Xylazine: A Dangerous and Growing Threat

This article was originally published in the Summer 2024 issue of Living Recovery. To view the full issue, click here.

Medically reviewed by Melinda Tuttle, Director of Infection Prevention and Control at ARC.

A dangerous and growing threat across the United States is the prevalence of xylazine. The issue caught national attention in 2023, when the Biden administration designated fentanyl combined with xylazine as an “emerging threat to the U.S.”
“Substance use has always been dangerous, but in recent years has become even more life-threatening,” said Matt Brown, ARC Chief Administration Officer and President of ARC Healthcare. “Mixing drugs can be a death sentence. It’s important that we not only educate community members on overdose prevention but that we continue to spread the word that treatment is available and recovery is possible.”

What You Should Know

Xylazine is a tranquilizer primarily used in veterinary medicine. The drug shares chemical similarities with sedatives, offering a calming effect without being an opioid.

Commonly known as “tranq” or “tranq dope,” xylazine often accompanies illicitly manufactured fentanyl — complicating the landscape of substance abuse. Unfortunately, those consuming fentanyl-laced products may unknowingly expose themselves to xylazine, amplifying the potential risk of overdose.

“Xylazine is making the deadliest drug threat our country has ever faced, fentanyl, even deadlier,” said Drug Enforcement Administration (DEA) Administrator Anne Milgram in 2023.

The DEA seized 12,000 pounds of fentanyl powder and 79.5 million fentanyl pills in 2023.

Signs and symptoms of an overdose include:

  • Difficulty breathing
  • Small pupils
  • Disorientation
  • Lips and fingernails turning blue or purplish black
  • Pale or clammy face
  • Choking or gargling sounds

Can naloxone help during an overdose involving xylazine?

Because xylazine is not an opioid, naloxone (Narcan) does not reverse the effects of an overdose. However, experts always recommend administering naloxone if someone might be experiencing an overdose.

If you are with someone who you believe is overdosing:

  • Call 911
  • Perform CPR based upon your level of training
  • Immediately administer naloxone (Narcan)

While naloxone may not counteract the effects of xylazine, it can still potentially save a life by reversing any concurrent opioid overdose, providing critical time for emergency medical services to arrive.