XYL, commonly known by its street name “tranq,” is a veterinary tranquilizer that has increasingly infiltrated the illicit drug market, posing significant public health challenges. Originally approved for animal use, xylazine is not intended for human consumption but has been found mixed with opioids like fentanyl, exacerbating the overdose crisis in various regions.
What Is XYL?
Xylazine is a sedative and muscle relaxant primarily used in veterinary medicine to anesthetize animals such as horses and cattle. It functions by depressing the central nervous system, leading to sedation, muscle relaxation, and pain relief in animals. However, it is not approved for human use due to its potent effects and potential for severe adverse reactions.
When consumed by humans, xylazine can produce profound sedation, respiratory depression, bradycardia (slow heart rate), hypotension (low blood pressure), and hyperglycemia (high blood sugar). Users may experience drowsiness, amnesia, and slow breathing rates. Chronic use has been associated with severe skin ulcers and abscesses, leading to necrosis, which has contributed to its moniker “zombie drug.” These wounds can be so severe that they resemble those caused by flesh-eating bacteria.
The infiltration of xylazine into the illicit drug supply has been notably documented in the United States. A study published in Psychiatric News reported that the prevalence of xylazine in overdose deaths rose from 0.36% in 2015 to 6.7% in 2020, with significant increases in areas like Philadelphia, Maryland, and Connecticut. Just from 2019 to 2020, the number of overdose deaths with xylazine involvement jumped by 44.8%
Combating Xylazine Overdoses
On the streets, xylazine is often referred to as “tranq.” It is frequently combined with fentanyl to prolong the euphoric effects, creating a dangerous and often lethal cocktail. This combination is particularly concerning because xylazine does not respond to naloxone (Narcan), the opioid overdose reversal drug, making overdoses more difficult to treat. However, since xylazine is often combined with opioids like fentanyl, administering naloxone is still recommended to counteract the opioid component. Supportive care, including maintaining airway patency, providing respiratory support, and monitoring cardiovascular function, is crucial. Immediate medical attention is essential to manage the multifaceted effects of a xylazine overdose.
The rise of xylazine in the drug supply has been linked to an increase in overdose deaths. According to the Centers for Disease Control and Prevention (CDC), xylazine was detected in 9% of fatal overdoses involving illicit fentanyl across 32 jurisdictions from January 2021 through June 2022. In Maryland, xylazine was involved in 27.7% of fentanyl-related deaths, while Connecticut reported a 26.4% involvement, followed by Pennsylvania at 23.3%.
The alarming rise of xylazine use has prompted responses beyond the United States. In the United Kingdom, xylazine was banned after being linked to multiple deaths. The UK government classified xylazine as a Class C drug under the Misuse of Drugs Act, aiming to curb its spread and associated harms.
Xylazine’s emergence as a contaminant in the illicit drug market has compounded the challenges of the opioid crisis. Its severe health effects, resistance to standard overdose treatments, and increasing prevalence underscore the need for heightened awareness, targeted harm reduction strategies, and comprehensive policy responses to mitigate its impact on public health.
