Xylazine is a non-opioid tranquilizer designed for veterinary use in animals. The sedative is not approved for use in people, yet it’s becoming more prevalent in the illicit drug supply.

Sometimes called “tranq,” it’s often mixed with other drugs, such as fentanyl, a potent opioid responsible for a growing number of overdose deaths. Last year, the White House Office of National Drug Control Policy declared fentanyl mixed with xylazine an “emerging threat.”

Read on to learn more about xylazine: what happens when people take it, what to do if an overdose is suspected, and how harm reduction tools can prevent overdose deaths.

How are people who use drugs exposed to xylazine?

Studies show people are exposed to xylazine—knowingly or unknowingly—when it’s mixed with other drugs like heroin, cocaine, meth, and, most frequently, fentanyl. When combined with opioids or other drugs, it increases the risk of a drug overdose.

What happens if someone takes xylazine?

Taking xylazine can cause drowsiness, amnesia, slow breathing, slow heart rate, dangerously low blood pressure, wounds that can become infected, and death, especially when taken in combination with other drugs.

Why does xylazine increase the risk of overdose?

Xylazine is a central nervous system depressant, which means that it slows down the body’s heart rate and breathing. It can also enhance the effects of other depressants, such as opioids, which may lead to suffocation.

What are the signs of a xylazine-related overdose?

Xylazine-related overdoses look like opioid overdoses. A person who has overdosed may exhibit a slow pulse, slow breathing, blurry vision, disorientation, drowsiness, confusion, blue skin, and loss of consciousness.

How many people die from xylazine-related overdoses in the U.S.?

Xylazine-related overdose deaths in the U.S. rose from 102 deaths in 2018 to 3,468 deaths in 2021. Most occurred in Delaware, the District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia. Fentanyl was the most frequently co-occurring drug involved in those deaths.

What should I do if an overdose is suspected?

If you suspect that a person has overdosed on any drug, call 911 and give them naloxone—sometimes sold under the brand name Narcan—a medication that can reverse an opioid overdose. You should also stay with the person who has overdosed until first responders arrive. Most states have Good Samaritan laws, which protect people who have overdosed and those assisting them from certain criminal penalties.

While naloxone cannot reverse the effects of xylazine alone, experts recommend administering naloxone if an overdose is suspected because it’s often mixed with opioids.

You can get naloxone for free from some nonprofit organizations and government-run programs. You can also purchase over-the-counter naloxone at pharmacies, grocery and convenience stores, and other retailers.

Learn how to use naloxone in this short training video from the American Medical Association, or sign up for a free online training.

How can people prevent xylazine-related overdoses?

Harm reduction programs are community programs that prevent drug overdoses, reduce the spread of infectious diseases, and connect people to medical care. These programs provide lifesaving tools like naloxone, as well as fentanyl and xylazine test strips, which can detect the presence of these drugs in a substance and prevent overdoses. Drug test strips can also be ordered online.

However, test strips are considered “drug paraphernalia” in some states and are not legal everywhere. Learn more about state laws around drug checking equipment from the Network for Public Health Law.

Learn more about harm reduction from the CDC.

This article first appeared on Public Good News and is republished here under a Creative Commons license.