Xylazine, also known as “tranq” and “tranq dope” (or in Spanish as “anesthesia de caballo”), is an animal sedative. Like fentanyl, it is most often found mixed with other substances and has been linked to an increasing number of overdoses over the past few years.

Xylazine is an incredibly dangerous substance for many reasons. It’s difficult to detect on routine drug tests. Also, it is not an opioid so opioid-reversal drugs like naloxone (aka Narcan) won’t work.

But one of xylazine’s telltale traits is its ability to cause very painful and severe wounds all over the body – not just where it is injected. In fact, xylazine can cause wounds even when it’s smoked or snorted.¹ These wounds can become infected and, in some cases, require limb amputation.

If your loved one is at risk of being exposed to xylazine, or if they are already struggling with xylazine-related wounds, the following information can help you understand how to best care for them.

What are xylazine wounds?

Xylazine wounds can take several forms and range in severity. These can include:²

• Skin infections
• Blisters
• Abscesses (wounds below the skin)
• Ulcers (open wounds)

A wound can start as a small bump or blister, or with a patch of scab-like dead skin (known as “eschar”). Without effective xylazine wound care, even a seemingly harmless wound can become an ulcer. Ulcers usually have a bad odor and ooze pus.³

Xylazine wounds can spread across the body and get worse quickly. They appear most often on the limbs (arms, legs, hands, and feet).⁴ This is known as “tunnelling.” Because of this, xylazine wounds are different from other injection-related wounds.

Besides being very painful, xylazine wounds can result in many medical issues, including sepsis, which is a potentially deadly condition that can stem from infection. In severe cases, limb amputation may be necessary.⁵

How are wounds treated?

When xylazine wounds first appear, it’s important to treat them like any other skin injury. Keep the wound clean with warm water, soap, and/or saline to stave off infection. An ointment like Vaseline can help keep the wound from spreading.⁶ Keep the wound covered and change the bandages regularly. It is most important to catch and treat the wounds early; if treated properly, they may go away on their own, though they are slow to heal.

However, if the wounds progress to abscesses or ulcers, basic care is no longer enough so seek out emergency care. It is important to know the warning signs for skin infection. These include:

• Fever
• Swelling
• Increase in pain
• Wound site feels hot
• Changing skin color (may get redder or darken, potentially even turning black)
• Chills
• Nausea and vomiting
• Loss of feeling in skin⁷
• Rapid spreading of wound
• Exposed bone

If your loved one experiences any of these symptoms, they should seek emergency care immediately.

How can I keep my loved one safe?

Studies have shown that people with xylazine wounds are often reluctant to seek treatment. Or they may choose to treat their wounds themselves.⁸ Xylazine withdrawal is incredibly painful, which can make extended hospital stays difficult for patients. Stigma against substance use disorder from healthcare professionals can also deter people from seeking treatment. So, it’s very important to show your loved one compassion and advocate for them if they seek treatment.

Some steps you can share with them to help prevent xylazine wounds or keep them from getting worse include:

• Obtain a wound care kit, which will include supplies like ointment, bandages, gauze, and gloves.
• Be careful of risky injection spots on the body. Unsafe injection sites include those around arteries or places where they potentially have poor circulation (like fingers and toes).⁹
• Rotate injection sites and do not inject at the site of a wound.¹⁰
• Needles, syringes, and anything else used to consume substances should be clean and never shared with others. Injection sites should also be clean and dry beforehand.
• Use xylazine test strips to see if it’s present.