July 3, 2023

Unmasking Xylazine: The Harrowing Reality of the ‘Zombie Drug’ Known As ‘Tranq’

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Table of Contents

Table of Contents

Contributors & Editors

Julie Miller

Addiction & Mental Health Writer

Last Update on July 3, 2023

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A drug designed to tranquilize large animals has now clawed its way into human veins, wreaking havoc on lives and communities.

Xylazine, also called the “Zombie Drug” or “Tranq”, has turned from a vet’s medication into a flesh-eating, life-stealing reality, becoming an insidious player in the global drug scene.

Today, we unmask the truth about this deadly substance, shining a light on its darkest corners to safeguard our society.

The Truth About Xylazine


Xylazine is a non-opioid sedative and analgesic primarily used in veterinary medicine.

Due to its muscle relaxant and sedative properties, it was first developed in the 1960s to serve as an anesthetic for large animals like horses and cattle.

However, over the years, it has increasingly found its way into the hands of drug users.

Due to its easy availability and ability to amplify the effects of other substances, Xylazine has become a popular additive in opioids like fentanyl.

This dangerous misuse has led to a worrying surge in Xylazine-related health issues and fatalities, making it a hidden yet deadly player in the global drug crisis.


As Xylazine infiltrated the world of recreational drugs, various street names or nicknames emerged, which are often used to avoid detection and talk about the drug in coded language.

The most common nickname for Xylazine is “Tranq” or “Tranq Dope” when combined with fentanyl or heroin.

In different communities, it may also be known as “sleep cut,” “anesthesia de caballo,” or “horse anesthesia,” alluding to its original use as a veterinary anesthetic for large animals like horses.

It’s essential to be aware of these nicknames, as they not only shed light on the underground drug culture but also aid in recognizing and addressing the misuse of Xylazine.


Xylazine has gained the grim nickname of the “Zombie Drug” due to the powerful sedative effects it has on its users.

When consumed, Xylazine slows down bodily functions, leading to a semi-conscious, trance-like state.

The individual under its influence may appear lifeless, unresponsive, or disconnected from their surroundings, much like the popular depiction of zombies.

In addition to these behavioral changes, the drug can cause severe damage to the skin over time, leading to open sores and a necrotic, or ‘zombie-like,’ appearance.

This devastating physical and psychological impact, coupled with the user’s inability to function normally in their daily life, is why Xylazine is referred to as the “Zombie Drug.”


While Narcan, or naloxone, is a well-known antidote for opioid overdoses, its effectiveness in reversing a Xylazine overdose is limited.

This is primarily due to the fact that Xylazine is not an opioid.

Naloxone works by binding to opioid receptors in the brain, displacing opioids and reversing their effects.

Xylazine, however, acts on different receptors – the alpha-2 adrenergic receptors – and naloxone has no effect on these receptors.

Therefore, if Xylazine is the sole drug involved in an overdose, naloxone would not reverse the overdose effects.

However, if Xylazine is used in combination with fentanyl (which is often the case), naloxone can still be effective in reversing the effects of the opioid component of the overdose.

This poses a significant challenge in the treatment of Xylazine overdoses, making them particularly dangerous and potentially fatal.

Medical attention should be sought immediately in such cases.


Symptom Details
Extreme Sedation Xylazine can cause extreme sedation leading to unresponsiveness or loss of consciousness. The user may appear to be in a deep sleep or a trance-like state.
Slow or Shallow Breathing The drug can slow down respiration considerably, leading to shallow or irregular breathing, or in some severe cases, stopping the breathing process entirely.
Lowered Heart Rate Xylazine can slow down the heart rate, leading to a condition known as bradycardia, which could potentially be life-threatening.
Decreased Body Temperature The drug may cause a significant drop in body temperature, leading to hypothermia.
Bluish Color to Lips and Fingernails This indicates a lack of oxygen in the blood, a condition known as cyanosis, which can result from the slowed or stopped breathing caused by Xylazine.

Please call 911 immediately if a loved one is experiencing any of these symptoms.
Reacting quickly could save a life!

The Effects of Xylazine


Xylazine carries an array of harmful side effects and risks.

It significantly depresses the respiratory system, which can lead to insufficient oxygen reaching the brain and other vital organs, causing them to shut down.

This risk is heightened when Xylazine is used in combination with other depressant drugs like opioids.

Other common side effects include low blood pressure, drowsiness, slow heart rate, and vomiting.

Long-term users may develop physical dependence on Xylazine, leading to severe withdrawal symptoms when trying to quit.

Furthermore, those injecting the drug face additional risks such as abscesses, infections, and the transmission of blood-borne diseases like HIV and Hepatitis C.

Ultimately, the use of Xylazine can result in irreversible damage to one’s health, and in severe cases, it can be fatal.

Side Effect/Risk Description
Respiratory Depression Significant slowing of breathing which can lead to insufficient oxygen supply to the brain and other vital organs, potentially causing them to shut down.
Low Blood Pressure Abnormally low blood pressure that can cause dizziness, fainting, and in severe cases, organ damage.
Slow Heart Rate Reduction in heart rate, which can affect the efficiency of blood circulation and put significant strain on the heart.
Vomiting May cause severe nausea leading to frequent vomiting.
Physical Dependence and Withdrawal Long-term use can lead to physical addiction, causing severe withdrawal symptoms when the drug use is stopped.
Injection-related Risks Those who inject Xylazine face risks such as abscesses, infections, and transmission of blood-borne diseases like HIV and Hepatitis C.
Overdose and Death Overdose can lead to severe respiratory depression, heart failure, and potentially, death. This risk is greatly increased when Xylazine is mixed with other drugs like opioids.


The misuse of Xylazine is known to cause severe medical complications beyond the usual systemic effects of drug abuse.

Users often inject Xylazine, and repeated injections, especially if done under unsanitary conditions, can result in skin and soft tissue infections.

Chronic use can lead to open sores or abscesses, which are painful, swollen, pus-filled areas of skin1.

If left untreated, these infections can spread to the surrounding tissue and even into the bloodstream, potentially causing life-threatening conditions such as sepsis.

Moreover, Xylazine has been associated with tissue necrosis – the premature death of cells in living tissue – which can eventually require amputation of the affected limbs to stop the spread of dead tissue.

These distressing physical outcomes make Xylazine a particularly dangerous substance, posing a significant threat to public health.

The Rise of Xylazine

The rise of Xylazine as a recreational drug is a troubling phenomenon2.

Despite its initial development as a veterinary anesthetic, Xylazine has carved out a sinister place for itself within the recreational drug landscape.

Its growing popularity can be attributed to several factors.

First, Xylazine is relatively easy to acquire due to its use in veterinary medicine and it’s cheaper than many other substances.

Second, it’s known to enhance the effects of opioids like fentanyl and/or heroin, making it a preferred additive among drug users seeking an intensified or extended high.

Moreover, as regulations around opioid prescriptions have tightened, some individuals have turned to Xylazine as an alternative.

This increasing popularity, however, comes with a steep price.

The misuse of Xylazine has led to a surge in drug-related health issues and fatalities, underscoring its dangerous and potentially deadly impact.


While the misuse of Xylazine is a growing global concern, certain regions and communities have been disproportionately affected.

Urban areas with higher rates of substance abuse, particularly in the United States, have seen a notable increase in Xylazine misuse.

Cities like Philadelphia and Baltimore have reported a significant rise in Xylazine-related overdoses and fatalities.

The opioid-stricken regions of Appalachia have also been impacted.

Internationally, Puerto Rico has reported a high prevalence of Xylazine abuse among people who inject drugs, with concerning rates of associated health complications.

It’s crucial to note that Xylazine abuse often aligns with social and economic disparities, impacting vulnerable communities with limited access to healthcare and addiction treatment resources, thereby exacerbating the devastating consequences of this drug.

The Role of Xylazine in the Opioid Crisis

Xylazines’ role in the opioid crisis has been increasingly noticeable.

Various reports have indicated a surge in Xylazine detections in drug seizures and overdose fatalities3.

For instance, in Philadelphia, Xylazine was detected in 31% of overdose deaths in 2019, a notable rise compared to previous years.

As of 2022, those rates have quadrupled, which is alarming.

In Puerto Rico, over a decade-long study revealed that over 80% of individuals who inject drugs had Xylazine present in their systems.

This data points to a worrying trend: the rise of Xylazine use is contributing significantly to the ongoing opioid crisis.

By intensifying the effects of opioids and increasing the risk of fatal overdoses, Xylazine is further compounding an already severe public health crisis.

The Legality and Regulation of Xylazine

Xylazine is not a controlled substance in many countries, including the United States, primarily because it is a veterinary drug not intended for human use.

However, its increasing misuse has led to calls for its regulation.

In the United States, some states like Pennsylvania have proposed legislation to add Xylazine to the list of controlled substances.

In contrast, in other countries like Puerto Rico, where Xylazine misuse is particularly prevalent, the drug is considered a controlled substance, making its illegal distribution punishable by law.

Across Europe, the legal status varies, and as of my last update, there wasn’t a Europe-wide regulation of Xylazine.

However, given the evolving nature of drug laws in response to the changing landscape of substance misuse, the legal status of Xylazine may be subject to change.

Treatment and Recovery from Xylazine Addiction


The treatment of Xylazine addiction poses significant challenges, largely due to the unique and potent properties of the drug itself.

First, Xylazines’ severe withdrawal symptoms can make detoxification a physically and emotionally taxing process, potentially deterring individuals from seeking treatment.

Additionally, unlike with opioid addictions, there are no FDA-approved medications specifically designed to alleviate Xylazine withdrawal or curb cravings, which can complicate the medical management of Xylazine addiction.

Another major challenge lies in the co-use of Xylazine with other substances, particularly opioids.

This polydrug use can complicate the treatment process as it necessitates addressing multiple dependencies simultaneously.

Furthermore, the physical health damage caused by Xylazine use, including skin lesions and increased risk of infections, may require extensive medical intervention, adding another layer of complexity to the treatment process.

Finally, socio-economic barriers and the stigma surrounding drug addiction often prevent individuals from accessing necessary treatment services.

Overcoming these challenges necessitates a holistic, integrated, and compassionate approach to treatment, coupled with wider social and policy-level interventions.


Long-term recovery from Xylazine addiction, like any substance addiction, is a journey that extends far beyond initial detoxification and treatment.

It involves reshaping one’s lifestyle and mindset, often requiring a holistic approach that addresses not just the physical aspect of addiction, but also the mental, emotional, and social factors.

Holistic practices can play a crucial role in achieving and maintaining long-term sobriety4.

Practices like yoga and meditation can promote mindfulness and reduce stress, helping individuals manage cravings and cope with triggers.

Physical exercises, such as jogging, swimming, or weight training, can improve overall health and wellbeing, boost mood, and provide a positive outlet for energy.

Nutrition is another key factor, as a balanced diet can help repair physical damage caused by substance abuse, strengthen the immune system, and improve mood and energy levels.

In some cases, certain supplements or nutritional therapies may be recommended to address specific health concerns.

Therapies like cognitive-behavioral therapy (CBT) or dialectical behavior therapy (DBT) can help individuals understand their addiction, develop healthier thought patterns, and build effective coping strategies.

Additionally, group therapies or support groups can provide a sense of community and shared understanding, which is often vital for long-term recovery.

Complementary therapies, such as acupuncture, massage, or art therapy, can also support recovery by relieving stress, promoting relaxation, and providing new ways to express emotions and experiences.

Importantly, holistic recovery also involves building a supportive and positive social environment, setting achievable goals, and developing new hobbies or interests.

This can provide a sense of purpose and fulfillment that helps replace the void left by substance use.

Remember, recovery is a personal journey and what works best may vary from person to person.

It’s always recommended to seek professional guidance when choosing a recovery path and to have patience, as true healing takes time.

Despite the challenges, the journey to recovery can be a transformative experience, leading to profound personal growth and a more fulfilling life.

If you or a loved one is struggling with “Tranq” Addiction or Addiction in general, please reach out to us at Cornerstone Healing Center for a free and confidential assessment today!


[1] Xylazine-Induced Skin Ulcers in a Person Who Injects Drugs in Philadelphia, Pennsylvania, USA
[2] The Growing Threat of Xylazine and its Mixture with Illicit Drugs
[3] Xylazine in the Opioid Epidemic: A Systematic Review of Case Reports and Clinical Implications
[4] An holistic approach to substance abuse treatment

Published: 7/3/2023
Contributor: Julie Miller

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Author & Reviewers

julie miller recovery writer and author
Julie is a recovery advocate, with over two years sober. She is a recovery speaker who believes people can change for the better. Her mission is to write factual, helpful information about addiction, treatment, and recovery. She believes that no one should be left in the dark about the process at any stage of their recovery.
lionel estrada lisac clinical director

Lionel is the Clinical Director of Cornerstone’s treatment facilities in Arizona. He has had over 4 years at Cornerstone. He is personally in recovery and passionate about helping others overcome substance abuse and mental health challenges, he is trained as an EMDR, adopting a trauma-informed approach to treat the underlying issues of conditions.

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