Overdose Deaths Involving Horse Tranq Have Skyrocketed, CDC Reports

Many recent opioid deaths involve a drug called “tranq,” warns the Centers for Disease Control and Prevention (CDC).

By 2023, xylazine was detected in approximately 23% of fentanyl overdose deaths nationally, according to CDC data. The White House designated xylazine combined with fentanyl as an emerging drug threat in 2023.

Once concentrated primarily in the Northeast, xylazine has now been detected in the drug supply in all 50 states. The DEA reported in 2023 that xylazine was found in 48 states, with fentanyl-xylazine combinations now common across much of the country.

This drug is not meant for human consumption.

What Is Tranq?

“Tranq” is a street name for xylazine, a tranquilizer drug designed for horses, cattle, and other non-human mammals.

Xylazine’s effects include:

• muscle relaxation
• sedation
• reduced blood pressure
• reduced heart rate
• respiratory depression

Veterinarians administer xylazine as an anesthetic before certain medical procedures.

Why Is Tranq Found In Illicit Opioids?

Drug dealers often cut street drugs such as heroin with other substances, such as flour, baking soda, and other white powders.

Often, cutting agents include other drugs. For example, fentanyl overdose deaths increased when drug dealers began mixing it into other substances.

Drugs like tranq and fentanyl accomplish two purposes when used as cutting agents.

One, they add bulk to a supply, allowing drug dealers to sell more product. Two, they increase or prolong the effects of the primary drug.

Many of the effects of tranq, including relaxation and sedation, are also effects of opioid drugs such as heroin.

A person with a severe heroin addiction, who may have developed a tolerance for the drug, may use heroin mixed with tranq to intensify its effects.

What Are The Complications Of Mixing Tranq With Opioids?

Individually, xylazine and opioids produce several side effects and complications. Mixing these drugs can worsen these complications and create additional dangers.

Xylazine test strips are now available through some harm reduction programs and can detect xylazine in a drug supply before use. Like fentanyl test strips, they are an important harm reduction tool for people who use illicit opioids.

Increased Risk Of Drug Overdose

Because tranq and opioids share several effects, consuming both drugs at the same time can heighten these effects to dangerous levels.

For example, both drugs slow breathing and heart rate. Combining them can cause a person’s heart and breathing to stop altogether.

Both drugs also cause sedation, and consuming them together can lead to unconsciousness that lasts for several hours at a time, leaving the person vulnerable in unsafe environments.

Naloxone Ineffectiveness

When people experience an opioid overdose, a drug called naloxone can restore normal breathing patterns, often saving lives.

However, while naloxone is an effective treatment for opioid overdose, it is not effective against xylazine overdose, as xylazine belongs to a different class of drugs.

Always administer naloxone if opioids are suspected, even if xylazine is also present. Multiple doses may be needed due to the high potency of fentanyl in the current drug supply.

After administering naloxone, call 911 immediately. Xylazine’s sedative and respiratory effects will persist even after opioids are reversed, and the person will need emergency medical care. Do not leave them alone.

Most states have Good Samaritan laws that provide legal protection to people who call 911 during an overdose. Fear of legal consequences shouldn’t prevent someone from seeking emergency help.

Side Effects In Humans

For medical purposes, xylazine is used only in veterinary medicine because it is known to produce profound side effects in humans.

In human clinical trials, otherwise healthy volunteers experienced dangerously low blood pressure and a slowed resting heart rate.

These side effects were significant enough that the U.S. Food and Drug Administration (FDA) did not approve xylazine for human use, as the side effects outweighed any benefit that the drug provided.

Tranq Wounds

Tranq wounds are a medical emergency that require prompt attention. Unlike typical injection site wounds, xylazine-associated wounds can appear on any part of the body — not just injection sites — and may develop into deep, necrotic ulcers that progress rapidly.

Without treatment, these wounds can become life-threatening infections requiring hospitalization.

Anyone with suspected tranq wounds should seek medical care as soon as possible. Harm reduction organizations in many cities now offer wound care services specifically for people who use xylazine-contaminated drugs.

Keeping wounds clean and covered and avoiding further drug injection into or near wound sites can slow progression while medical care is sought.

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Written by the Addiction Resource Editorial Staff