Nov. 4, 2023 – SIMON: More than 111,000 people died of overdoses in America in the past year. Most involved synthetic opioids, including fentanyl. But complicating both treatment and intervention is a relatively new drug that dilutes the fentanyl supply. It is a veterinary sedative called xylazine. On the streets, it’s known as tranq. The drug causes horrific complications in human beings. Authorities, including Dr. Rahul Gupta, director of the Office of National Drug Control Policy, warn of its dangers. We began by asking the doctor how in a country as wealthy as the United States, so many people are caught in the grip of drug addiction.

RAHUL GUPTA: It is not only the issue of the disease of addiction, which is certainly true and real, but it is the drivers that get us there. Whether it’s the challenge of income inequality, the challenge of housing, transportation, child care, childhood trauma. But at the same time, what we’re seeing is a drug environment that is the most dangerous ever seen in human history. Now we’re seeing synthetic drugs become much more lethal as opposed to what we’ve had for thousands of years, which is organics like heroin or cocaine. Secondly, the way drugs are being bought and sold has changed. Today, on an app on your phone, you can purchase what could be the last drug you will ever take. And the way drugs are consumed has changed. Now we see a lot more pills – especially counterfeit pills – and polysubstance use, the mixture of stimulants and depressants, has become a norm rather than an exception.