Xylazine

What Is Xylazine?

Xylazine is a medication used as a sedative or tranquilizer for animals but has been increasingly found in illicit drug supplies nationwide. While xylazine can be used on its own, it’s most frequently found mixed with other illegal drugs, making most of its use unintentional and adding to its danger.

Often referred to as “tranq”, “tranq dope”, or “zombie drug”, xylazine can be taken orally, snorted, or smoked. It has also been injected into the muscle, under the skin, or into veins for faster onset.

How Does Xylazine Work?

Xylazine is an alpha-2 agonist in the central nervous system. These agents stop the release of norepinephrine and epinephrine, leading to central nervous system depression, sedation, analgesia, and euphoria. In addition, xylazine decreases heart rate and blood pressure.

Xylazine can produce dependence with continued use. The withdrawal effects of xylazine dependency are unpleasant and can include irritability, anxiety, and dysphoria. Many people find they are unable to manage withdrawal from xylazine on their own and continue to use it to avoid these effects.

Xylazine Mixed With Other Drugs

Xylazine is mainly found mixed with other drugs, such as fentanyl, heroin, and cocaine. This is done for a multitude of reasons, including increasing the weight of the drug mixture to achieve a higher street value, but the main reason is to prolong the effects of the base drug. Xylazine has a rapid onset (within minutes) and can last up to eight hours or longer, depending on how it was taken. That’s why people who take the drug assume that xylazine can “solve the problem” of the “short legs” of the combined opioids or cocaine.

Xylazine is most often found mixed with fentanyl (commonly referred to as fentanyl-adulterated xylazine or FAAX), as it is believed to prolong and intensify the effects of the synthetic opioid.

This is an incredibly dangerous practice and can lead to deadly consequences. In 2021, 99.5% of xylazine-involved overdose deaths also involved illicitly manufactured fentanyl or fentanyl derivatives.

Side Effects

Xylazine can produce multiple adverse effects, including:

• Low blood pressure
• Excessive sedation
• Low heart rate

Skin Lesions

One of the most extreme and dangerous signs of xylazine use is the skin lesions that develop when the drug is ingested. These wounds can look different than traditional drug injection wounds and can lead to severe skin death, not only at the site of injection.

These flesh wounds can present as black necrotic tissue, abscesses, and skin ulcerations. The skin effects include rotting skin and expanding skin death across or down a limb, similar to gangrene. In addition, many users may not seek care for these wounds until much later, leading to significant tissue injury. This can lead to permanent harm and loss of function of a limb or amputation.

Xylazine-induced wound care can complicate addiction treatment since these wounds may require specialized wound care and intravenous antibiotic treatment or wound debridement, which is not available in traditional outpatient addiction treatment centers.

What Are The Symptoms Of A Xylazine Overdose?

A person who has used xylazine can look extremely tired, have low blood pressure, and have a very slow heart rate. Identifying a xylazine overdose can be difficult since many people are unaware they are using it when combined with an opioid.

Xylazine overdose can lead to a prolonged period of sedation, at times lasting for hours. During an overdose, the person taking the drug can appear unconscious and experience amnesia and out-of-body experiences, while observers may be unable to find a pulse. If an overdose is suspected and naloxone is not effective in restoring consciousness, a fatal xylazine overdose can occur. Rescue breathing is suggested until advanced medical help arrives.

If you believe someone is experiencing an overdose, stop reading immediately and seek medical attention.

Can You Use Naloxone To Reverse Xylazine?

When xylazine is used in combination with an opioid, naloxone can only reverse the effects of the opioid, not the effects of xylazine.

If a person has taken too much xylazine or appears to be suffering from a xylazine overdose, emergency intervention involves maintaining the person’s airway by emergency airway placement or rescue breathing and treating hypotension. This will require advanced medical care. There is no antidote or reversal agent for xylazine. If an overdose is suspected, it is recommended to still administer naloxone to reverse any opioid effects while treating the symptoms that do not reverse from xylazine.

Testing

Law enforcement and advanced medical centers have equipment that can test for xylazine; however, options available to the general public are limited. Xylazine testing strips have recently been released on the market, but their use and accessibility is not widespread. The White House National Response Plan outlines a goal to develop and make xylazine tests more widely-available in the future.

A Nationwide Threat

In April 2023, the White House Office of National Drug Control Policy declared xylazine an emerging threat to US citizens. This is the first time a warning of this type has been made. In particular, the concern of FAAX is highlighted in this alert.

Dividing the country into four geographic divisions, between 2020 and 2021, the number of overdose deaths that included xylazine increased by 1127% in the South, 750% in the West, and 500% in the Midwest. The deaths in the East continue to climb by more than 100%. These alarming statistics highlight the importance of knowing the adverse effects of xylazine use and getting help before it’s too late.

Treatment For Xylazine Use

Ignoring the dangers of xylazine can lead to life-threatening consequences. If you or a loved one use xylazine, fentanyl, or FAAX, it is crucial to seek treatment as soon as possible.

Contact a treatment provider today to explore your rehab options.