Xylazine is an alpha-2 adrenergic agonist and non-opioid sedative medication and muscle relaxant that comes in a clear liquid and is used as a veterinary anesthetic. It is not approved by the U.S. Food and Drug Administration (FDA) for human use.
Xylazine is cooked down from a liquid into a powder and added to illicit opioids such as heroin or fentanyl to heighten and prolong their effects. It can also be mixed into counterfeit pills including opioids (e.g., Norco, Percocet, Vicodin, etc.), sedatives (Xanax), or stimulants (Adderall) as a cheap additive.
People who are obtaining these drugs may not be aware that xylazine may be present in what they’re using, which can increase the risk of a fatal overdose.
Xylazine can be swallowed, inhaled, smoked, snorted, or injected into muscles or veins. When mixed with opioids and other central nervous system depressants, like alcohol or sedatives, xylazine intensifies the effects, including sedation (drowsiness leading to unresponsiveness) and respiratory depression, and can lead to a fatal overdose. Xylazine overdoses have been observed to last from 8 - 72 hours.
Because it is not an opioid, naloxone is not effective against xylazine. However, because xylazine is frequently mixed with opioids, naloxone is still recommended to reverse the opioid contribution to overdose.
Chronic xylazine exposure can lead to physiologic dependence and withdrawal symptoms, which include irritability and anxiety. Repeated xylazine injection has also been associated with severe, necrotic skin lesions often requiring advanced wound care. These wounds may occur in areas of the body away from the injection site.
Xylazine is colorless, odorless, and there are no rapid drug tests that screen for it. Xylazine can be detected in a comprehensive toxicology screen, such as a gas chromatography-mass spectrometry test, ordered by a provider in an emergency room, hospital, or clinic when the sample is sent to a lab that conducts spectrometry test for xylazine.