Fentanyl And Xylazine

What Is Xylazine?

Xylazine is a powerful central nervous system depressant that is FDA-approved as a tranquilizer for animals since 1962. Recently, warnings have been issued about xylazine being used as an additive to illicit drugs, most commonly fentanyl.

Although often mixed with opioids, xylazine is not an opioid itself. It is an alpha-2 adrenergic receptor agonist that decreases the release of norepinephrine and dopamine. It is used as a veterinary sedative, muscle relaxant, and analgesic. Legal forms of xylazine for veterinary use are liquids sold in vials or preloaded syringes, but it is sold illicitly as a liquid or powder.

It can be swallowed, inhaled, smoked, snorted, or injected.

Xylazine Mixed With Fentanyl

The Drug Enforcement Administration (DEA), Food and Drug Administration (FDA), National Institutes of Health (NIH), and the White House have issued warnings about xylazine mixed with fentanyl.

This combination, called fentanyl adulterated or associated with xylazine (FAAX), has been declared an emerging threat by the Office of National Drug Control Policy due to the devastating consequences of this drug mixture.

The practice of mixing xylazine with illicit street drugs began in the Northeast US and has spread to the southern and western regions of the country, where it’s been linked to a significant increase in overdose deaths. A recent DEA report indicated that xylazine-related overdose deaths increased by 1127% in the south and 750% in the west between 2020 and 2021, and FAAX has been identified in 48 of the 50 states.

According to the DEA, 23% of fentanyl powder and 7% of fentanyl pills seized in 2022 included xylazine, with rates as high as 90% in some areas. Xylazine has also been identified in batches of cocaine and methamphetamine.

Why Is Xylazine Mixed With Fentanyl?

Substances like xylazine are often added to street drugs to increase the weight of the drug to produce more profit.

They are also mixed to amplify the effects of the primary substance. Since xylazine is a depressant, like fentanyl and other opioids, the effects are more intense and long-lasting when combined.

Most of the evidence indicates that xylazine extends the euphoric effects of fentanyl, prolonging the high. However, the withdrawal effects from FAAX are also stronger than opioids alone since the opioid effects taper while the xylazine effects continue to sedate the person. Once the xylazine effects subside, opioid withdrawal symptoms can be severe, leading the user to seek more of the substance to alleviate that pain.

Street names for xylazine mixed with fentanyl include:

• Tranq
• Tranq dope
• Horse tranq
• AnaSed
• Rompun
• Zombie drug

Side-Effects Of Xylazine And Fentanyl

Effects of xylazine can start within minutes and last 8 hours or longer. The addition of xylazine to fentanyl has only increased the toxicity and likelihood of extreme consequences, including fatal overdose. Since it is not intended for human use, xylazine can lead to toxic symptoms. Short-term effects include:

• Loss of consciousness
• Difficulty breathing
• Dangerously low blood pressure
• Dangerously low heart rate
• Reduced body temperature
• Loss of motor control

The severity of these depressant effects is stronger when combined with alcohol, Opioids, or other sedatives like benzodiazepines, which accounts for the high rates of fatal overdose on FAAX.

Xylazine-Related Skin Lesions

Xylazine use also comes with dangerous long-term effects such as amnesia and skin lesions. One of the more dangerous and extreme effects of xylazine is that it directly constricts blood flow throughout the body. This constriction causes lesions of skin necrosis that can become infected and lead to amputation.

Although injection of other drugs is also associated with skin abscesses and infections, xylazine related skin lesions are distinctly different and dangerous in several ways:

• Xylazine-related lesions are not restricted to injection sites and often appear on the lower legs between the knees and ankles.
• Xylazine wounds can resemble chemical burns.
• Xylazine wounds can have significant drainage and a foul smell.
• Xylazine wounds are likely to become necrotic, which appears as scaly black dead tissue called eschar.
• Xylazine wounds can take months or years to heal and are unlikely to heal without medical care.
• Xylazine wounds can penetrate the bone, necessitating amputation.

Xylazine-related skin sores or lesions usually require medical care as soon as possible to contain the infection and heal the wounds. Wound clinics and community clinics can provide essential care and wound-management techniques.

Xylazine And Fentanyl Overdose

Suspected xylazine overdose is a medical emergency. Since it is often mixed with opioids, administering Narcan can reverse the effects of opioid overdose but not the effects of xylazine.

Additional life-saving measures are often needed, including rescue breaths every 5 seconds, CPR, and medical care. Currently, there is no approved medication to reverse xylazine overdose.

For people who are ready to quit using FAAX, opioid treatment options can be supplemented with sedative addiction protocols.

Xylazine And Fentanyl Treatment

Since xylazine is a depressant, withdrawal can be intense and painful. Medically supervised detox programs are likely the best option for people using xylazine or FAAX regularly.

If you are struggling with xylazine, FAAX, or fentanyl addiction, know that help is available. To find a treatment program, contact a treatment provider today.