Tranq Dope: Dangers Of Injecting Heroin Cut With Xylazine

Of the drug overdose deaths in the United States in 2023, over 70% involved an opioid, primarily illicitly manufactured fentanyl. While fentanyl has dominated the overdose crisis, drug dealers have increasingly mixed it with other adulterants, creating new and more complex dangers for people who use drugs.

One such adulterant is a veterinary tranquilizer called xylazine, also known on the street as “tranq” or “tranq dope.” When mixed with fentanyl, xylazine significantly complicates overdose response and can cause severe, disfiguring wounds.

In 2023, the White House Office of National Drug Control Policy (ONDCP) declared fentanyl mixed with xylazine an “emerging threat.” This was the first time that designation had ever been used, and the government released a National Response Plan to address it.

Here, you will learn more about:

• what tranq dope is and where it’s found
• how tranq dope is used
• dangers and side effects of tranq dope use
• why naloxone has limitations with tranq dope overdoses
• treatment programs for substance use disorders

What Is Tranq Dope?

Xylazine is an FDA-approved veterinary sedative used in animals like horses, dogs, and cattle. It’s not approved for use in humans and is not currently classified as a controlled substance under federal law, though some states have added it to their own controlled substances lists.

Tranq dope refers to a combination of fentanyl (and sometimes heroin) with xylazine. Originally concentrated in the Northeast, tranq dope has now spread across the country.

By 2023, the DEA had seized xylazine and fentanyl mixtures in 48 out of 50 states, and xylazine detection more than doubled in 30 states from 2019 to 2022. In some cities, such as Philadelphia, xylazine has been found in up to 90% of the local fentanyl supply.

The scale of the problem has grown rapidly. Xylazine-involved overdose deaths rose from 627 in 2019, to 1,499 in 2020, to 3,468 in 2021, a 35-fold increase compared to just a few years earlier. In 20 states and Washington D.C., the share of fentanyl overdose deaths that also detected xylazine increased 276% between January 2019 and June 2022.

How Is Tranq Dope Used?

Xylazine typically comes in liquid form and is mixed with fentanyl by dealers before sale. The mixture is most commonly injected, though xylazine can also be snorted, swallowed, or inhaled.

Why People Use Tranq Dope

Many people who use tranq dope do so unknowingly. They purchase what they believe is fentanyl, unaware that xylazine has been added. Others knowingly seek out the combination for its extended sedative effects, which last longer than fentanyl alone, or use it as a “nighttime hit” before sleep.

Some people who use illicit opioids actively try to avoid tranq dope, reporting they dislike its disorienting effects or that it dulls the euphoria of fentanyl.

Dangers Of Tranq Dope Use

Skin Wounds And Tissue Damage

One of the most serious effects of prolonged xylazine exposure is the development of severe skin wounds and lesions.

These ulcers are not limited to injection sites, either. They can appear anywhere on the body, for reasons that are not fully understood. Without treatment, the wounds can progress to deep tissue loss and may require amputation.

Wound care for people who use xylazine is a serious and growing challenge for harm reduction programs and healthcare providers nationwide.

Overdose Risk And Complications

Xylazine is a central nervous system depressant that can cause:

• extreme sedation and loss of consciousness for hours
• slowed breathing and heart rate
• dangerously low blood pressure
• respiratory depression
• coma

Most overdose deaths involving xylazine also involve fentanyl and other substances, including benzodiazepines, cocaine, alcohol, and gabapentin.

Why Naloxone Has Limitations With Tranq Dope

Xylazine is not an opioid, so naloxone (Narcan) does not reverse its effects. This is one of the most important harm reduction considerations with tranq dope.

That said, experts strongly recommend administering naloxone whenever an overdose is suspected because fentanyl is almost always present alongside xylazine. Naloxone will then at least reverse the fentanyl component and can restore breathing. Call 911 immediately in any suspected overdose situation.

Harm reduction organizations are now distributing xylazine test strips alongside fentanyl test strips, so people can check their drug supply before use.

Who Is Most At Risk?

Research shows that men experience xylazine-related deaths at roughly twice the rate of women. Black men appear to be disproportionately affected.

As with other aspects of the overdose crisis, people from underserved communities face heightened risk due to barriers to harm reduction resources and addiction treatment.

Treatment Options For Substance Use Disorder

Help is available if you or a loved one are addicted to opioids or other illicit drugs. Below you will find some of the evidence-based treatments available at a drug rehab center.

Treatment services for drug use may include:

• medication-assisted treatment (MAT) for opioid use disorder
• support groups for controlled substance addiction
• dual diagnosis treatment for co-occurring mental health disorders
• treatment for drug overdose using naloxone
• medically monitored detox

Substances such as opioids may cause life-threatening withdrawal symptoms. It’s important that you seek the assistance of a healthcare professional before attempting to quit using drugs cold turkey.

Find A Rehab Facility For Substance Use Disorder

For more information about opioid overdose or other related issues, contact our helpline today. Our team can assist you in finding an addiction treatment provider in your area.

Written by the Addiction Resource Editorial Staff