A new drug has emerged as a serious threat across the US. Its official name is Xylazine, but many refer to it simply as tranq. Tranq (which is short for “tranquilizer”) is a veterinary anesthetic that is mixed with fentanyl and other illicit drugs. Some suspect tranq has become more common because it extends the high caused by fentanyl. 

How does Xylazine affect the body? 

Tranq mimics the way opioids affect the body. Opioids bond to receptors in the brain, blocking pain signals. In addition to providing pain relief, this can produce feelings of euphoria and relaxation, but it can also cause nausea and slow breathing. 

Xylazine has never been approved for human consumption, so its effects on the body are not fully understood. We do know that it acts as a powerful sedative that depresses the central nervous system and can cause drowsiness, amnesia, slow breathing, and drops in heart rate and blood pressure. 

Are there any other side effects?

Harm reduction groups and doctors report that tranq often causes painful skin lesions and sores that can easily become infected, causing the skin to die and rot. This condition is called necrosis and can require amputation. 
Wounds like this are typically only a risk for injection drug users — but experts say that even people who smoke or snort tranq are at-risk for dangerous sores that can quickly get infected if left untreated. 

Does naloxone work on tranq overdoses?

Experts recommend administering naloxone every time an overdose is suspected.  Naloxone is harmless if someone isn’t overdosing, and it could save their life if they are. While naloxone does not work for xylazine the same way it does for opioids, the drugs are often combined, so it’s important to administer naloxone to address the overdose and call emergency services for help.  

“Xylazine, to our knowledge, does not respond to naloxone, but the opioids that are almost always present with the xylazine will respond to it. And what you want to do is give that person the opportunity to breathe,” Jen Shinefeld, an epidemiologist with the City of Philadelphia’s Department of Public Health, told VICE News.

How can people who use drugs reduce risks? 

• Never use alone
• Have naloxone nearby and make sure you’re with someone who knows how to use it
• Prevent infections by using clean needles and kits
• When possible, test your drugs before use with fentanyl test strips or xylazine test strips
• Use in a secure location

What should you do if you suspect someone is overdosing?

• Call 911
• Administer naloxone
• Begin rescue breathing 
• If/when breathing resumes, roll the person into the recovery position

How can tranq and opioid use be treated? 

There are several highly effective treatment options for opioid addiction. The gold standard is medications – including methadone, buprenorphine, and naltrexone – which greatly reduce the risk of deadly overdose, reduce cravings, and help many patients achieve lasting recovery. Therapy, support groups, and other treatments work well, too. 

Stigma is always a big barrier to addiction treatment and recovery, and its effect is even more powerful when a new, lesser-understood drug emerges within the street supply. 

Many people don’t know that xylazine is in the drug supply, so they may not understand the risks and side effects. They also may be embarrassed by their symptoms, preventing them from seeking care. 

“A concern is that people who use drugs — because they are often treated poorly by medical providers — won’t seek help for their wounds until they’ve advanced to a dangerous point,” STAT reports.

Medical professionals who aren’t aware of the emerging drug, or who aren’t used to treating patients who use drugs, may not be able to care for these patients effectively. That’s why sharing accurate, useful information is so critical.