Xylazine (tranq)

No. At the moment, we have only found xylazine, combination with fentanyl, in dope samples.

As of March 2023, xylazine test strips are now commercially available. These test strips allow individuals to test for the presence or absence of xylazine in their substances. The Philadelphia Department of Public Health works with local community groups to distribute the tests strips. Find a community partner on the get supplies page. Xylazine test strips work like fentanyl test strips- you just need to dip the strip in a mixture of a small amount of drug residue and water. Reading the results is the same as reading a fentanyl test strip, two lines mean that it is negative and xylazine hasn't been detected, and one line means positive and that xylazine was detected. These test strips are known to cause false positives when lidocaine is present, however the amount of lidocaine necessary to cause this false positive is unknown. What does this mean when you're testing your drugs? That testing powdered cocaine, which is often cut with lidocaine, may cause a false positive. However, they will be accurate for opioids and other drugs.

The Philadelphia Department of Public Health will continue to work with a forensic toxicology lab to test drug samples and identify emerging drugs, including xylazine.

Unfortunately, tranq has been found in over 90% of dope drug samples. However, if you're not sure, you can follow these steps.

First, try to ask around and see how the drug is making other people feel before you buy or use it. Since tranq can cause a really heavy nod, try to use somewhere that you will be safe and won’t fall and hurt yourself. Finally, if you think there is tranq in your dope let others know - including someone at your local exchange program - so folks know to be careful.

Yes, in Pennsylvania, xylazine is a controlled substance. However, it is not currently on the list of controlled substances under the federal Controlled Substances Act (CSA).

In 1962, it was first created for use in humans, but due to harmful side effects, the FDA has approved it only for veterinary use.

It’s unclear when xylazine first appeared in the illicit drug markets. Reports suggest that its use began in Puerto Rico in the early 2000s, where it’s known as “Anestesia de Caballo” or horse anesthetic. The Philadelphia Medical Examiner’s Office included xylazine in toxicology reports beginning in 2006.

No, other states including Ohio, Connecticut, Maryland, Massachusetts, and more recently Texas have identified xylazine in overdose deaths.

The “high” from fentanyl lasts for a very short time compared to the high from heroin and other opioids. Xylazine may be added, at least in part, to extend the effects of fentanyl and mimic the high of heroin. However, not everyone who uses fentanyl is intentionally seeking out xylazine. In some cases, people are not aware that xylazine is in the drugs they are buying and using.

The main effect of xylazine is heavy sedation, so the person who has overdosed will likely be unresponsive. Xylazine is almost always found in combination with fentanyl, so an overdose will most likely resemble an opioid overdose. The signs and symptoms can include blue/greyish skin and slowed breathing and heart rate.

Not exactly. Xylazine is not an opioid, so naloxone (NARCAN®) will not reverse a purely xylazine overdose. However, because xylazine is almost always found in combination with opioids, including fentanyl, naloxone (NARCAN®) should still be administered whenever an opioid-involved overdose is suspected.

Although research has yet to definitively prove that xylazine causes skin ulcers, there appears to be an association between the two. People who regularly use xylazine often have severe skin ulcers and abscesses. Since xylazine became more prevalent in Philadelphia’s drug market, local hospital systems have reported an increase in skin and soft tissue infections. These wounds are presenting atypically, often all over the body (away from the site of injection) and appear to worsen more quickly than other skin infections. Many organizations in the Kensington area offer wound care and supplies. View locations and hours of operation.

Are you a healthcare or social service provider looking for recommendations for treating xylazine-associated wounds? Visit the trainings page for more information.

Yes. People who use xylazine heavily and frequently are at risk of withdrawal. Xylazine withdrawal is often marked by irritability, anxiety and a feeling of unease. It may also cause a rapid heart rate and high blood pressure, though these are not always present. The Philadelphia Department of Public Health has issued clinical guidance on managing xylazine withdrawal.