Xylazine Addiction: Signs and Side Effects of Xylazine Abuse

As a veterinary drug, xylazine isn’t intended for human purposes, but it’s increasingly found in illicit human drug supplies. While it isn’t an opioid, xylazine abuse is associated with street opioids because it may be used to cut fentanyl or heroin. Street names for the drug include tranq, sleep-cut, tranq dope and horse tranquilizer.

Xylazine addiction often occurs through misuse patterns that begin with other drugs. Many people unknowingly take it because it’s in a substance sold as something else, such as heroin. This article explores addiction to veterinary sedatives in street drugs, including how it happens, what withdrawal looks like and how xylazine dependence is diagnosed, but it doesn’t discuss rehab or treatment options.

Xylazine misuse can drive opioid use disorder, as it impacts the feeling someone gets when they use opioids. It may also create a more pronounced sedation or longer euphoria when combined with a drug such as fentanyl.

Information published by the National Institute on Drug Abuse indicates that some organizations manufacturing street drugs use xylazine on purpose. In 2022, the Drug Enforcement Agency (DEA) found it in almost a quarter of the fentanyl powder it seized and in 7% of fentanyl pills seized. While some individuals have told researchers they didn’t know drugs were cut with xylazine, there may be some perception on the street that fentanyl or heroin that includes this substance is “better” because of the longer high.

At the same time, xylazine comes with its own withdrawal symptoms and can increase the symptoms associated with other drugs. The mix of xylazine and opioids can lead to increased physical and mental withdrawal symptoms that cause people to return to use.

Common reasons for repetitive xylazine misuse cycles include:

• Short-lasting relief when someone uses contaminated supplies, followed by rebound withdrawals, which may be worse if someone tries to quit on their own
• Fear-based use when people know they’re using unpredictable drug mixes, so they don’t know what the come-down might feel like
• Polysubstance use, which refers to using more than one substance, can make compulsive use more likely
• Xylazine cravings, which people may not realize are related to an unknown substance in a street drug mixture

Understanding xylazine abuse vs xylazine addiction can help someone understand potential treatment needs. Xylazine abuse refers to using the drug in a way that can cause harm.

While frequent use or using drugs in unsafe locations are common signs of abuse, any use of xylazine qualifies, as there’s no approved human use of this veterinary drug.

Addiction occurs when someone is driven to compulsive drug use.

Substance use disorder signs that might involve xylazine addiction include:

• Strong cravings for opioids, especially if you crave a specific type or from a certain supplier
• Continued use of opioids that may contain xylazine despite the risks of harm or past harmful experiences, including overdoses or wounds
• Risky behavior or use patterns, such as making illegal decisions or sacrificing relationships so you can continue to access or use drugs
• Chasing stronger sedation or highs or using more than you intended

Xylazine dependence isn’t well studied, particularly as a singular substance people abuse. However, xylazine withdrawal symptoms occur, particularly when people use the drug alongside opioids. In these situations, tranq dope dependence is likely.

Tranq dope dependence may involve:

• Physical dependence. A person’s body can adapt to a certain amount of xylazine exposure. If you suddenly stop taking the drug, your body may perceive it as abnormal. This can lead to withdrawal symptoms, which are signs of your body and brain reacting in distress to what they feel isn’t normal.
• Psychological dependence. When someone is used to using drugs containing xylazine, they may feel emotionally or mentally unable to function without the substance. Signs of psychological dependence can include not being able to cope with life without feeling sedated by xylazine or being unable to sleep without it.

Dependence on xylazine isn’t the same thing as substance use disorder or addiction. However, continued and escalating drug use due to these types of dependencies can be a warning sign that addiction cycles are building.

The signs of xylazine addiction can be behavioral, physical or mental. You might notice behavioral and physical symptoms of addiction if a loved one is dealing with xylazine substance use disorder.

Common signs include:

• Intense cravings. Having intense cravings for a specific substance can indicate growing dependency that’s become addiction. In the case of xylazine addiction, cravings can be confusing because individuals don’t always know it’s xylazine they’re craving.
• Seeking out specific suppliers. If you find yourself craving street drugs from a certain supplier or feel like other supplies of the same drug don’t meet your needs, you may be addicted to xylazine, which you didn’t realize was in the drugs.
• Continued use despite harm. Continuing xylazine or opioid use despite experiencing serious harm is typically a clear sign of addiction.
• Loss of control over use. Being unable to cut back on your own, using more than you intended or participating in binge use can indicate a substance use disorder.
• Neglecting responsibilities. People with opioid use disorder involving xylazine use may not uphold responsibilities at work, school or home. Reasons for neglecting obligations and relationships can include prioritizing tasks that involve obtaining drugs, using drugs and dealing with the aftereffects of use.
• Risky behavior. As someone needs more drugs to get the same experience, they may make riskier decisions. People with opioid use disorder may engage in increasingly illegal or dangerous activities to support access to drugs, even if they’ve already had negative outcomes with law enforcement.

Tranq dope withdrawal symptoms are often a driver for continued use of contaminated drug supplies.

Common xylazine withdrawal symptoms include:

• Body aches, similar to what you might expect with a bad case of the flu
• Faster heart rate and high blood pressure (hypertension)
• Sweating or feeling clammy
• Anxiety signals, such as restlessness and irritability
• Intense cravings

Rebound agitation, which refers to a sudden and intense wave of withdrawal symptoms once drugs start to clear the body, is possible. Often, rebound symptoms involve severe discomfort that makes it almost impossible for someone to avoid returning to xylazine use without outside help.

Xylazine withdrawal is usually part of general opioid withdrawal. Because of this, symptoms can vary. They depend on the overall doses, what’s been mixed together and how someone uses opioids and contaminants, such as xylazine.

Xylazine side effects can be difficult to differentiate from the general effects of opioid misuse. However, some side effects, such as tranq dope wounds, may help people realize that they’re using xylazine.

Signs that you or a loved one might be misusing xylazine include:

• Sedation and drowsiness. Because xylazine is a sedative, it can create extreme drowsiness that lingers. Blackout-like episodes are possible, and you might find that you’re missing bits of your memory.
• Changes to heart functions. Xylazine use can lead to low blood pressure (hypotension) and a slow heart rate. In all cases, this can be dangerous, and in xylazine overdose scenarios, it can be life-threatening.
• Breathing changes. As a sedative, xylazine suppresses breathing. This respiratory depression can lead to poor outcomes, especially when mixed with opioids and other drugs that have the same impact.
• Cognitive changes. Xylazine can create amnesia, drowsiness and slower reactions, impairing a person’s ability to function in day-to-day life.
• Skin problems and wounds. Xylazine is associated with wounds and skin ulcers. You don’t have to inject the drug for these side effects to occur, and wound care from a health professional is often required to reduce ongoing risks.
• Infection risks. Tranq dope wounds are vulnerable to bacterial infection, and untreated wounds can progress to abscesses and other serious conditions.

Typically, xylazine isn’t a substance many people are at risk of using on its own. Xylazine misuse often occurs when someone uses opioids.

Risk factors for xylazine addiction include:

• Opioid use. A history of opioid use disorder or active opioid use makes exposure to xylazine more likely. DEA data indicates that the risk of high fentanyl contamination is high. As more drug suppliers explore new ways to expand their markets, veterinary drugs, such as xylazine and medetomidine, are likely to show up in other illicit drug supplies.
• Using multiple substances. If you’re engaging in polysubstance use, which means using alcohol, benzodiazepines, opioids and other sedatives at the same time, it increases your risk for addiction and overdose. That can be true even if you only use multiple substances at the same time occasionally.
• Unstable housing. Environmental factors, such as unsafe or unstable housing, limited access to safer drug supplies or social circles that are heavy into opioid use, increase your risks.
• Access to vet drug supplies. Easy access to veterinary drugs can increase the risk that someone may attempt to use xylazine or another vet sedative recreationally.
• Mental health factors. A preexisting mental health condition, such as depression, anxiety or post-traumatic stress disorder, can increase someone’s risk for problematic drug misuse.

A substance use disorder diagnosis doesn’t come after a blood test. Drug testing is limited, as not all drugs are confirmed via routine screening. Toxicology also doesn’t do much to tell a story about how substances are used and to what extent. Instead, addiction treatment providers and other healthcare professionals look at patterns of xylazine use over time.

Assessment for xylazine use disorder will likely include:

• Discussions about drug use. Providers will want to understand whether you feel a loss of control over drug use, what type of cravings you feel and how and when you use xylazine.
• Screening for opioid use disorder. Most treatment programs will look at whether you’re using xylazine as part of your overall opioid use, as this is the most common delivery method.
• Polysubstance use assessment. Providers will likely ask about other substance use. Answering assessment questions honestly and completely can help ensure you receive an accurate diagnosis.
• Screening for mental health symptoms. Understanding whether you have a dual diagnosis helps providers develop a strong treatment plan.

Diagnosing xylazine addiction can be challenging, as use of this drug is tied to an opioid use disorder. If you or your providers suspect xylazine is part of the picture, a wound compilation assessment can help support appropriate treatment, even if the overarching diagnosis is opioid related.

Many people fall into xylazine addiction without ever realizing they were taking it. Escalating use of opioids and related adulterants can happen quickly, and they can occur in the lives of people of all personalities and backgrounds. Getting help for xylazine addiction can help you break use cycles and seek a healthier life.

Consider seeking tranq dope support if you:

• Have tried to stop using it on your own and failed
• Are dealing with worsening wounds and other physical effects
• Have had opioid overdose scares or required naloxone for overdose reversal
• Are tired of chasing opioids and other drugs and want to work on bettering your life or implementing harm reduction tactics
• Think you might have behavioral health concerns, such as depression or anxiety, in addition to substance use disorder

RehabNet is a free, confidential source for xylazine addiction resources. Use our confidential treatment finder to find rehab locations and providers near you that meet your preferences.