities. The UK is looking to classify xylazine as a Class C drug.

A Class C drug in the UK is considered the least harmful, but it includes substances like benzodiazepines and steroids. If caught supplying a Class C drug, you could face unlimited fines, up to 14 years in jail, or both. This is significant because the UK tends to act more expediently when moving things into regulatory legislation. They would be the first country to take such a step, potentially positioning everyone else—like the US, Canada, and Mexico—to consider their next move.

Peter Weinstein, DVM, MBA: Can I add a point? It has nothing to do with xylazine specifically, but it relates to the whole opioid discussion. I've done a lot of different things in my career, and when speaking to Kelley 3 or 4 years ago, I learned about the issues within the veterinary profession regarding controlled substances, substance abuse, and diversion. That really piqued my interest in the need to help the veterinary profession understand the risks—risks to their staff, to themselves as veterinarians, and to their clients.

A lot of what we're doing with the talks we give is really aimed at helping the veterinary profession do a better job of protecting themselves. We want them to understand these risks so we don’t have colleagues and friends becoming victims of substance abuse, which can happen all too easily given the stressors in this profession. The biggest part of the vision and mission Kelley and I share is to help the veterinary profession stay clean—not just from substance abuse, but also from compliance issues with the DEA.