You may have heard of fentanyl, a very strong and harmful substance that has resulted in many opioid overdoses in the United States. However, there is another dangerous substance in the drug supply alongside fentanyl: xylazine.

Overdoses linked to xylazine were first spotted in the Philadelphia area, but have since spread to other parts of the country including Maryland, Connecticut and Massachusetts.

What is xylazine?

Xylazine, also known as “tranq” and “tranq dope” (or in Spanish as “anesthesia de caballo”), is an animal sedative. It is used by veterinarians to relieve pain, relax muscles, reduce anxiety and cause sleep in animals. It is not approved for use in humans.

It is a depressant, meaning it slows brain activity and causes extreme drowsiness. It can result in slowed breathing and heart rate in people who use it, as well as dangerously low blood pressure. Individuals using this substance may black out or experience a loss of memory.

More and more, xylazine is being found in substances, especially fentanyl. People who use fentanyl may seek out xylazine because the high lasts longer – more like that of heroin. In other cases, people may be exposed to it without knowing it.

While there are no definite signs of what this substance looks like or how it can be detected, those who have used it have reported:

• A strong gasoline smell
• Feeling of dry mouth
• It can be dyed pink or purple, but can be the same brown or white color as fentanyl

Why is xylazine so dangerous?

This substance can cause significant damage to the body in addition to increasing the risk of overdose and death.

• Overdose: It is most often used along with opioids or other substances, increasing one’s risk of overdose. When an overdose involving xylazine occurs, the individual is usually heavily sedated, unresponsive, and may have a blueish skin tone. Additionally, overdoses involving this substance are harder to reverse. Because xylazine is not an opioid, opioid-reversal drugs such as naloxone (Narcan), do not work as well on it.
• Severe wounds: A major factor of this substance is its ability to cause very painful and severe wounds all over the body – not just where it is injected. These can become infected and, in some cases, require limb amputation.
• Difficult to detect: It is difficult to detect when xylazine is part of an overdose, as it does not show up on routine drug tests.

How can you protect against xylazine?

There are a few things you can do, including:

• Talk to your loved one to see what they know about the risks of xylazine.
• Have naloxone on hand and know how to use it in case of an overdose.
• Discuss other harm reduction tips, including using clean and sterile needles, never using substances alone and ingesting xylazine through a nasal spray.
• Make sure your loved one receives medical attention as soon as possible if they have physical wounds from xylazine use.

Additionally, xylazine test strips have recently been developed and are becoming more widely available via wholesale retailers BTNX  and DanceSafe. Doctors, health departments and other direct-service organizations can order them to be distributed in their community. Many are taking advantage of this opportunity; for example, the New York state government launched a request form via MATTERS for xylazine test strips to be sent to individuals and organizations.

Source: Prevention Point Pittsburgh

Source: University of Pittsburgh

The Philadelphia Department of Health also has a detailed guide on caring for individuals with xylazine-associated wounds, which you can find here.

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