What You Need to Know About ‘Tranq’ & Why Narcan is Not The Answer

As if the nation’s opioid epidemic couldn’t get any worse, an emerging drug threat is contributing to the rise in overdose deaths and threatening harm reduction efforts.

Commonly referred to as ‘Tranq’ or the ‘zombie drug,’ xylazine (zy-la-zine) is intended to be used by veterinarians to sedate horses and cattle. In recent years, drug dealers have been leaning on it as a cheap way to cut drugs, including fentanyl, heroin, and cocaine. Theories about why they turned to xylazine range from the desire to provide a longer-lasting high to building dependency among users due to the intense and painful withdrawal symptoms it causes.

Regardless of the reasons, xylazine has found its way into the local drug supply stream and is contributing to an increased number of ODs and fatalities. In 2022, xylazine was involved in 68 fatal opioid overdoses in Vermont; up from 29 in 2021. And in just the first two months of 2023, xylazine contributed to 12 overdose fatalities across the state, putting it on track to exceed 2022’s total.

A big part of what makes xylazine so deadly is the fact that it’s NOT an opioid so rescue treatments such as Narcan do not reverse its effect. As a result, users often experience respiratory depression, meaning the individual ends up breathing slower and shallower than normal. Untreated, the condition can lead to a heart attack, brain damage, coma, and death.

But even for users who don’t experience respiratory depression, the side effects of the xylazine can be disturbing and life altering. Xylazine can cause blurred vision, disorientation, staggering, and coma. In addition, xylazine can cause pus-oozing lesions at the site of injection and throughout the body. Medical providers often say the drug ‘eats the body from the inside out’ as untreated lesions can lead to gruesome sores, rotting skin and, in many cases the loss of limbs—most commonly toes and fingers. 

Another challenge that xylazine presents is that, unlike fentanyl, there’s currently no way for users to test their supply for its presence. As a result, many people are unknowingly taking xylazine and when ODs occur, they’re unprepared when previously reliable rescue treatments don’t work.

Although Narcan will not reverse the effects of xylazine, it should still be used any time an OD is suspected as very often other opioids are contributing to the OD. In addition, CPR should be administered to address the respiratory depression until emergency help arrives.

For information on learning CPR locally at no cost, click here.

If you’re interested in learning more about treatment and recovery, contact the following organizations and agencies:

VERMONT
Bennington  

The Collaborative

Spoke Services

Turning Point Center of Bennington

Wilmington

Voices of Hope

NEW YORK
Rensselaer County

Conifer Park

St. Peter’s Addiction Recovery Center

MASSACHUSETTS
Berkshire County

The Brien Center

Northern Berkshire Community Coalition

SaVida Health

Todd Salvesold, RN, MA, is the Program Manager with Vermont Blueprint for Health.