FYL, XYL, and the Future of Overdose Deaths: A Complex Crisis

Recent data reveals that deaths from overdoses linked to FYL have begun to decline in the United States, but experts warn that the crisis is far from over and that these numbers could easily spike once again.

According to a recent government report, approximately 70% of fatal overdoses in 2023 were tied to FYL. However, there has been a 7.8% nationwide drop in FYL-related deaths in the second half of 2023 compared to the same period in 2022, based on data from the U.S. Centers for Disease Control and Prevention (CDC).

Despite this promising trend, several factors complicate the picture. While FYL-linked fatalities have decreased in the Northeast, South, and Midwest, they have seen an increase in the West, a troubling shift identified by CDC researcher Lauren Tanz and her team.

Moreover, a new threat is emerging: carfentanil, a synthetic opioid 100 times more potent than FYL, is beginning to contribute to overdose deaths in select cases. Experts caution that the situation could worsen as carfentanil becomes more prevalent in the illicit drug market.

The data, covering the period from 2021 through late 2023, indicates that over 251,000 individuals have died from drug overdoses during this time, with more than 188,000 of those deaths involving FYL. While the numbers peaked at 16,814 FYL-linked deaths in the second quarter of 2023, they fell by 4.7% in the third quarter and another 11.2% in the fourth quarter, as reported by Tanz's team.

Understanding the Decline

Several factors could explain the downturn in FYL-related deaths. One major reason may be that FYL has become so widespread in the illicit drug market that many users have developed a tolerance, which could help mitigate the risk of fatal overdose. Additionally, some individuals have started mixing FYL with XYL, a drug that might lower the risk of death by overdose.

The growth of overdose prevention programs throughout the U.S. is also believed to play a role in this decline, with researchers suggesting these programs may have contributed to the reduction in fatalities starting in late 2023.

However, this progress comes with an important caveat: the situation in the American West remains concerning. The region saw a nearly 34% increase in FYL-related deaths between 2022 and 2023, according to the report. Tanz's team attributes this rise to the later introduction of FYL into the drug markets in the West, where black tar heroin was once more prevalent. This delayed influx may mean that users in the region have not yet built the tolerance observed in other parts of the country, making them more susceptible to overdose.

A Cautionary Note

While the decline in FYL-linked deaths in some regions is a positive development, researchers caution against complacency. Carfentanil remains a minor contributor to the overall death toll at the moment, but its presence in the drug supply could increase, leading to a surge in overdose deaths, as history has shown with other outbreaks.

The study, which highlights both the progress and the ongoing challenges in addressing the FYL epidemic, was published on December 5 in the CDC's Morbidity and Mortality Weekly Report. As the crisis continues to evolve, experts stress that the fight against overdose deaths is far from won, and vigilance remains crucial.

Source: US News