Xylazine is a tranquilizer commonly used by veterinarians. But now it’s running rampant through the illicit drug market and fueling opioid-involved overdose deaths.
Among the many reasons why this is a problem is the fact that xylazine doesn't respond to common antidotes for opioid overdose, like naloxone. This is because it’s not an opioid. Instead, it boosts the effects of fentanyl, intensifying and prolonging the “high” for users. Long story short, this drug makes an already alarming public health issue even more deadly. Below, we explain exactly what xylazine is and why it poses such a threat.
What is xylazine?
Xylazine is a veterinary tranquilizer and not approved by the United States Food and Drug Administration (FDA) for use in humans in any form. A non-opioid agent, the drug was approved as a sedative for use in animals in 1972.
Since then, it's made its way into the illicit drug market under names like sleep-cut, Philly dope, zombie drug, tranq, and tranq dope. It’s often mixed with fentanyl, a synthetic opioid.
Side effects of xylazine
While xylazine isn't an opioid, it has similar effects. The drug releases dopamine and norepinephrine into the central nervous system and has a sedative-like effect. Effects of xylazine include:
- Disorientation
- Blurry vision
- Drowsiness
- Decreased blood pressure
- Shallow breathing
- Physical staggering
- Skin wounds and infections when injected
In some cases, xylazine use may lead to coma. Additionally, when mixed with opioids like fentanyl, xylazine worsens the tranquilizing effect of the opioid.
This increases the risk that the individual will lose consciousness, which can lead to extreme depression of respiratory function and increase the risk of suffocation. Users are also more vulnerable to dangers like sexual assault, robbery, or violence.
Challenges of addressing xylazine misuse
Since xylazine isn't an opioid, it doesn't respond to overdose antidotes like naloxone. This increases the risk of overdose deaths. If a person overdoses on opioids alone, it’s safe to administer multiple doses of naloxone if they don’t respond within 2 or 3 minutes—but xylazine will most likely keep the person unconscious, meaning any follow-up doses will have no effect.
Another problem is the fact that it's difficult to study xylazine in humans. Since the drug is intended for veterinary use only, there's limited understanding of its impact on the human body. Many reports have already emerged that when injected, xylazine can be incredibly harmful to skin tissue causing infection and disfiguration.
Additionally, it's generally difficult to determine what kinds of drugs are involved in an overdose incident since many substances found on the street are mixtures. For example, one study of drug samples in Kentucky and Vermont discovered multiple active agents in 89% of drugs sold as straight cocaine or opioids. They may be cut with diverse substances, from acetaminophen to benzocaine—or xylazine.
Should naloxone be given in case of suspected xylazine use?
According to the National Institute on Drug Abuse, experts recommend giving naloxone in case of suspected xylazine overdose. Since xylazine is often combined with opioids, the naloxone may be able to offer some help—even though it can't reverse the xylazine's effects.
For example, naloxone can't reverse the impact that xylazine has on a person's breathing. This is why it's so important to call emergency medical services when an overdose is suspected.
Addressing the dangers of xylazine use
The threat of xylazine on public health is part of the larger opioid epidemic in the U.S. Harm reduction experts generally agree that it's just as important to find ways to minimize potential dangers as it is to stop the spread of the drug's use.
Examples of harm reduction measures could include on-the-spot drug testing locations (to check what substances a drug actually contains), clean needle sites, and safe facilities where people can get medical help if needed.
The Food and Drug Administration (FDA) has also stepped in to issue an import alert for xylazine, meaning the agency will be examining shipments arriving in the U.S. to be sure they’re intended for legitimate veterinary use. Any shipments that appear to be labeled improperly or tampered with may be detained for further study. The agency’s announcement indicates they’ll be working with the United States Drug Enforcement Agency (DEA) and federal, state, and local agencies to stay on top of a growing problem.
At the same time, the DEA has begun studying xylazine to form the basis of a request for scheduling classification from the Office of Health and Human Services (HHS). However, this process has not moved forward since late 2022, and experts are worried that the FDA import alert means it will remain stalled.
Medication-based treatment on your time
Individuals with opioid use disorders (OUD) may also benefit from medication-assisted treatment (MAT) to help manage cravings and receive ongoing clinical support. Ophelia offers online opioid addiction treatment, making it easier to access the care you need when you need it.
After a brief welcome call, we’ll determine whether Suboxone® or another buprenorphine-naloxone treatment is right for you and connect you with a dedicated care team. Follow-up appointments are available 7 days a week, so you can decide what fits into your schedule.
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