Drug dealers are increasingly mixing xylazine, an animal tranquilizer, with fentanyl, a powerful synthetic opioid, to create a deadly cocktail that can cause serious and life-threatening side effects in users. Xylazine is not approved for human use by the FDA and can slow down breathing, heart rate, and blood pressure to dangerously low levels. When combined with fentanyl, which also depresses the central nervous system, the risk of overdose and death is greatly increased.

According to the FDA, xylazine has been detected in illicit drugs such as heroin, cocaine, and counterfeit pills in several states, including Pennsylvania, Ohio, Kentucky, North Carolina, and Florida. The agency issued a warning to health care professionals on November 8, 2022, to be cautious of possible xylazine inclusion in drug samples and to report any suspected cases to their local poison control center or health department.

Xylazine is also known as “tranq” on the street and is used by some drug users to enhance the euphoric effects of opioids or to counteract the stimulant effects of cocaine. However, xylazine can also cause drowsiness and amnesia, making users more vulnerable to sexual assault or robbery. Xylazine can also impair the ability of naloxone, a medication that reverses opioid overdose, to work effectively.

The National Institute on Drug Abuse (NIDA) advises that anyone who uses drugs should carry naloxone and have someone nearby who can administer it in case of an overdose. NIDA also recommends that drug users avoid using drugs alone or mixing drugs with other substances. Additionally, drug users should seek treatment for substance use disorders and mental health issues that may contribute to their drug use.

The rise of xylazine-fentanyl mixtures is another alarming sign of the ongoing opioid crisis in the United States, which claimed more than 93,000 lives in 2020. The COVID-19 pandemic has worsened the situation by disrupting access to treatment and recovery services and increasing stress and isolation among people who use drugs. The federal government and state authorities are working to expand access to evidence-based prevention, treatment, and harm reduction interventions to reduce the harms of opioid use and save lives.