In most cases, the tranquilliser is mixed or “cut” with strong opioids such as heroin or fentanyl by dealers aiming to lower their costs and increase demand.
Users often develop skin sores and infections where they inject and have previously told Sky News that the mix increases their addiction.
Last year, amid rising deaths attributed to xylazine, the White House announced a six-point plan to tackle the problem.
Researchers, led by academics from King’s College London, say the health threat has “now expanded to the United Kingdom”.
Their study, published in the journal Addiction, examined various toxicology, drug testing and drug seizure sources.
While usually mixed with illegal drugs, it found xylazine had been discovered in counterfeit prescription medication tablets, THC (tetrahydrocannabinol) vapes, and cocaine.
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Image: Tranq users can develop sores or infections
What is xylazine?
In the hands of vets, xylazine is a commonly used tranquilliser, often mixed with ketamine to sedate animals, including horses, cattle, and cats.
As a non-opioid sedative, it is able to inhibit the transmission of brain impulses to the central nervous system. But in recent years, it has become synonymous with a darker usage, as a cutting agent for illegal drugs such as heroin.
In the US, its mixture with fentanyl has had a widespread impact among drug users in American cities. Such is the concern in Washington about its spread, that Joe Biden’s administration has labelled it an emerging threat to the nation and outlined a six-point plan to tackle it.
There it has gained the nicknamed “tranq” or “the zombie drug” – because of its characteristic effect of putting users into a zombie-like state. But it has, perhaps, an even more grim side effect on users, who often develop skin sores and infections where the drug is injected.
Xylazine’s usage appears to be increasing at an alarming rate. From November 2021 until August 2022, 80% of drug paraphernalia which tested positive for fentanyl at needle exchange programmes in Maryland also contained xylazine.
And in May last year, the first death following its usage was recorded outside the US – Karl Warburton who died at his home in Solihull in May 2022.
Researchers found 35 cases of xylazine in England, Scotland and Wales by the end of August last year. No cases were found in Northern Ireland.
They published data on samples from toxicology labs, where the drug was found in 16 people – including 11 who had died.
Eleven of the samples were from summer last year.
They also referenced the death of Mr Warburton, who the coroner said had a history of using illegal drugs.
Image: Karl Warburton had xylazine in his system when he died. Pic: Facebook
A post-mortem on the 43-year-old found he had heroin, fentanyl and cocaine in his system, as well as xylazine.
A report in the Journal of Forensic and Legal Medicine said he was “likely to have bought heroin and not known it was laced with xylazine and fentanyl”.
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Dr Copeland urged the government to introduce “simple” measures to prevent an epidemic of xylazine, including testing strips and making healthcare providers aware of the signs of xylazine use.
She also said pathologists and coroners should request toxicology testing for xylazine in relevant cases to understand its true prevalence.
Despite the results of the study, Manchester-based MANDRAKE, England’s first publicly-funded city centre testing and harm reduction facility, said it hadn’t yet detected the substance in samples from 2022 to the start of 2024.
A government spokesperson said: “We are aware of the threat from xylazine and are determined to protect people from the threat posed by this drug and other illicit synthetic drugs.
“We will not hesitate to act to keep the public safe.
“Following advice from the Advisory Council on the Misuse of Drugs (ACMD), we intend to make xylazine a Class C drug, meaning anyone supplying this substance will face up to 14 years in prison, a fine or both.”
We’re sat in a silent, empty, cardiac treatment room – on the other side of the door, you can hear the bustle of the largest A&E and major trauma ward in Devon.
Ambulances arrive, patients are wheeled on stretchers, families wait pensively.
Consultant Dr Anne Hicks, from Derriford Hospital in Plymouth, is with me – she’s worked in emergency care for more than 30 years.
There is a long pause when I ask what the hardest part of her job is.
“I don’t think it’s looking after the trauma patients,” she says.
“The toughest part is talking to the relatives. I get huge satisfaction from doing it well – but I can remember the face of every relative I think I’ve ever spoken to.”
She, like many of her colleagues, has had to tell the parents of teenagers killed in car crashes the worst news.
“The tragedy is nothing to what that parent feels when you tell them their child has gone. That their child has died.”
Image: Consultant Dr Anne Hicks
This is the so-called ripple effect – so many lives impacted by deaths on our roads, beyond the immediate family.
Sky News has spent the last year reporting on a long-running campaign – led by grieving families – to get the government to toughen rules on new young drivers within its Road Safety Strategy, which is set to be announced soon.
But as well as relatives, there is a whole other group impacted by deaths on Britain’s roads.
Emergency service workers are often the first to arrive at some of the most horrific and distressing scenes.
We’ve been given access inside Derriford Hospital in Plymouth and Devon Air Ambulance – to understand how frontline workers deal with such trauma.
Grant Thompson is a paramedic with the air ambulance team based at Exeter Airport. We’re inside the medical stockroom, used to refill the chopper after each callout.
He remembers a callout last summer.
‘A shock to the system’
Image: Grant Thompson, a paramedic with the air ambulance team based at Exeter Airport
“It was one of those jobs when you’re not expecting, I suppose, what you’re going to see,” he says.
“We started realising this was going to be a bad job. You started thinking, ‘how are we going to split up as a team?’We got there reasonably quickly and three of these young people actually died at the scene, which was quite difficult.
“It was trying to give the best care you can for everybody – they were quite severely injured. It’s always a shock to the system when you get to those jobs. It can be tricky. It can be tricky.”
Those three young deaths were among more than 1,600 on Britain’s roads last year – with nearly 130,000 injured.
Some 22% of those fatalities involved a young person behind the wheel.
New data released by the Department for Transport also shows male drivers aged 17-24 are four times more likely to be killed or seriously injured than all drivers aged over 25.
Death is one thing, life-changing injuries another.
Inside the major trauma unit at Derriford, ward manager Larissa Heard says she’s seen the “whole scale” of reaction.
“Some patients are amazingly resilient and take it really well – for others it is absolutely life-changing, and they are hysterical,” she says.
“This could be the first time that they’re actually seeing their injuries in full light. It might be the first time that they’re actually aware they’ve had an amputation or are actually paralysed.
“So having to manage that for us can be really hard.”
Image: Devon air ambulance workers
‘It’s only afterwards the impact hits you’
As we chat, an 18-year-old who has lost a leg in a car crash pushes himself past us; staff say there are always victims of RTCs on the ward.
Treating the physical and mental scars of collisions is, of course, their job.
Like all those in the NHS, that responsibility comes first.
“I don’t think you feel it until you get the lovely thank-you cards at the end, and you find out the patients you looked after knew your name,” says Catie Crisp, a trainee advanced clinical practitioner.
“It’s only afterwards the impact hits you: ‘I can take a deep breath now, that was really hard, that was really emotional.'”
Image: Catie Crisp, a trainee advanced clinical practitioner
A possible solution?
Like the families who lost children, emergency workers would welcome any measure that could reduce the number of young people injured and killed.
Graduated driving licences (GDLs) place restrictions on new young drivers in the first few months of driving, such as a ban on driving late at night and with a car full of people – factors so often part of fatal accidents.
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What are graduated driving licences?
In Canada, one of the first countries to introduce GDLs, it takes at least 20 months to gain a full driving licence, with learners earning certain freedoms in stages. Deaths among young drivers are down 83% in the five years to 2022, compared to the same period before GDLs were brought in.
For emergency consultant Dr Tim Nutbeam, introducing a similar scheme would be a step in the right direction:
“I believe in evidence informed practice and for me the evidence from Canada, from other parts of the world is really strong. I believe GDL saves lives.
“I’ve got four children. One of them in a couple of years will be driving. I as a parent will be making sure a similar structure to GDL is in place to try to keep her safe.”
Image: Dr Tim Nutbeam
But the Department for Transport says it is not considering them.
A spokesperson told Sky News: “Every death on our roads is a tragedy and our thoughts are with everyone who has lost a loved one in this way.
“Whilst we are not considering graduated driving licences, we absolutely recognise that young people are disproportionately victims of tragic incidents on our roads and continue to tackle this through our THINK! campaign.
“We are considering other measures to address this problem and protect young drivers, as part of our upcoming strategy for road safety – the first in over a decade.”
‘They need to reconsider’
For those representing emergency service workers, the government’s position must change.
“In my view, the evidence is overwhelming that they need to reconsider it,” says Philip Secombe – the joint lead on road safety for the Association of Police and Crime Commissioners.
“We need to look at not restricting our young drivers, but actually safeguarding them, and their passengers and other road users.”
Back at the Devon Air Ambulance base, Grant explains how the ripple effect can spread far and wide.
“The loss of any life is tragic and affects a lot of people and clinicians as well, but I think when there’s a young person who survives as well, they’ve got to walk with that for the rest of their lives, 60 odd years or whatever it’ll be, that you’ve got to carry that with you – and more than likely it’d be one of your friends.
“I just hope that shapes people’s attitudes to save driving. You know, these are my mates, my best mates in the world, in my car, I need to adapt my driving to come out safe of this.”
Sir Keir Starmer says AI will improve public services, put money in your pocket, create jobs and improve your children’s future.
Politicians are betting the house on it – but how much are they actually spending? And on what?
Sky News asked consultancy Tussell, which analyses government contracts and spending, to help find out.
Image: AI is kind of a big deal for the prime minister. Pic: PA
Over £3.35bn is the overall spend by government departments on AI contracts, infrastructure and services, since the technology first really appeared on the scene in about 2018. The number of contracts has been going up each year.
The biggest by far is a 2021 contract by the Met Office with Microsoft to build the world’s most powerful weather and climate forecasting supercomputer, plus a few small contracts for departments to use its Copilot AI.
It’s worth more than £1bn overall.
Another big contract is for Init – the German public transport technology company – with Transport for London, worth £259m.
But this might be surprising: one of the smallest recipients is Alphabet.
The company behind Google, and a massive AI investor, has just two contracts with the Cabinet Office and the Ministry of Justice, worth £2.5m.
Fellow US firm Palantir has lots of smaller value contracts – 25 in total, worth £376m.
Its UK boss, Louis Mosley told Sky News that Palantir is helping junior doctors draft discharge summaries. And in defence, it helps intelligence officers collate information and process it more quickly.
Asked whether people were right to be concerned about big AI companies coming in and using their data, he replied: “Those are very legitimate concerns, and they’re right to interrogate this, but Palantir is actually the answer to those problems. We are the way you keep data secure, and we are the way you make AI transparent and auditable”.
‘Ministers need to be brave’
However, Mr Mosley said the government could go further.
“What they’re saying publicly is what they’re saying privately, but the challenge is always a fear of change,” he said.
“And in this case, you’ve got to embrace change. And ministers need to be brave. They need to take on the system and tell them this is the way things need to work today.
“There is a lot of fear that tomorrow I’m going to have to do a different thing to what I was doing yesterday.”
Who’s spending the most?
Sky News also looked at which departments have the biggest spending on AI. They are science and technology, which has the Met Office contract, and transport with the Init deal.
But the biggest, most data-intensive departments feature low down the table.
The Treasury, which encompasses the taxman, and the Department for Work and Pensions (DWP), which handles benefits, are in the bottom three.
The DWP has an annual IT budget of over a billion pounds a year, yet has spent less than £100m cumulatively since 2018 on AI.
Industry insiders blame a short-term government mindset, lack of IT expertise and backwards technology – up to 60% of some bits of government are running on legacy, older versions, of IT.
The areas of government where a revolution could save us the most money appear largely as yet unexplored. The AI journey has barely begun.
Prince William has talked about the need for more good leaders, as well as putting on a display of his less serious side, on the first day of his tour to Brazil.
William, who is in the country all week for both his annual Earthshot Awards on Wednesday and COP30, the UN’s climate conference, started his trip with a penalty shootout at the iconic Maracana Stadium in Rio, before heading to Copacabana Beach to kick off his shoes and take part in a volleyball game.
Image: Pics: PA
On Tuesday, he will focus more heavily on his environmental work with a series of visits.
On Monday morning, he was welcomed to Rio with an honour reserved for the carnival king – the keys to the city.
Standing on top of Sugarloaf Mountain with a bird’s eye view of the city and the iconic Christ the Redeemer statue, he was greeted by the mayor of Rio, Eduardo Paes.
Speaking about the significance of the key ceremony, he joked, “So he’s got the keys, he can do whatever he wants in the next 72 hours. The city belongs to Prince William. I’m still the king, but it will belong to him!”
William’s legacy goals
Ticking off some of the city’s most iconic locations, he met with Brazilian football legend Cafu at the Maracana.
Image: Pic: PA
He enlisted his help to highlight his Earthshot Awards, as they joined an event for young environmental campaigners and entrepreneurs.
Speaking to one group, William talked about the need for more good leaders, saying: “I need to work out how do I speed that up, but you guys are my hope, you’ve got the passion, the ambition that’s what this needs.”
He added: “That’s what I hope my legacy will be, in a few years time you’re kind of household names.”
Image: Pic: PA
William then went pitch side and met children learning about the environment and climate change through the sport-based organisation Terra FC.
The prince ended his football drills by taking a penalty against keeper Pedro Enrique, 14, and was mobbed by youngsters wanting a high-five after he scored.
Pedro said afterwards: “I was scared and nervous but very excited as he was most the famous person to take a penalty kick. I didn’t let him score. It was a good penalty.”