Most people are familiar with the opioid epidemic in Ohio. Headlines warn of the dangers of heroin mixed with fentanyl, but an even deadlier drug has made an appearance in the state in recent years: xylazine. 

Xylazine is not FDA-approved for human consumption, but according to recent Ohio news reports, the sedative, commonly used in veterinary medicine, is now being mixed with heroin and fentanyl, increasing the risk of fatal overdoses. What’s worse, Narcan cannot revive someone who’s overdosed on the mixture. 

What Is Xylazine or “Tranq”?

Sometimes referred to by its street name “Tranq,” xylazine is a potent veterinary tranquilizer, often used to treat horses or cattle. Xylazine has muscle relaxant properties and is a central nervous system depressant. The drug is injected into the veins, muscles, or under the skin, and it may be used alongside other anesthetics like ketamine or halothane.

Xylazine has historically been used as a recreational drug adulterant in Puerto Rico and was associated with a series of drug-related deaths at a criminal justice hospital in Aguadilla, Puerto Rico. Xylazine abuse was common in Puerto Rico in the early 2000s, and by 2006, the drug had made its way to the United States. The Philadelphia Medical Examiner’s Office detected xylazine in overdose deaths that also featured fentanyl. 

According to the Drug Enforcement Administration (DEA), xylazine typically comes in a liquid solution and helps with handling large animals and performing diagnostic or surgical procedures. It is also used as a pain reliever and local anesthetic in veterinary medicine. The drug has been studied for use in humans, but trials have been discontinued due to severe side effects in human populations. 

Xylazine Effects on Humans

Given that xylazine is designed to be a horse tranquilizer, its effects on humans can be fatal. Since it is a central nervous system depressantxylazine in humans can cause respiratory depression, slowed heart rate and low blood pressure. 

According to the DEA, other side effects of xylazine in humans include:

  • Blurry vision
  • Disorientation
  • Feelings of drowsiness
  • High blood sugar
  • Staggering
  • Coma

Someone under the influence of xylazine may display some of the above symptoms and appear especially sleepy or sedated. While people may abuse xylazine because they enjoy its sedative properties, they are often unaware they are using it because it is mixed with opioids. When a person purchases these drugs off the street, they may be unknowingly ingesting xylazine as well.

Even unintentional xylazine use can lead to a dangerous addiction. Repeated use of this substance can make a person physically dependent upon xylazine, in addition to their dependence on the opioids it’s mixed with. Abusing two or more substances at once is called polysubstance abuse. Not only is polysubstance abuse more dangerous, but it can make treating the addiction even more difficult. 

Xylazine and Narcan

Unlike opioids such as heroin or fentanyl, an overdose from xylazine cannot be reversed with Narcan (naloxone), a life-saving medication that combats opioid overdoses. If xylazine causes respiratory depression or dangerously low blood pressure when combined with an opioid, naloxone may not reverse these side effects enough to prevent death, even if it does block the opioid’s effects.

Xylazine and Overdose Deaths in Ohio

Unfortunately, xylazine has come to the forefront in Ohio overdose statistics, as it has become more involved in overdose deaths in the Midwest. According to a Franklin County Ohio coroner report, the drug was responsible for 3.4% of the county’s overdose deaths in 2020, up from 2.1% in 2019. 

However, the horse tranquilizer may be involved in more overdose cases than experts realize. Fentanyl was involved in 86% of overdose deaths in 2020, and xylazine is often mixed with fentanyl. 

Xylazine has also caused an uproar in neighboring Pennsylvania. The drug was detected in 2% of unintentional overdose deaths in Philadelphia between 2010 to 2015, but that number rose to 31% in 2019. All xylazine overdoses also involved fentanyl. Nationwide, 1.8% of overdose deaths were positive for xylazine in 2019, suggesting that the drug’s presence may be regional. 

If you or a loved one is living with an addiction to opioids or other drugs, The Recovery Village Columbus is here to offer support. We offer a full spectrum of addiction treatment services in the Columbus area, including medical detox, inpatient care and outpatient services. Contact us today to learn more. 

Editor – Melissa Carmona
As the content manager at Advanced Recovery Systems, Melissa Carmona puts years of writing and editing experience to work helping people understand substance abuse, addiction and mental health disorders. Read more
Medically Reviewed By – Jenni Jacobsen, LSW
Dr. Jenni Jacobsen is a licensed social worker through the Ohio Counselor, Social Worker and Marriage and Family Therapist Board. She has over seven years working in the social work field, working with clients with addiction-related and mental health diagnoses. Read more

Kariisa, Mbabazi; Patel, Priyam; Smith, Herschel; Bitting, Jessica. “Notes from the Field: Xylazine Detect[…]ted States, 2019.” Centers for Disease Control and Prevention, September 17, 2021. Accessed September 27, 2021.

Drug Enforcement Administration. “Xylazine.” February 2021. Accessed September 28, 2021.

Jayanth, Amber. “New Warning of Deadly Drug in Ohio.” Fox 19 Now, May 8, 2019. Accessed September 27, 2021.

Maryland Poison Center. “Xylazine.” January 2019. Accessed September 28, 2021.

NBC4. “Coroner: Overdose deaths up by 45 percen[…]tly due to fentanyl.” February 12, 2021. Accessed September 28, 2021.

Johnson, Jewell; Pizzicato, Lia; Johnson, Caroline; Viner, Kendra. “Increasing presence of xylazine in heroi[…]lvania, 2010–2019.” Injury Prevention, July 21, 2021. Accessed September 28, 2021.

Reyes, J.C., et al. “The Emerging of Xylazine as a New Drug o[…]sers in Puerto Rico.” Journal of Urban Health, 2012. Accessed September 28, 2021.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.