The Danger of Xylazine

April 6, 2026

Joshua Bennett-Johnson, Author and  Licensed Addictions Therapist, LADC-II

Tom O'Connor, Publisher

Xylazine, commonly known as "tranq" or "zombie drug," is a non-opioid, veterinary tranquilizer (sedative, muscle relaxant, and pain reliever) that has not been approved for human use. It has recently emerged as a dangerous adulterant in the illicit drug supply, particularly when mixed with fentanyl and heroin, due to its low cost and ability to extend the duration of the "high". 

National Institute on Drug Abuse (NIDA). Because xylazine is not an opioid, standard overdose reversal medications like naloxone (Narcan) do not reverse its effects. 

Here are the primary dangers of xylazine in humans:

1. Severe Skin Wounds and Necrosis 

Repeated use of xylazine is strongly associated with severe, necrotic skin ulcers, abscesses, and infections. These wounds can become deep, exposing bone, and are frequently described as "flesh-eating" or "zombie-like". Unlike other injection-related infections, these wounds can appear anywhere on the body, not just at the injection site, and have been reported in people who snort or smoke the drug, not just those who inject it. If left untreated, these infections can lead to amputation of limbs. 

2. High Risk of Fatal Overdose 

Xylazine is a potent central nervous system depressant. It causes marked reductions in respiratory rate, heart rate, and blood pressure. When mixed with fentanyl ("tranq dope"), the sedative effects of xylazine intensify the already deadly respiratory depression of fentanyl. High doses can cause extreme sedation and long-lasting unconsciousness, increasing the risk of death if a person is in an unsafe position or environment. 

3. Ineffectiveness of Naloxone

Because xylazine is not an opioid, Narcan will not reverse a xylazine-only overdose. If a person overdoses on a mixture of fentanyl and xylazine, naloxone will reverse the opioid (fentanyl) and help them breathe. Still, the person may remain unconscious and heavily sedated for hours due to the xylazine. Experts still recommend administering naloxone in suspected overdoses because xylazine is rarely used alone and is almost always combined with opioids. 

4. Severe Withdrawal Symptoms 

Regular use of xylazine causes severe physical dependence. Withdrawal symptoms can be more intense than those of opioids alone. Intense agitation, severe anxiety, restlessness, and high blood pressure. Because it is not an opioid, medication-assisted treatments (MAT) like methadone or buprenorphine do not treat xylazine withdrawal. 

5. Increased Physical Vulnerability 

The extreme sedation (heavy nodding) caused by xylazine can leave individuals unconscious for long periods, making them easy targets for: 

• Physical or sexual assault.

• Theft.

• Environmental risks (e.g., passing out in unsafe places). 

READ: The Recent Surge of Nitazenes

Harm Reduction Strategies

• Test Drugs: Use xylazine test strips, which are now available through some harm reduction programs.

• Never Use Alone: Use with someone who can administer naloxone and call 911.

• Wound Care: Seek medical attention immediately for any non-healing wounds, sores, or abscesses.

• Supportive Care: In an overdose, focus on rescue breathing/CPR until emergency services arrive. 

Author Joshua Bennett-Johnson is a Licensed Addictions Therapist, LADC-II, at JBJ Counseling in Newton, MA. He specializes in working with individuals and families navigating substance use and recovery. 

After seven years in a clinical setting, Joshua transitioned to private practice, where he has spent the past six years helping clients at all stages of recovery. He values client autonomy and works alongside each person to identify the path to their healing. As a harm reduction advocate, Joshua focuses on education, safety, and reshaping relationships with substances. 

According to Joshua Bennett-Johnson:

There are more & more reports of a powerful tranquilizer, called Xylazine (commonly nicknamed "tranq"), increasingly infiltrating the fentanyl street supply, but also starting to rear its ugly face in the cocaine supply, as well, in more and more places in our country.

It'll continue spreading outward, eventually reaching every community. This stuff is WICKED dangerous — a central nervous system depressant that amplifies the risk of respiratory arrest when used with another upper or a downer or whatever else it's mixed with. It's making it incredibly difficult to resuscitate persons experiencing an overdose successfully.

I'm talking A LOT of rescue breathing when combined with naloxone administration for opioid overdose (always administer Narcan whether or not you're sure of opioid involvement) — and now it's also causing unsuspecting cocaine users to "fall out", as well.

Before attempting emergency CPR, always first call EMS to report that the person is "unresponsive & not breathing".

Worse still, it's creating awful abscess wounds when injected, with a high incidence of rapidly worsening infection & even necrosis, sometimes leading to necessary amputations.

Think: open, oozing wounds that don't heal, even with medication & proper care.

I'm hearing more & more stories of ongoing symptoms long after use — sudden & ongoing spikes of high blood pressure, a common example. It's getting increasingly dangerous out there. Fatal overdose rates are on the rise.

Until we, as a culture, come to our freaking senses collectively & decriminalize drugs — ALL DRUGS — people will continue dying.

Point blank. Full stop. On an exponential level. Education and prohibition will not fix this problem.

Drug users deserve the right to use their drugs safely. We need to provide them with a SAFE SUPPLY. It's the only, actual, immediate solution. Then, we can keep working on the healing stuff. 

PS: To anyone who finds that last statement shocking and/or controversial, see: liquor stores, bars & other drinking establishments for better context and clarity.

PPS: alcohol, so that you know, is one of the most dangerous and deadly drugs known to man. In a league of its own, really, when compared to any other substances that a person might use to "feel good"…and it's not even really close.

---

To learn more about Joshua Bennett-Johnson's work, please visit his website at

https://jbj-counseling.com/

If you enjoyed this article, 

Please forward to a friend or colleague who might benefit from it!