Xylazine ("Tranq"): What Families Need to Know About the Drug Mixed Into Fentanyl

If someone you love uses opioids, there is a good chance they have been exposed to a drug they never chose to take. Xylazine, often called “tranq,” is a veterinary sedative that has turned up in the illicit drug supply, most often mixed into fentanyl.

Most people who take it do not know it is there. Here is what families need to know, based on what the National Institute on Drug Abuse has published.

What is xylazine?

Xylazine is a sedative and pain reliever approved by the FDA for use in animals only. It has never been approved for people. According to NIDA, illicit xylazine is most often mixed into fentanyl, but it is not an opioid. When it is combined with fentanyl or other opioids it is sometimes called “tranq dope.”

Some people use it on purpose to make fentanyl’s effects last longer, NIDA says. Many others are exposed by accident and describe it as an unwanted additive.

What does xylazine do to the body?

Xylazine is a central nervous system depressant. It causes drowsiness and can slow breathing, heart rate and blood pressure to dangerously low levels. Those effects are most dangerous when it is mixed with other depressants such as opioids, alcohol or benzodiazepines.

NIDA also notes that in overdose deaths involving both xylazine and fentanyl, other substances were usually present too, including cocaine, heroin, benzodiazepines, alcohol and prescription opioids.

Does naloxone work on xylazine?

No, but you should still give it. Naloxone and other opioid overdose reversal medications do not reverse xylazine’s effects. NIDA explains that experts still recommend giving them in any suspected overdose, because xylazine is almost always taken with fentanyl or other opioids, and reversing the opioid can save a life.

If you think someone is overdosing:

• Give naloxone if you have it.
• Call 911 right away.
• If they are unconscious, check that they are breathing and place them on their side with their head supported.
• If they stop breathing, give rescue breaths if you can, and stay with them until help arrives.

What are xylazine wounds?

Repeated xylazine use can cause painful, hard-to-treat sores on the skin and in the tissue underneath. NIDA says that if left untreated these wounds can grow, become infected and lead to patches of dead tissue, and in rare severe cases may require amputation.

The sores can appear far from where the drug was injected, and some clinicians report them even in people who smoke or snort the drug. Any wound like this needs medical care.

Does xylazine make it harder to stop using?

It may. NIDA reports that early research suggests substance use disorder symptoms and withdrawal symptoms may be more intense for people taking xylazine with fentanyl than for people taking fentanyl alone. More research is needed, but it is one more reason not to try to quit opioids abruptly on your own.

How can treatment help?

Because xylazine usually comes with fentanyl, treatment starts with the opioid use disorder, with medical care for withdrawal and for any wounds. Nova’s continuum covers each step:

• Medical detox, where withdrawal is managed with 24-hour care
• Residential treatment, Nova’s 90-day program on its Wimberley campus outside Austin
• Intensive outpatient (IOP) and online IOP, for structured care after detox or while living at home

Our guide to illegal opioids covers the wider fentanyl risk, and our article on Red Ribbon Week explains how fake pills can contain fentanyl.

When you are ready to talk

If someone you love is using fentanyl or other opioids, Nova’s admissions team answers 24 hours a day. The first conversation is free and confidential, and the team can help you understand what level of care fits. You can also verify your insurance online in a few minutes.

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