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What You Should Know About Xylazine Drug Overdose CDC Injury Center

Large drug seizures of xylazine have occurred in Pennsylvania, Connecticut, Maryland, Puerto Rico and California. Xylazine was reported to be involved in 19% of all fatal drug overdose deaths in Maryland in 2021, and 10% of Connecticut overdose deaths in 2020. It is a tranquilizer, sedative and pain reliever that is FDA approved ONLY for use in animal medicine. In veterinary medicine, it is used as a component of diagnostic and surgical procedures in animals ranging from cats and dogs to horses and cattle. Xylazine is often mixed with heroin, fentanyl and other opioids that are taken illegally.

It slows a person’s breathing and heart rate, and lowers their blood pressure. An overdose can put them into a coma-like state, leaving them frozen and vulnerable for hours on the street. In November, the Food and Drug Administration distributed guidance to health care professionals warning of the risk of patients being exposed to xylazine in illicit drugs. Because the tranquilizer isn’t an opioid, its effects can’t be reversed by the opioid overdose antidote naloxone (aka Narcan). Public health officials worry that the spread of xylazine in the opioid supply could render naloxone less effective for some overdoses, the NIH says.

Xylazine was found in over 90% of drug samples tested in Philadelphia in 2021, the program says. There are currently no validated drug-checking tests or tools for detecting xylazine; the health department got that data by testing drug samples with a forensic toxicology lab. Routine toxicology screens do not detect xylazine, according to the FDA, so additional tests are needed to determine whether the tranquilizer was involved in a drug overdose. While most jurisdictions don’t routinely test for xylazine in postmortem toxicology, the Drug Enforcement Administration estimates xylazine was involved in at least 1,281 overdose deaths in the Northeast and 1,423 in the South in 2021. The drug is showing up in synthetic opioids, particularly fentanyl, leading to more overdoses and alarming side effects, according to the White House Office of National Drug Control. “Because of the sedation effect (of xylazine), it takes people a bit longer to rouse and become alert,” said Dittmore, who said she has reversed dozens of overdoses.

  1. Xylazine is seen primarily as an additive in the unregulated drug supply and is not typically a substance that is used on its own.
  2. A safe and controlled sedative intended only for large animals like horses is becoming an increasingly popular adulterant to substances like fentanyl, prompting flesh-eating skin ulcerations in humans — earning it the apt slang term “zombie drug.”
  3. Last week, the US Drug Enforcement Administration issued an alert about a “sharp increase in the trafficking of fentanyl mixed with xylazine”, saying it had seized xylazine and fentanyl mixtures in 48 out of 50 states.
  4. This will allow the government to boost law enforcement, health care strategies, and data review to help fight the drug on the streets.

Drug Enforcement Agency has found xylazine in illicit drugs, including cocaine, heroin, and fentanyl, throughout the country. If you suspect someone has overdosed on xylazine, call emergency medical services right away. While there is no treatment for xylazine itself, other treatments alcohol use disorder symptoms and causes may be used. Because xylazine is often combined with an opioid, a medicine used to treat opioid overdose, called naloxone, may be used. Medicines used to treat low blood pressure and low heart rate also may be used to treat the symptoms of xylazine use and withdrawal.

What is xylazine (“tranq”)?

Political officials are implementing legislation and law enforcement is navigating how to combat its presence on the street, all while veterinarians are hoping its accessibility for the intended use in animals remains uninhibited. “In California, there is legislation out there trying to get it to where controlled substances like that [xylazine] can not be removed from a brick and mortar building,” she said. “I think that we would have some reverse and we may not be as high as we are now with our overdose trend, our fatal overdose trend, had it not been for something like a xylazine that’s coming on and complicating the matter of other life-saving drugs.” As every corner of the country continues to combat deadly fentanyl overdoses, xylazine has been simultaneously infiltrating communities. As fentanyl analogs grow in potency, using an adulterant like xylazine only adds fuel to the fire. People can sample using pills or powdered substances, although it’s advised to shake the bag or crush the pill prior to testing.

Xylazine was involved in 19% of all drug overdoses in Maryland in 2021 and 10% of drug overdoses in Connecticut in 2020, the NIDA states. Because xylazine is often mixed in with fentanyl (an opioid), naloxone (an opioid overdose reversal medication) always should be administered when responding to any suspected overdose. However, because xylazine is a sedative, rescue breathing is an effective overdose response strategy and should be performed until Emergency Medical Services (EMS) arrive. Symptoms of xylazine overdose may include slowed breathing and heart rate; confusion; slurred speech; constricted pupils; hypothermia; and low blood pressure, according to the FDA.

Naloxone should be given in response to any suspected drug overdose to reverse any possible opioid effects. Naloxone will not reverse the effects of xylazine.11 However, because xylazine is often used with opioids like fentanyl, naloxone should still be given. It’s important to call 911 for additional medical treatment, especially since the effects of xylazine may continue after naloxone is given. Xylazine is seen primarily as an additive in the unregulated drug supply and is not typically a substance that is used on its own. Although it has been found to be mixed in with other substances, xylazine most commonly is being added to illicitly manufactured fentanyl.

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Despite xylazine’s horrors, advocates hope it could serve as another wakeup call for a national breakthrough in drug policy. See says there’s “a mountain of peer-reviewed evidence” to suggest that overdose prevention centers would make a difference in the opioid crisis, “but what’s important for Americans is American examples and American evidence”. Healthcare providers should continue to administer naloxone when they suspect an opioid overdose and consider that xylazine may be involved as a component of an overdose if the patient does not respond as expected.

Headaches, insomnia, and nausea can also occur during xylazine withdrawal. People experiencing xylazine withdrawal might require hospitalization for treatment with medications that can reduce the severity of the withdrawal symptoms. Illicit formulations of liquid and powdered xylazine are available for purchase from online retailers for less than $20 per kilogram, making the drug an attractive option for illicit drug manufacturers. alcohol use disorder diagnosis and treatment Xylazine and other adulterants are added to illicit drugs to increase the bulk volume of the drug, increase profits for drug traffickers, and enhance the “high” of the drugs. The use of opioids with sedating medications like xylazine increases the risk of fatal overdose. Historically, people who use drugs have been unaware that xylazine is in the drug supply and are unable to tell whether they have been exposed to it.

It’s too soon to see how the policy will impact efforts to curb xylazine use and overdose on the ground, said Kimberly Sue, MD, PhD, assistant professor of medicine in the Program in Addiction Medicine at Yale University School of Medicine. Severe, necrotic skin ulcers may also be a sign that repeated xylazine exposure has occurred. Xylazine also serves as a transport inhibitor by suppressing norepinephrine transport function through competitive inhibition of substrate transport. This means if you’re admitted to the hospital, they’ll give you fluids through your veins (IV fluids) and saline eye irrigation.

Is xylazine a controlled substance?

Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include Micromedex (updated 3 Mar 2024), Cerner Multum™ (updated 17 Mar 2024), ASHP (updated 20 Mar 2024) and others. It is not yet known if xylazine is produced illegally or diverted from the veterinary drug supply, although reports have stated supplies are thought to originate from China, Mexico, India or Russia.

Xylazine is a medicine given to animals to sedate them for surgery or relieve pain. They analyzed past Facebook posts from Black and white people who self-reported depression severity through the Patient Health Questionnaire (PHQ-9) – a standard self-report tool used by clinicians to screen for possible depression. Participants were primarily female (76%) and ranged from 18 to 72 years old. The researchers matched Black and white participants on age and sex so that data from the two groups would be comparable.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. From 2015 through 2020, based on forensic information from the DEA, xylazine was identified in over 3,800 reports. Routine toxicology screens do not identify xylazine and it may be difficult to determine if it is involved in an overdose without additional, more advanced analytical measures like gas chromatography–mass spectrometry (GC-MS).

This can include benzodiazepines, alcohol, gabapentin, methadone, and prescription opioids. Xylazine has been used in attempted sexual assaults, accidental or intentional poisoning, and drug abuse. Tranq found on the streets is largely mixed with heroin, fentanyl, or cocaine to enhance or modify the drug’s effects. Veterinarians regularly use it to tranquilize (sedate), relieve pain, or as a muscle relaxant for animals like dogs, cats, and horses.

The critical goal of administering naloxone is to prevent patients from dying of dangerously low breathing rates. Bystanders who suspect an overdose should always call 911 to bring in experts in case treatment is required. There are antidotes (atipamezole, yohimbine) for xylazine that vets use on animals, but they’re not FDA-approved for use in humans. This guide answers some common questions about xylazine, xylazine use, and overdoses involving xylazine.

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