Opioids Laced With Xylazine: Effects & Risks

Xylazine is a veterinary tranquilizer that has been increasingly found in illicit opioids like fentanyl and is making a significant contribution to the opioid overdose epidemic. The Centers for Disease Control and Prevention (CDC) reports that the monthly percentage of fentanyl-involved deaths with xylazine detected increased 276% from January 2019 (2.9%) to June 2022 (10.9%).1,2

Keep reading to learn more about what xylazine is, the risks of combining it with opioids, the potential for xylazine overdose, xylazine addiction, and how to find treatment for opioid addiction.

What Is Xylazine?

Xylazine, also known by the street name “tranq,” is a sedative medication used by veterinarians. It was first developed in 1962 by Bayer Pharmaceuticals.3

Clinical trials investigated xylazine’s potential uses for humans as a sleep aid, pain reliever, and anesthetic, but research was stopped due to severe reactions, including dangerously low blood pressure and slowed breathing.3

Although xylazine is not approved for use in humans, its illicit use is gaining traction across the U.S. and being used—both intentionally and unintentionally—in combination with opioids, especially illicitly manufactured fentanyl (IMF).1,2

What Is Xylazine Used For?

Xylazine is FDA-approved for veterinary use as an injectable in animals who require sedation, such as before surgery and to calm irritable or unmanageable animals.5

Recently, however, the drug has been appearing as an adulterant in illicit drugs like fentanyl, cocaine, heroin, and other substances. People are also mixing xylazine-laced fentanyl with other substances, including benzodiazepines, alcohol, gabapentin, methadone, and prescription opioids.1,3,4

Because it’s relatively cheap to buy, drug suppliers may use xylazine to boost profits by increasing their products’ weight.4

People may misuse xylazine to experience different effects, such as prolonged euphoria. When it is misused, xylazine is usually injected, but it can also be swallowed or sniffed.1,3–5

Effects of Xylazine

There is limited research on the effects of xylazine in humans. Some people who have used it report effects similar to opioids.6

These potentially serious health effects of xylazine include:1,6

  • Drowsiness.
  • Memory loss.
  • Slowed breathing.
  • Decreased heart rate.
  • Low blood pressure.

Dangers of Opioids Mixed with Xylazine

Using opioids laced or mixed with xylazine can be very dangerous. Like fentanyl, xylazine is not only being increasingly found in illicit opioids, it is also exacerbating the opioid epidemic and contributing to the number of overdoses.1,2,4

People who use street drugs might be unaware of the possible presence of xylazine. In 2022, an estimated 23% of fentanyl powder and 7% of fentanyl pills seized by the U.S. Drug Enforcement Administration (DEA) contained xylazine.4

While experts still have more to learn about the combined use of xylazine and opioids, there are some known risks. These include:6–8

  • Skin wounds and patches of rotting or dead tissue (i.e., necrosis) from injecting xylazine, which can lead to severe infection and possible amputation.
  • Physiological dependence and withdrawal. Xylazine could complicate opioid withdrawal management, as medications typically used to treat opioid withdrawal are likely ineffective for xylazine withdrawal. Anecdotal evidence from xylazine users also indicates that xylazine withdrawal symptoms may be more severe than those associated with heroin or methadone, including sharp chest pains and seizures.
  • Heightened CNS depression. This can be a particular danger because xylazine can lead to critically slowed breathing and heart rate, and low blood pressure and body temperature.

Can You Overdose on Xylazine?

Yes, overdose is the most significant risk of xylazine use. Mixing xylazine with opioids like fentanyl, or other substances, such as cocaine, benzodiazepines, alcohol, or gabapentin, can increase the risk of overdose and death.1,6,7

Possible xylazine overdose symptoms include:9

  • Diminished reflexes.
  • Muscle weakness.
  • Lack of coordination and slurred speech.
  • Extreme drowsiness or sedation.
  • Stupor or confusion.
  • Vomiting.
  • Pinpoint pupils.
  • Decreased heart rate and weak pulse.
  • Low blood pressure.
  • Slow or labored breathing.

It’s important to note that while xylazine may produce opioid-like effects, it is not an opioid and does not respond to naloxone, the opioid overdose reversal drug. However, authorities recommend that people still administer naloxone if someone shows ANY signs of overdose because xylazine is frequently mixed with opioids.1,6

Xylazine overdoses are on the rise. Reports from the DEA’s field divisions indicate that all four U.S. census regions experienced a dramatic increase in xylazine-related overdoses from 2020-2021. During those two years, nearly 2,000 deaths occurred in the Northeast, the most of any other region.6

And these numbers could be even higher, as it’s likely that many xylazine-involved overdoses have gone undetected or unreported because many jurisdictions do not routinely test for the presence of xylazine.6

Is Xylazine Addictive?

Xylazine’s addictive potential is not yet fully understood, but the risks are generally believed to be those associated with polysubstance use (using more than one substance at a time). A recent report in the New England Journal of Medicine indicates that some people may present with symptoms that are consistent with a xylazine-related use disorder, or xylazine addiction.8,10

As xylazine is increasingly present in fentanyl and other opioids, the primary concern appears to be opioid addiction, as well as addiction to other substances contaminated with xylazine. Opioid addiction can lead people to purchase unregulated and dangerous opioids on the street, which can contain deadly adulterants like xylazine, unbeknownst to the buyers, as with fentanyl.1,3,11

Opioid Addiction Treatment in Texas

Addiction treatment can help people who are struggling with the use or misuse of opioids and xylazine. Greenhouse Treatment Center, our inpatient rehab near Dallas, offers a wide range of evidence-based therapies and different types of rehab care to suit all needs. We can provide:12

  • Medical detox, which helps ensure patient safety and comfort during withdrawal.
  • Inpatient treatment, where patients live onsite and receive 24/7 care from our expert team of addiction professionals.
  • Outpatient care, where patients live at home but travel to our rehab to receive treatment on a regular basis.
  • Aftercare, like our sober living facility, which helps patients transition back to day-to-day life in a substance-free, supportive residential environment.

If you or a loved one is ready to get help, call to speak with one of our caring admissions navigators who can discuss your rehab options and guide you through the treatment admissions process. You can also learn about insurance coverage for rehab, paying for addiction treatment, and more.

It’s never too late. Contact us to begin the path to recovery today.

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