What Is Xylazine (‘Tranq’)? Here’s What You Should Know

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Xylazine, also known as "tranq," is an illicit drug that's been found in the U.S. since the mid-2010s. But its use has increased in recent years. And since xylazine is usually mixed with other illicit drugs, such as fentanyl, users may not even be aware they're taking it.

It is a dangerous substance that can lead to a life-threatening drug overdose. So knowing more about it can help protect yourself or a loved one.

Here, we'll review what xylazine is, the risks of using it, and what to do if you or a loved one are exposed to it.

What is xylazine?

Xylazine is a prescription medication that's approved for use as a sedative in large animals, such as horses, elk, or deer. It is not approved for humans.

Xylazine isn't an opioid, but it has pain-relieving effects. It causes a sleep-like state by relaxing muscles, slowing down breathing, and reducing heart rate.

Xylazine is often mixed with other illicit drugs, such as fentanyl or heroin. Its sedative effects make other substances feel more potent. And xylazine's effects last longer than some other substances. Adding xylazine allows drug traffickers to reduce the amount of substances like fentanyl or heroin in the mixture - often without the user knowing.

Is xylazine dangerous?

Yes, xylazine is a dangerous drug. In April 2023, the White House issued a statement declaring xylazine an emerging national threat. The two main dangers of xylazine are overdose and severe skin wounds.

Xylazine overdose

As mentioned, xylazine can reduce your blood pressure, heart rate, and breathing. If these levels become too low, it can lead to death. The other substances xylazine is often mixed with can also cause these effects. So the risk of overdose and death is even higher when xylazine is combined with other substances, as is often the case.

The number of overdose deaths involving xylazine was more than 30 times higher in 2021 than in 2018, and it's still increasing. What's more, a routine toxicology test won't detect xylazine. This makes it harder for healthcare professionals to detect and treat xylazine if an overdose happens.

Xylazine skin wounds

In addition to the dangers of overdose and death, xylazine can also cause severe skin wounds that can easily become infected. These wounds can appear anywhere on the body, not just at the injection site.

Xylazine skin wounds may start as small, pinpoint blisters or holes or in the skin. Eventually, these may join together to form a larger open sore. Wounds may become infected or begin to decay, leading to black pieces of dead skin. In fact, the physical appearance of the multiple open skin wounds caused by xylazine use has led to it being referred to as the "zombie drug." If these wounds aren't treated properly, amputation is often needed.

What are the other risks and side effects of xylazine?

The risks and side effects of xylazine (other than overdose, death, and skin wounds) can also be severe. This is largely the reason it hasn't been approved for use in humans. Xylazine can cause:

• Sedation

• Memory loss

• Feeling "high"

• Dry mouth

• Disorientation

• Slowed breathing

• Low blood pressure

• Slow heart rate

• Irregular heart rate

• Low body temperature

• High blood glucose (sugar)

• Sepsis

• Heart attack

• Coma

No amount of xylazine is considered safe for human use. Repeated use of xylazine can lead to tolerance and dependence, which can develop into substance use disorder.

Good to know: The Combating Illicit Xylazine Act is a bill that's been proposed to help protect the public against the dangers of illicit xylazine use. Among other provisions, it suggests a change to make xylazine a controlled substance. If passed by Congress, this would help regulate the sale and manufacturing of xylazine to reduce illicit access to the medication.

How are people exposed to xylazine?

Most people are exposed to xylazine by using illicit substances. In 2022, almost 25% of the fentanyl powder seized by the DEA contained xylazine. And a syringe service program in Maryland found that from 2021 to 2022, almost 80% of opioid samples also contained xylazine.

Some people may seek out xylazine on its own. But often, it's added to other substances without the user's knowledge.

Is there a way to know if a substance contains xylazine?

Drugs that are mixed with xylazine may not look any different than usual. So you probably won't be able to tell from looking at it whether xylazine is present.

The best way to know if a substance contains xylazine is by using a xylazine test strip. Some areas may offer test strips through community programs or your state health department. You can also purchase them online, and they do not require a prescription. Just be sure you're purchasing test strips from a reputable source.

How can you reduce the risk of harm from xylazine?

Here's how you can lower your risk of overdose if you use illicit drugs:

• Use xylazine test strips and avoid drugs that test positive for xylazine.

• Use clean needles and change injection sites frequently.

• Keep an eye out for skin wounds, and seek medical care right away if they appear.

• Don't use illicit drugs alone. Having someone with you to call 911 can save your life in the event of an overdose. Services such as Never Use Alone can provide support if you don't have someone with you in person.

• Have naloxone on hand and know how to use it - more on this next.

Does Narcan reverse xylazine's effects?

No. Xylazine is not an opioid, so naloxone (Narcan) can't reverse its effects. But you should still administer naloxone if you suspect a drug overdose, since xylazine is often used along with opioids.

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