What is xylazine?
The bottom line
Xylazine, also known as "tranq," is a powerful animal tranquilizer. Although it is not intended for human use, xylazine is a common contaminant of illicit drugs in the US. It can worsen toxic effects of some drugs. Xylazine use causes sleepiness and a slow respiratory rate and might result in development of necrotic skin wounds (skin wounds with dead tissue).
Prevention Tips
Only use drugs that are prescribed to you by a licensed medical practitioner; do not use illicit drugs.
Do not purchase medications from online pharmacies that do not require a prescription or doctor’s order.
Talk to your doctor if you develop unexplained skin changes or wounds after injecting xylazine.
This Really Happened
A 37-year-old woman was admitted to a hospital in Philadelphia because of large, necrotic, and foul-smelling ulcers on both legs. She had a history of intravenous drug use and reported using approximately 10 bags of intravenous fentanyl or heroin daily. Contamination of fentanyl and heroin with xylazine is common In Philadelphia. She told the doctors that she typically injected the drugs into the veins in her hands but occasionally injected them into her legs. She reported that the wounds began after she had injected drugs into her legs. Due to the extensive wounds and infection, she was treated with intravenous antibiotics. The wounds were cleaned and covered with dressings, and she was eventually discharged to a recovery house with instructions to complete an 8-week course of oral antibiotics (from Malayala, et al., 2022).
What is xylazine ("tranq")?
Xylazine, also known as "tranq", is an animal tranquilizer used to provide sedation, pain relief, and muscle relaxation in dogs, cats, horses, and other animals. Xylazine was initially studied in humans as a potential blood pressure-lowering drug, but its use in humans was abandoned after the drug was found to cause excessive sleepiness. Currently, xylazine is not approved for human use by the US Food and Drug Administration. Xylazine was initially discovered as an illicit drug contaminant in the US in the early 2000s. Since then, the US Drug Enforcement Agency has found xylazine in illicit drugs, including cocaine, heroin, and fentanyl, throughout the country.
How is xylazine used?
Xylazine is available in liquid or powder formulations and can be swallowed, inhaled, smoked, or injected. In one study, most deaths due to xylazine overdose were related to injection of the drug. Xylazine has also been used to facilitate sexual assault. In one case, a 4-year-old boy collapsed after returning home from a nearby playground. He was taken to a hospital, where xylazine was detected in his blood and urine. A police investigation found that the boy’s godfather had injected him with xylazine after he had returned from the playground. The godfather later admitted that he had intended to sexually assault the boy after poisoning him with xylazine.
What are the side effects of xylazine?
In humans, xylazine use can cause drowsiness, abnormally slow or absent breathing, low blood pressure, and a slow heart rate. In severe cases, a coma can develop and require the insertion of a breathing tube and hospitalization in an intensive care unit. The signs and symptoms of xylazine overdose are similar to those of heroin, fentanyl, and other opioids. When xylazine is added to opioids, severe toxicity and death can occur due to the combined effects of the drugs.
Does xylazine cause wounds?
Xylazine use causes blood vessel narrowing, which leads to decreased blood flow to the skin in areas where xylazine was injected. This can result in the formation of necrotic wounds, which are wounds with dead tissue, that can easily get infected due to poor circulation. Skin wounds due to xylazine injection are often managed with specialized dressings and antibiotics. Some wounds can require treatment with skin grafting or other surgical procedures, and severe cases might result in amputation.
Is xylazine a controlled substance?
In the US, xylazine is not a controlled substance. It can be obtained, with a prescription, from veterinary pharmacies. Illicit formulations of liquid and powdered xylazine are available for purchase from online retailers for less than $20 per kilogram, making the drug an attractive option for illicit drug manufacturers. Xylazine and other adulterants are added to illicit drugs to increase the bulk volume of the drug, increase profits for drug traffickers, and enhance the “high” of the drugs.
Does xylazine cause withdrawal?
Withdrawal can occur in people who abruptly discontinue the use of xylazine. Xylazine withdrawal can result in markedly elevated blood pressure, a rapid heart rate, and agitation. Headaches, insomnia, and nausea can also occur during xylazine withdrawal. People experiencing xylazine withdrawal might require hospitalization for treatment with medications that can reduce the severity of the withdrawal symptoms.
Is xylazine zombifying?
Xylazine acts within the brain to cause sedation and abnormally slow breathing. The clinical effects of severe xylazine intoxication can last for several days. In some cases, affected people can appear to be in a trance-like state that people describe as being zombie-like.
Does Narcan reverse the effects of xylazine?
Naloxone (Narcan) is designed to reverse the effects of opioid drugs such as heroin, fentanyl, and oxycodone. Since xylazine is not an opioid, naloxone is unlikely to be effective in treating people who overdose with xylazine. However, since xylazine is a common contaminant of many illicit opioids and because naloxone is unlikely to cause harm in people who have overdosed on xylazine, it is reasonable to administer a dose of naloxone in the event of a suspected xylazine overdose. Because overdose symptoms can recur after naloxone is given, it’s important to call 911 or seek emergency medical care as soon as possible after administering naloxone for a suspected opioid overdose.
What happens if someone gets sick after using xylazine?
If unwanted or unexpected symptoms develop after taking xylazine, use the webPOISONCONTROL® online tool to get help, or call your poison center at 1-800-222-1222. Whether online or by phone, expert guidance is always free, confidential, and available 24 hours a day.
