What you should know about the drug xylazine and why it makes fentanyl worse

The Drug Enforcement Administration is warning that a powerful veterinary sedative is being illegally combined with fentanyl, making it even more dangerous.

In the past, the DEA issued a public safety alert about the widespread threat posed by a mixture of a non-opioid animal tranquilizer called xylazine, also known as “Tranq,” and fentanyl. According to the DEA, trafficking of the drug combination has increased sharply.

According to DEA Administrator Anne Milgram, the fentanyl-xylazine mixture has been found across the country.

“Xylazine makes the deadliest drug threat our country has ever faced, fentanyl, even deadlier,” Milgram said. “The DEA has seized xylazine and fentanyl mixtures in 48 of 50 states. The DEA Laboratory System reports that in 2022, approximately 23% of fentanyl powder and 7% of fentanyl pills seized by the DEA contained xylazine.”

Xylazine is a powerful sedative that was approved for veterinary use by the Food and Drug Administration in 1972, but is not approved for use in humans.

Users of the mixture may be at higher risk of a fatal overdose because, unlike fentanyl, xylazine is not an opioid and therefore the common opioid overdose treatment naloxone (Narcan) is not known to be effective in reversing its effects, according to the federal government.

In addition to the risk of increased death from xylazine, “people who inject drug mixtures containing xylazine may also develop serious wounds, including necrosis – the rotting of human tissue – that can lead to amputation,” the DEA said in a statement.

According to an FDA warning to healthcare stakeholders last November, xylazine is not easily detected during routine toxicology testing, making it difficult to diagnose exposure to the drug.

As of 2020, drug overdoses have been linked to more than 100,000 deaths annually in the United States, about two-thirds of which are due to fentanyl.

In 2023, the White House announced a formal plan to address the “emerging threat” of fentanyl in combination with xylazine, a drug combination that has proven fatal in a growing number of Americans.