The opioid epidemic is still ongoing in the U.S., though recent data indicates a significant decline in overdose deaths. Data from the CDC shows a nearly 27% decrease in drug overdose deaths in 2024 compared to 2023. However, there is a new and disturbing substance emerging in the illicit drug supply: xylazine.
Known on the street as “tranq” or “tranq dope,” xylazine is a veterinary tranquilizer not approved for human use. Despite this, it’s increasingly being found mixed with opioids like fentanyl and often without the person’s knowledge.
What makes xylazine especially dangerous is that it isn’t an opioid, which means it doesn’t respond to naloxone (Narcan) and causes its own unique set of health risks. Understanding what xylazine is, how it works, and why it’s a threat can help keep you and others safe.
What Is Xylazine?
Xylazine is a sedative and muscle relaxant used by veterinarians to calm large animals such as horses and cattle. It works by depressing the central nervous system, slowing heart rate, lowering blood pressure, and inducing deep sedation. In medical terms, it’s classified as an alpha-2 adrenergic agonist—not an opioid.
At one point, xylazine was tested on humans as a potential sedative, but it caused severe central nervous system depression. Therefore, the drug is not approved for human use, though it has found its way into the illegal drug supply as a cutting agent, often mixed with fentanyl to prolong its effects or make the drug feel stronger. This combination is not only unpredictable—it’s deadly.
Why Xylazine Is So Dangerous
Not an Opioid, But Acts Like One
Many people using street drugs don’t know they’re ingesting xylazine. It mimics opioid-like sedation and slows down the body’s systems. The problem is that naloxone, the life-saving medication used to reverse opioid overdoses, does not work on xylazine.
If someone overdoses on a fentanyl/xylazine combination, naloxone may reverse the opioid portion of the overdose, but the xylazine may continue to depress breathing and heart rate, putting the person at continued risk of death.
Increases the Risk of Fatal Overdoses
Xylazine is intensifying the overdose crisis. According to recent CDC data, xylazine was detected in over 10% of fentanyl-related deaths in certain regions. Because it enhances sedation and respiratory depression, xylazine makes fentanyl—already one of the most dangerous drugs on the market—even more lethal.
What’s especially alarming is that there’s no known antidote or reversal agent for xylazine, which leaves medical responders with limited options.
Causes Severe Wounds
One of the most visible and disturbing effects of xylazine use is skin ulceration and tissue damage, even at injection sites far from the area of use. These wounds can develop into necrotic tissue, requiring extensive wound care, and in some cases, surgical intervention or even amputation.
Medical professionals aren’t exactly sure why xylazine causes this kind of damage, but it’s believed that poor circulation, immune response suppression, and prolonged sedation may play a role. These wounds also increase the risk of infections like MRSA or sepsis, especially in people without access to regular healthcare.
Leads to Dependence and Withdrawal
Though xylazine is not officially classified as addictive in the same way opioids or stimulants are, frequent use can still lead to physical dependence. Withdrawal symptoms can include anxiety, high blood pressure, agitation, and intense cravings.
When combined with opioid withdrawal, xylazine withdrawal can complicate and intensify the detox process, making it harder for individuals to enter recovery safely. Because few residential treatment centers are equipped to manage xylazine-specific detox symptoms, people often fall through the cracks of care.
Why Is Xylazine Being Used in Street Drugs?
Drug suppliers often add xylazine to stretch out or enhance the effects of fentanyl. Since fentanyl wears off quickly, xylazine’s sedative effect can make the “high” last longer, which some users may come to expect, even if they don’t know it’s xylazine causing it.
Unfortunately, this is a cost-saving measure for traffickers that comes at great cost to human life. People who believe they are buying heroin or fentanyl may instead be exposed to a cocktail of substances with little idea of the dangers involved.
How to Protect Yourself and Others
Because xylazine is not an opioid, overdose reversal and treatment strategies must adapt:
- Carry naloxone anyway: While it won’t reverse xylazine, it can still save a life if opioids are part of the mix. Always call 911, even after administering Narcan.
- Test your supply: In some areas, xylazine test strips are becoming available. These can help identify whether xylazine is present in street drugs.
- Seek medical care for wounds: Early treatment of skin ulcers can prevent serious complications. Don’t ignore wounds, even if they seem minor.
- Access harm reduction services: Syringe exchanges, wound care clinics, and peer support networks can provide critical help.
- Connect with treatment professionals: If you or a loved one is struggling, reach out to a treatment provider familiar with xylazine use and co-occurring opioid dependence.
Final Thoughts: It’s Not Just Fentanyl Anymore
Xylazine’s growing presence in the drug supply adds a frightening new dimension to an already complex substance use crisis. Its sedative effects, resistance to naloxone, and ability to cause horrific wounds make it one of the most dangerous substances currently circulating.
At Pura Vida Recovery, we are committed to staying ahead of emerging drug trends and providing compassionate, evidence-based care for those affected. If you or someone you care about is using substances and feeling overwhelmed, you’re not alone. Help is available. Contact us today at 707-879-8432 to learn more about our programs and how we support individuals.
