Xylazine and wound care: An unexpected complication in the fight against tranq

Discover the health concern of xylazine wounds in opioid users and how these side effects can affect & complicate opioid treatments.

Ophelia team
Xylazine (a.k.a tranq) and wound care
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Arthur Robin Williams, MD

As fentanyl use continues to spread across the country, xylazine, or “tranq”, follows closely behind—and it’s causing unique problems among opioid users. This veterinary-strength tranquilizer isn’t an opioid itself, but it’s often used to cut opioids and extend their effects. And now, doctors, harm reduction specialists, and community organizers are finding that this combination leads to xylazine wounds, a new health concern that can complicate opioid treatments.

What are xylazine wounds?

Since xylazine is mixed with an opioid, it’s most commonly injected, but it could also be smoked. As xylazine becomes more widespread, health advocates and medical professionals have observed a major uptick in an alarming side effect: xylazine wounds. These wounds develop on the skin, like lesions or abscesses. They’re slow to heal, often requiring special treatment.

We still don’t know what causes these gruesome wounds, but their link to xylazine is undeniable. In general, wounds from opioid injections are common, but xylazine wounds are especially gnarly. These large wounds grow easily and put patients at risk of deadly infections. If left untreated, they can even turn black– which indicates necrosis or tissue death.

With tranq present in a growing percentage of the country’s fentanyl supply, millions of people are at increased risk of developing xylazine wounds, becoming dependent on the drug, and experiencing an opioid-related overdose. 

Why are xylazine wounds so dangerous?

Activists working to help opioid users have noticed an increase in the number of people who show up to their outreach programs with large, dramatic, untreated wounds. For many, seeking medical treatment for their lesions is not an appealing option. This problem stems from two main concerns.

The first major concern among people with opioid use disorder (OUD) is the threat of xylazine withdrawal. The drug has notoriously difficult and painful withdrawal symptoms. Many people are worried that seeking medical treatment for their wounds will cut off their access to xylazine-laced opioids, leading to painful withdrawal.

Most doctors—even those who specialize in opioid treatment—aren’t equipped to deal with xylazine cases because the drug doesn’t respond to the FDA-approved medication treatments for opioid withdrawal. This makes the treatment of xylazine wounds both painful and potentially dangerous.

Second, many medical professionals are simply not well-informed on the causes of xylazine wounds and how to treat them. Too many doctors see xylazine wounds and assume that they function similarly to wounds caused by infection. In many cases, wounds caused by infection are amputated to stop it from spreading and causing harm elsewhere in the body.

However, xylazine wounds respond to proper treatment and rarely require amputation. The gap in available knowledge about these wounds has led to a number of unnecessary amputations that ultimately don’t solve the problem.

What can be done?

The most important step toward addressing the high volume of xylazine wounds among opioid users is to increase medical research surrounding the drug and its effects. Because xylazine isn’t intended for human use, there is very little reliable data about how it impacts human health, and medical professionals are unprepared to treat problems relating to xylazine. It will also be important to understand better treatment options for xylazine withdrawal so users can feel more secure seeking medical help.

As fentanyl use spreads, so will accompanying xylazine use, and this problem is set to worsen without intervention. When medical professionals are better able to address these concerns, opioid users will begin to see more meaningful treatment options. 

Medication-based treatment for OUD without the barriers

Treating opioid use disorder is a key part of limiting the risks of xylazine. Help is just a consultation call away. We’ll get to know you and your needs and set up a personalized treatment plan, including Suboxone® or another buprenorphine-naloxone treatment if it’s appropriate. From there, you’ll meet with a dedicated care team who will make sure you’re adjusting to the medication and making progress in the weeks and months that follow.

Ophelia’s clinicians are available 7 days a week, morning through evening, so you can create an appointment schedule that fits into your real life. Set up a welcome call to get started.


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