You've Heard of Fentanyl and Oxytocin—Now, Here's What Parents Need To Know About Xylazine
Xylazine is adding another layer to the drug crisis—here's why it's so scary.
The U.S. has grappled with a second wave of the opioid epidemic since 2010. And unfortunately, it hasn't gotten much better in the last decade-plus. More than 70,000 people died from a synthetic opioid overdose, primarily fentanyl, in 2021, according to CDC data.
That's not just a number—it represents people's brothers, sisters, parents and friends. And while people may want to see the light at the end of the tunnel, it appears the crisis will deepen before it gets better. That's in part because of a drug called Xylazine. The drug is actually not an opioid. Rather, it's a sedative used in veterinary medicine.
So why is it being mentioned as part of the opioid crisis? And what are the risks? Here's what experts want people to know and how parents can discuss drug risks with their children.
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What is Xylazine?
Xylazine is a tranquilizer, explains Aymet Demara, a licensed associate substance abuse therapist (LASAC) and the associate clinical director at Scottsdale Recovery Center.
"The drug is used mainly for large animals in the veterinarian field for medical procedures," Demara says. "[It is] not meant for the human population but can be seen in drugs that are used today, such as fentanyl. This drug can mimic the use of a tranquilizer as well."
According to a New York Times report, Xylazine was discovered in Kensington, Pennsylvania, in 2006, but unintentional use surged there and spread throughout the Northeast region in 2018.
Xylazine, pronounced zai-luh-zeen, has several nicknames.
"Tranq and zombie drug are the most common names for this as it is a sub-name for a tranquilizer," Demara explains, adding that she expects more names to develop as the drug's use grows.
Dr. Julian Lagoy, MD, a psychiatrist with Mindpath Health, adds that some other names include Tranq dope, sleep cut and anesthesia de caballo (horse anesthesia).
Why Are People Using Xylazine?
Unlike opioids, people aren't actively seeking out Xylazine.
"It has been found in drugs, often co-occurring with fentanyl and other substances," says Dr. Tasha Turner-Bicknell, DNP, RN, CPH, an associate professor and director of public health nursing DNP and certificate programs at the University of Cincinnati. "Xylazine has been found in heroin, cocaine and illicitly manufactured fentanyl.
And it may be in other drugs too.
"Since fentanyl is often in meth and cocaine, I think it is fair to say we could see xylazine in stimulants such as methamphetamine and crack," Dr. Bicknell adds.
Why Would People Lace Drugs With Xylazine?
"In the illicit drug market, drug adulterants are added as fillers to increase the weight or enhance the delivery of a drug," Dr. Bicknell explains. "Illicit drugs such as heroin, cocaine, crack (cocaine) and meth are likely to have adulterants due to the unregulated nature of the illicit drug market."
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What Are the Issues With Xylazine?
Lacing drugs isn't exactly a novel idea. But what makes Xylazine so different? Developed for veterinarian use in the 1960s, human trials ceased because Xylazine carried respiratory suppression risk. That remains a problem today.
"Risks of Xylazine include hypotension, bradycardia, hypothermia, over sedation, respiratory suppression and death," says Dr. Lagoy.
Dr. Bicknell adds that it can also trigger "skin rot," or open wounds that can erupt and become infected. Left untreated, amputation may be required.
And experts say it's making opioid addiction worse.
"As with any other substance, individuals can create tolerance within the drug itself, which then can increase the addictiveness within the drug, especially if it’s mixed with other common substances," says Demara.
Reversing an overdose is challenging. Unlike opioids, the drug is a sedative and does not respond to naloxone (NARCAN), explains Demara. So, if a person is overdoses on fentanyl and Xylazine, NARCAN can address the fentanyl—but not the Xylazine.
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Talking To Your Kids About Drugs
Prevention is the best medicine when it comes to drug addiction. But the days of simply saying "Just say no" are over.
Experts say that doesn't mean parents should steer clear of frank discussions about drug use.
"You need to be upfront with them and honest and straightforward about the severe dangers of drug use so that they make the right decision not to use it," says Dr. Lagoy.
But even experts who spend days treating and talking about drug use can empathize with parents—the conversation isn't easy.
"Parents are often uncomfortable talking about drugs," concedes Dr. Bicknell.
But she agrees with Dr. Lagoy—it's a worthwhile conversation, especially because today's street drugs are now more potent, thanks in part to Xylazine.
"I think for previous generations, such as Baby Boomers and Gen X, there was a certain amount of drug experimentation that was considered harmless—those days are over," says Dr. Bicknell. "The emergence of fentanyl, fentanyl analogs, and the use of animal tranquilizers in the preparation and trafficking in the illicit drug market has made even a small dose deadly."
The conversation can be challenging to start. Demara suggests parents start by doing more listening than talking.
"Always ask questions," she says.
For example, parents can look for natural ways to bring up conversations, such as seeing a report on drug use. Then, they can ask their child what they know about drugs. Listen and share what you've heard. Make sure they know they can always come to you with questions.
"It’s always good to be educating children on what is going on so that they can ask questions as well," says Demara.
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Sources
Dr. Tasha Turner-Bicknell, DNP, RN, CPH, an associate professor and director of public health nursing DNP and certificate programs at the University of Cincinnati
Aymet Demara, LASAC, licensed associate substance abuse therapist and the associate clinical director at Scottsdale Recovery Center
Dr. Julian Lagoy, MD, a psychiatrist with Mindpath Health
