Xylazine is a non-opioid sedative used in veterinary medicine that is increasingly found in the U.S. illicit drug supply, especially mixed with illegally made fentanyl. It is not approved for use in people. People may be exposed without knowing it, and the combination can increase the risk of prolonged sedation, slowed breathing, low blood pressure, serious skin wounds, and overdose.
If an overdose is suspected, call 911 immediately and give naloxone if available. Naloxone does not reverse xylazine itself, but it can reverse opioid effects from fentanyl or another opioid that may be present.
What is xylazine?
Xylazine is a sedative and tranquilizer used in veterinary medicine. The CDC states that xylazine is not approved for human use. It can cause heavy sedation, slowed breathing, slowed heart rate, low blood pressure, and wounds that may become infected.
Why is xylazine mixed with fentanyl?
CDC reports that illegal drugs such as fentanyl, heroin, and cocaine can be mixed with xylazine, sometimes to alter drug effects or increase the weight or street value of a product. People using the drug may have no way to know xylazine is present.
Because xylazine is not an opioid, it does not respond to naloxone. When it is combined with fentanyl, a person can experience both opioid toxicity and non-opioid sedation at the same time.
What makes xylazine especially dangerous?
Xylazine can deepen sedation and suppress normal breathing. It is also associated with serious skin and soft-tissue wounds that can occur even when the drug is not injected directly into the affected area. Untreated wounds can become infected and, in severe cases, lead to life-threatening complications.
Does naloxone work if xylazine is involved?
Naloxone should still be given in a suspected overdose because fentanyl or another opioid may also be present. Naloxone will not reverse xylazine itself, so sedation or breathing problems may continue after the opioid effects improve.
Call 911, give naloxone if available, stay with the person, and provide rescue breathing or other emergency support as instructed.
Can xylazine cause withdrawal?
Yes. CDC has reported that people with repeated xylazine exposure can develop severe withdrawal symptoms. Because xylazine withdrawal is different from opioid withdrawal, people exposed to both fentanyl and xylazine may need clinical assessment for more than one type of withdrawal syndrome.
How can someone know whether fentanyl contains xylazine?
Laboratory testing can identify xylazine, and xylazine test strips are available in some harm-reduction settings. However, no single test rules out every dangerous substance in the illicit drug supply.
What treatment is available for someone exposed to fentanyl and xylazine?
Treatment depends on the person’s actual clinical needs. Assessment may address opioid use disorder, withdrawal risk, wounds, infections, psychiatric needs, and other medical concerns. Xylazine exposure does not replace the need to treat opioid use disorder when opioids are also involved.
Trinity Behavioral Health provides information about adult detox and withdrawal management and residential addiction treatment. Specific treatment recommendations require individualized assessment.
Frequently asked questions
Is xylazine an opioid?
No. It is a non-opioid sedative.
Can xylazine be reversed with naloxone?
No, but naloxone should still be given in a suspected overdose because fentanyl or another opioid may be present.
Can xylazine wounds happen without injection?
Yes. Public health agencies have reported skin wounds in people exposed to xylazine even when injection did not occur directly at the wound site.
Is xylazine approved for people?
No. Xylazine is not approved for human use in the United States.
Sources
This article is for general education and does not replace emergency care or individualized medical treatment.