Xylazine is a sedative which causes analgesic and muscle-relaxing properties and is approved for veterinary medicine. Xylazine was first produced in 1962 by the Bayer company1. It has been studied for human use, but clinical trials had to be terminated due to severe adverse side effects, including central nervous system (CNS) depression1. Xylazine is not approved for human consumption, but it has been found as an adulterant being added to drugs, and it has been used in drug facilitated crimes to induce sleep. According to the DEA, there were 149 reported cases from federal and state laboratories involving xylazine in 2015, but that number jumped to 8,938 in 20211.
Some individuals exposed to xylazine may not be aware of its presence. Xylazine has been found as an adulterant in white powder drugs. Primarily xylazine has been detected in heroin and fentanyl supply, though it has also been discovered in some stimulant supply such as methamphetamine and cocaine2. Other users actively seek out and use xylazine along with speedball, the street name for a mixture of heroin and cocaine, to mitigate some of xylazine’s negative effects. Xylazine containing products can be marketed on the street as tranq, sleep-cut, Philly-dope, or zombie drug.
Negative side effects of xylazine include CNS and respiratory depression, hypotension, hypothermia, high blood glucose levels, miosis, hypotension, and necrotic skin ulcerations that can lead to amputation if not treated. Additionally, because xylazine is not an opioid, naloxone is ineffective in the event of an overdose. The FDA issued a safety alert warning in November 2022 about the severe risks associated with the drug3.
Xylazine is not currently scheduled, though legislation was proposed in March 2023 to make xylazine a Schedule III Substance4. Congress has considered scheduling the substance prior to this legislation, but scheduling the drug would significantly impede the veterinary use of the medication5. Currently, the FDA is working to more strictly regulate the importation of xylazine and verify the legitimate veterinary supply6.
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