The Down and Dirty of Xylazine AKA “Tranq or Tranq Dope”

Xylazine is a powerful substance that is contaminating the drug supply across America. In fact, the DEA estimates that there has been a 198% increase in prevalence (how much it is found) in the illicit drug supply in the South (2022). Xylazine has been detected in the drug supply across North Carolina including in Robeson and surrounding counties. It is most commonly combined with Fentanyl but has been found in other substances such as methamphetamines and/or cocaine (UNC Drug Analysis, 2024). 

Why Do I Need This Information?

Xylazine was created as a tranquilizer for animal use and has not been approved for use in humans. There is no reversal agent for Xylazine- NARCAN WILL NOT REVERSE XYLAZINE overdose. Exposure to Xylazine can be fatal. Nonfatal exposure can result in prolonged sedation, difficulty breathing, low blood pressure and heart rate, withdrawal symptoms that mimic opioid withdrawal, as well as, severe wounds that can result in skin and muscle death. These wounds are not just affecting those that use via injection but can occur regardless of HOW the substance is used.

What Can I Do in the Event of Suspected Xylazine Overdose?

1. Call 911– Xylazine overdose is a MEDICAL EMERGENCY. Stay with the person until help arrives!
2. Administer Narcan (naloxone)- While Narcan does not treat Xylazine overdose it can reverse the effects of opioids that may be contributing to the overdose. Administering Narcan to a person who does not have opioids in their system will not harm them!
3. Provide rescue breathing– Xylazine can slow breathing which does not allow the body to receive the oxygen it needs. Providing rescue breaths can ensure that the brain, heart and other parts of the body receive the oxygen it needs until 911 arrives. “To give rescue breaths to adults, make sure the person’s airway is clear; place one hand on the person’s chin, tilt the head back, and pinch the nose closed. Place your mouth over the person’s mouth to make a seal and give two slow breaths. Watch for the person’s chest (but not the stomach) to rise and follow up with one breath every 5 seconds” (CDC, 2024)

As always, we at Breeches Buoy Addiction Medicine Service, are here to throw you a life-saving buoy and pull you to shore. If you need help with Xylazine, or any other substance, please do not hesitate to contact us. For more immediate evaluation please present to your local emergency room. 

Article by Heidi Smith, APRN, PMHNP-BC AKA Nurse Practitioner

References:

Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. (2024, February 22). What You Should Know About Xylazine. https://www.cdc.gov/drugoverdose/deaths/other-drugs/xylazine/faq.html

UNC Drug Analysis Lab. North Carolina Xylazine Report. Data retrieved 2024, March 4 from https://ncxylazine.streamlit.app/

US Department of Justice Drug Enforcement Agency. (2022, October). The Growing Threat of Xylazine and its Mixture with Illicit Drugs. https://www.dea.gov/sites/default/files/2022-12/The%20Growing%20Threat%20of%20Xylazine%20and%20its%20Mixture%20with%20Illicit%20Drugs.pdf