Xylazine (“Tranq”): What Everyone Should Know

Quick Facts

• Xylazine is a non-opioid veterinary sedative/tranquilizer. It is not approved for human use in the U.S.

• It is increasingly found mixed with illicit drugs (especially fentanyl) and is linked to overdose deaths.

• People often don’t know their drugs contain xylazine.

• Naloxone still matters: it reverses opioids, not xylazine, so you must also give rescue breaths and call 911.

What is Xylazine?

Xylazine (often called “tranq” or “tranq dope”) is a non-opioid sedative. In humans it can slow breathing, lower blood pressure, and slow the heart rate. It can also cause sedation, severe withdrawal, difficult-to-heal wounds, and death—especially when combined with opioids like fentanyl.

How are People Exposed?

Illicit fentanyl, heroin, and cocaine are commonly adulterated with xylazine to intensify effects or increase product weight. Many users are unaware of its presence. Xylazine is most often injected, but can also be snorted or swallowed.

Health Risks and Symptoms

• Profound sedation or unresponsiveness

• Slow or stopped breathing

• Dangerously low blood pressure; slow heart rate

• Skin ulcers/wounds that can worsen quickly and become infected

• Severe withdrawal symptoms

• Fatal overdose, especially with opioid co-use

Clinical note: Xylazine-associated wounds can be misidentified as infection. Early, basic wound care (gentle cleansing, non-adherent dressing, light compression/ACE wrap when appropriate, and follow-up) can prevent rapid deterioration. Escalate to medical assessment for signs of infection, systemic illness, or impaired perfusion.

Responding to a Suspected Overdose (Opioids ± Xylazine)

1. Call 911 immediately. Overdose is a medical emergency.

2. Give naloxone (Narcan/Kloxxado) right away.

   • Naloxone reverses opioids but does not reverse xylazine.

   • If no response in 2–3 minutes, give another dose.

3. Provide rescue breaths.

   • Tilt head back, lift chin, pinch nose, make a seal over the mouth, give 2 slow breaths, then 1 breath every 5 seconds.

4. Recovery position once breathing resumes (on the side).

5. Stay until help arrives. Most states have Good Samaritan protections for overdose response.

Harm-Reduction Strategies for People who Use Drugs

• Never use alone. If you must, consider remote monitoring services (e.g., “Never Use Alone”) so someone can call 911 if you become unresponsive.

• Carry naloxone and know how to use it; tell friends/housemates where it is.

• Rescue breaths save lives with xylazine exposure—practice the steps.

• Test before you use.

  • Fentanyl test strips can detect fentanyl in opioids, stimulants, and counterfeit pills.

  • Xylazine test strips can detect xylazine in a small sample.

• Know the risks of the unregulated supply. Counterfeit “pharmaceutical-looking” pills are common.

• Wound care early, every time. Clean, cover, compress (when appropriate), and seek care early—delays increase amputation risk.

• Lower injection-related risk. Use sterile supplies, rotate sites, allow skin/veins to heal, and consider non-injection routes.

Guidance for Community Partners

Community-Based Organizations & Public Health

• Educate about xylazine in the supply, overdose recognition, and rescue breathing.

• Provide fentanyl and xylazine test strips, naloxone, and brief overdose response training.

• Share local drug-supply alerts and overdose trends in partnership with public safety and harm-reduction groups.

• Track outreach, link to wound care, and retain participants in services.

Harm-Reduction Organizations

• After naloxone administration, call 911—xylazine effects can persist.

• Emphasize rescue breaths and recovery position in training.

• Expand drug checking, distribute test strips, and provide wound-care supplies with education.

First Responders

• Consider xylazine when naloxone is partially effective or ineffective.

• Prioritize airway and ventilation; continue rescue breaths and supportive care.

Healthcare Professionals

• Screen for xylazine exposure in opioid-involved overdoses and unexplained necrotic skin wounds.

• Counsel that naloxone won’t reverse xylazine, but should still be given; instruct on rescue breaths and 911 activation.

• Provide warm handoffs to MOUD (medications for opioid use disorder), wound care, and recovery supports.

• Implement post-overdose protocols linking public health, treatment providers, and harm-reduction services; integrate naloxone distribution.

Testing and Supplies

• Naloxone: widely available without a prescription in many pharmacies; also via community distribution.

• Fentanyl & xylazine test strips: increasingly available through harm-reduction programs and some health departments.

• Sterile supplies & wound-care kits: contact local harm-reduction programs or syringe services programs.

Key Takeaways

• Xylazine is not an opioid—naloxone won’t reverse it, but still give naloxone for suspected opioid involvement.

• Breathing support (rescue breaths) and 911 are essential.

• Early wound care prevents complications.

• Test strips, naloxone, and never-use-alone strategies lower risk.

• Community-wide, coordinated responses save lives.

If you or someone you love uses drugs, Reclamation Sisters supports non-judgmental, evidence-based harm reduction and recovery. We can help you:

• Learn overdose recognition and response (including rescue-breathing practice)

• Get naloxone and test strips

• Connect with treatment, wound care, and peer support

*This article is educational and not medical advice. In an emergency, call 911.