Silhouettes lying in the streets or performing jerky and disorderly movements. You may have seen these many videos taking place in the United States and showing people – probably – under the effect of xylazine, also called “zombie drug”. An anesthetic drug for animals authorized in France for veterinarians. To form the “tranq” or “tranq dope”, this product is accompanied by fentanyl, a synthetic painkiller fifty times more powerful than heroin. “An ultra-dangerous combo”, according to Michaël Bisch, addictologist psychiatrist and vice-president of the French Federation of Addictology.
This cocktail with heavy sedative effects causes necrosis that can lead to amputation. It is also extremely lethal because, unlike opioids, it does not respond to naloxone, the overdose antidote. The substance is currently wreaking havoc on the American continent, especially in Philadelphia and San Francisco. But what about France?
Anecdotal presence in France
Many videos reporting cases in France, particularly in Toulouse, have been massively relayed on social networks in recent weeks. If it was easy to verify that these images had actually been filmed in the United States, is the tranq therefore absent from our country? “Xylazine was found anecdotally in France,” reassures Michaël Bisch. In a 2021 report, the French Observatory of Drugs and Addictive Tendencies (OFDT) notes that “twice, xylazine has been identified in heroins collected and purchased at different places in the Lyon metropolitan area. »
Small parenthesis: xylazine is often used as an adulterant, that is to say as a cutting product, like codeine paracetamol or caffeine, for heroin (which actually only contains 0 to 20% heroin) .
No trace in substance identification networks
“The presence of xylazine is not observed on national territory through the National Identification System for Toxics and Substances (Sintes) piloted by the French Observatory for Drugs and Addictive Tendencies (OFDT), informs us moreover this same OFDT. Its consumption remains confined to the United States to this day. »
The Centers for Evaluation and Information on Pharmacodependence-Addictovigilance (CEIP-A), which monitor products based on declarations by health professionals and confirmed by biological analyses, have also not noticed the presence of xylazine on the French market.
No trace either on the “KnowDrugs” application, a platform created by users to identify possible undesirable substances and unexpected effects of drugs. However, since this application is used more to analyze ecstasy, this may explain the absence of xylazine, which is rather present in products such as heroin.
A risk of arrival in France?
If its presence therefore remains very anecdotal today in France, is it likely to make its arrival there in the coming years? “There is always this old rumor of a new zombie drug”, laments Philippe Batel, professor of addictology, co-president of the scientific committee of SOS Addiction and head of the addictology department in Charente. “Ten years ago, with the arrival of cathinones, such as 3-MMC, in the United States, the same thing happened. Videos looped with haggard patients in a trance. They were even thought to be cannibals. We were swimming in delirium. Today, these drugs like 3-MMC are “used in France, but in a recreational environment or in a sexual context. “A far cry from the images conveyed in the videos.
“We have the case of crack, whose consumption began in the United States and then arrived twenty years later in France, illustrates Marie Jauffret-Roustide, sociologist at Inserm. But it is not because at some point, a drug was exported to France, that it will happen for the tranq. The specialist cites the example of methamphetamine, very present on the American continent but which remains at extremely low levels of consumption in France.
“I don’t think that a major xylazine crisis will happen in France,” summarizes Philippe Batel. We can clearly see this with fentanyl and opioids, there is no crisis comparable to the one taking place in the United States. According to the OFDT, the distribution of fentanyloids in the French population remained “marginal” in October 2021.
Situations not comparable
“What is happening in the United States is very worrying, but the French and American situations are incomparable,” insists Marie Jauffret-Roustide. Not only are the products in circulation not the same, but the society is also very different. “The United States, and more particularly a city like Philadelphia, is crossed by immense social inequalities, much more than any French city. In addition, in France, support for treating addictions is funded by the State, unlike the United States where the devices are private.
But the vice-president of the French Federation of Addictology is a little less optimistic. According to him, there is no reason that drug traffickers should not seek to conquer new markets. “Vigilance is necessary without being alarmist and catastrophist”, estimates the addictologist, who however wishes to differentiate the American and French systems. “The opioid crisis in the United States is linked to the American ultraliberal model, with massive prescriptions of opiates by doctors. »
Measures taken in France
France has thus taken the lead. Medicines based on codeine and other opium derivatives, formerly over the counter, have been, since 2017 and a decree of the former Minister of Health Agnès Buzyn, only issued on medical prescription. “In France, we have a lesser fentanyl crisis because we have prevented it”, considers the doctor.
And the current government remains on the same path. On June 20, the deputies passed a bill authorizing customs to seize chemical substances which are nevertheless authorized but which can be used in the manufacture of synthetic drugs. Like xylazine.