There’s a new drug out there called Xylazine, a sedative commonly used in veterinary medicine.

Often called tranq, tranq dope, sleep cut, Philly dope, or zombie drug and is often mixed with other illegal drugs which makes it particularly dangerous. Because when someone overdoses there are often multiple drugs in the mix and that makes keeping the individual alive very complicated because of dangerous reactions to what is administered during withdrawal to help.

Top co-occurring substances with which xylazine is often mixed

• Fentanyl
• Heroin
• Cocaine
• Tramadol

While these are the most common drugs, the truth is most drugs today have all kinds of dangerous, unknown substances. So marijuana or even Adderall can be mixed with fentanyl or any number of other substances.

Why do dealers add it? To enhance the high and the effects and get people hooked on it so they can sell more. It’s a dirty business but still a business.

Will Narcan help prevent a death overdose from xylazine?

Yes! Naloxone, or brand name Narcan, should always be administered when you suspect a drug overdose because opiates are often in the mix. If someone overdoses on xylazine, it won’t reverse the xylazine but it will reverse the opiate component and give the person time.

Even if the patient doesn’t wake up right away, it can help the person survive. But it’s very important with a xylazine withdrawal, that the person is supervised by medical staff. So if someone overdoses, call 911 first, then do Narcan if you have it.

How is xylazine taken?

Since it’s not for human consumption, it’s most often found as an injectible solution. Since it’s growing in abuse potential it can now be found in these forms.

• Injection
• Pills
• Capsules
• Powder

If someone does cocaine, for example, and they are falling asleep after, a person might suspect fentanyl which would be. a likely guess. But someone with SUD can use a test strip to see if there is an opioid in the mix. And if the test strip says it’s not, then the substance is likely xylazine. Because cocaine doesn’t make someone tired.

Signs of xylazine addiction in layman’s terms

• Depression and significant mood changes like despair which puts the person at risk not only for OD but suicide.
• The Nods (falling asleep)
• Wears long sleeves to cover up rashes and skin lesions. Early lesions look like large scabs on the skin in clusters. The late stage can lead to skin grafts and amputation. (I won’t post the photos here as they are pretty gross.)
• Ragged breathing due to heart and respiratory issues
• Dizziness and unsteadiness. This can be caused either by low blood pressure, increased heart rate, or slowed heart rate
• Miosis or constricted pupils. When someone takes a drug like xylazine, it can cause the pupils, the black part of the eye, to get very small. So if a doctor shines a flashlight into the eye of someone on xylazine, their pupils may not respond by getting smaller like they normally would in a person who hasn’t abused the drug.
• Other toxic effects reported include blurred vision, disorientation, staggering, coma, and hyperglycemia. (Source: DEA pdf on Xylazine)

Official signs of Xylazine addiction with more scientific detail

These are longer explanations of the side effects.

1. The Nods. Like heroin and fentanyl, the effects of xylazine or tranq, include sedation, drowsiness, and unresponsiveness because it is a potent sedative. I remember when Charles was on heroin, there were a couple of times he’d just fall asleep in front of me. That’s what they refer to as “the nods.”
2. Skin lesions and necrosis if injected. When necrosis occurs in the skin, it typically involves the death of skin cells and surrounding tissues. Reduced blood flow caused by the drug makes these skin issues worse. These lesions are the result of it being injected in the same site over and over to relieve pain and a lack of oxygenation and blood flow by the drug prevents it from healing. Individuals might wear long sleeves to cover up injection sites and this can become infected, lead to serious skin issues that require surgery and grafting, and even result in amputation.
3. Slurred speech and impaired coordination. Xylazine abuse can cause motor impairment and coordination problems, including unsteady movements or stumbling.
4. Confusion and disorientation. Misuse of xylazine can result in mental clouding, confusion, and difficulty focusing or making coherent decisions. Individuals may exhibit disorientation or have difficulty with memory and concentration.
5. Respiratory depression: Xylazine depresses the respiratory system, leading to slowed or shallow breathing. This will look like slow, irregular breathing patterns or even shortness of breath.
6. Changes in blood pressure and heart rate: Xylazine abuse can lead to fluctuations in blood pressure and heart rate. Individuals may experience unusually low blood pressure or bradycardia (a slower-than-normal heart rate).
7. Depression and mood changes: Prolonged use of xylazine can impact mood and mental well-being. Individuals may exhibit signs of depression, such as feelings of sadness, hopelessness, and a lack of interest or pleasure in activities they once enjoyed.

Withdrawal symptoms

Withdrawal from sedative drugs can involve symptoms such as anxiety, restlessness, irritability, sleep disturbances, tremors, sweating, nausea, and in some cases, seizures.

Like any of these illegal street drugs, withdrawal from xylazine can be painful. Do note that it is during withdrawal that a person is at higher risk of suicide. So it’s important they be monitored for that, too. And because xylazine is often mixed with other drugs and substances, it can be difficult to figure out the right cocktail for withdrawal because a lot of what might aid the person can’t be used because it makes something else like heart rate slow.

For more information on this drug:

An animal tranquilizer is making street drugs even more dangerous (NPR)

AnneMoss Rogers

AnneMoss Rogers is a leading wellness and suicide education expert and one of the top mental health speakers and suicide prevention speakers. Known for her powerful, motivational keynotes, AnneMoss combines her personal story of loss with proven strategies to help organizations build a wellness culture that drives results and saves lives.  She speaks at conferences, workplaces, K-12 schools, and universities, delivering impactful presentations that inspire change and promote mental health awareness.
AnneMoss does this work in memory of her son, Charles, who struggled with anxiety, depression, and addiction, and died by suicide at age 20 in 2015.