The American Curse That Is Xylazine Worsens

The gruesome consequences of xylazine abuse make this new illicit drug one to be feared, but in some areas, it is found in nearly every packet of heroin or fentanyl.

Addict on a street

At one time not that long ago, the worst threat for those using drugs was heroin. Around 2013, heroin’s threat was supplanted by a new threat: fentanyl. Year by year, fentanyl has been taking more and more American lives until by 2022, 76,000 died from this drug.

But every year, the landscape of drug trafficking and drug abuse changes. This is dramatically unlike years past, when the drugs plaguing Americans changed little. Since fentanyl hit the market in 2013, one synthetic drug after another has made its way into America, mostly from foreign sources.

Wherever the sources are, xylazine is one of the newest drug threats in the country, and it is devastating the lives and health of American drug users.

What Is Xylazine and Where Does it Come From?

Xylazine drug lab

Xylazine is a tranquilizer that has long been used by veterinarians. When used on horses or other animals, the brand name is Rompun. The Drug Enforcement Administration describes xylazine as a powerful non-opiate sedative, analgesic, and muscle relaxant.

According to the State of New York, “Xylazine was never approved by the U.S. Food and Drug Administration (FDA) for use in humans because in clinical trials it caused severe central nervous system (CNS) depression or sedation in humans.” And those are the dangerous effects seen when xylazine is abused by drug users.

According to a September 2023 report, xylazine enters the drug supply in a few different ways:

  1. Diverted from veterinary supplies
  2. In solid form coming from China
  3. Mixed with fentanyl coming across the U.S.-Mexico border

Xylazine was first found in Puerto Rico, but by 2016, it had moved to Philadelphia where it was soon detected in 90% of fentanyl samples. According to a January 2024 report, xylazine is now being found in 48 of 50 states plus the District of Columbia. Between 2019 and 2022, this drug’s expansion across America was incredibly fast. Every year, the proportion of fentanyl powder sold on the street that is adulterated with xylazine increases.

The epicenter of destruction is the Kensington district of Philadelphia. This is the neighborhood most frequently featured on news reports focusing on the destructiveness of drugs. In Kensington and other areas, xylazine is referred to as tranq for its intense tranquilizing effects. Those injecting what they think is heroin or fentanyl may freeze in hunched-over positions, lie comatose, or stagger when they try to walk.

Incredible Growth of the Illicit Xylazine Market

In this chart, you can see the number of xylazine samples reported by the National Forensic Laboratory Information System. The way this statistic climbs is an index to the incredible growth of the illicit xylazine market. (The NFLIS collects drug identification results from federal, state, and local forensic laboratories.)

An accurate picture of nationwide xylazine adulteration in drug supplies is difficult to assemble since not every state provides yearly statistics. All we know is that xylazine is in nearly every state and it isn’t going anywhere any time soon.

Gruesome Effects of Xylazine Use

Those addicted to opioids may not know they are obtaining drugs contaminated with xylazine. If they need their next hit of heroin or fentanyl, they generally have to take what they can get, and in some areas, those bags of opioids are nearly always going to contain xylazine.

Why would anyone put xylazine in fentanyl or heroin? Because it makes the opioid more potent. The impact from the opioid is heavier while the dosage can be lower, meaning more profits for the drug dealer.

As of January 2024, the Drug Enforcement Administration reports that xylazine has also been found in cocaine. This drug is rated among the top five drug threats in the Northern Atlantic Region and the North Central Region.

The Savage, Life-Threatening Problems Created by Xylazine Use

Man sleep problems

It is possible to become addicted to xylazine itself. In a worst-case scenario, a drug user could be addicted to both opioids and xylazine at the same time. Unfortunately, each type of drug has its own separate set of withdrawal symptoms. Xylazine’s withdrawal symptoms include:

  • Anxiety
  • Panic
  • A feeling of unease
  • Increased heart rate or blood pressure

Interviews of drug users who were being exposed to xylazine in Philadelphia showed that no one thought it was a desirable drug and no one wanted it in the drug supplies. As noted, they may not have a choice. Also, there are not yet tests to detect xylazine in the drug supplies.

Fatal overdoses of xylazine are possible but not very likely. If a person overdoses on a mixture of fentanyl and xylazine, an opioid antidote—naloxone—will bring the person around by reversing the effects of the opioid. This antidote will not touch the effects of xylazine, however. The overdose victim will start breathing again when the fentanyl is reversed, but they may still be tranquilized into a comatose state.

The most gruesome, destructive effects of xylazine are the deep, rotting wounds on limbs. These limbs may be used for injecting the drugs or not—even people who snort or smoke xylazine may suffer these wounds on their limbs. Xylazine cuts off blood circulation to the surface of the body. The affected tissues die, resulting in deep, infected ulcers. Some people are losing fingers or toes because of soft tissue destruction that eventually eats its way down to the bones. Tendons may be exposed and destroyed.

Images from the streets of Kensington and elsewhere show people living on the streets with deep, infected wounds that won’t heal. Medical personnel hit the streets to pass out antibiotics and instruct people on how to treat their own injuries. ER doctors and community workers work with people on the streets to dress wounds and distribute antibiotics. It is possible for these infections to kill the drug users, even if an opioid overdose does not.

Solving America’s Drug Problem

America’s drug problem will never be solved by attacking the problems with any individual drug. Not the heroin problem or not the methamphetamine, fentanyl, or xylazine problems. There will always be another drug. Since synthetic drugs began to hit the market soon after the new millennium, the illicit drug market has been flooded with literally hundreds of synthetic drugs. Remember Spice and bath salts? They were followed by fentanyl and now xylazine. There will always be another new drug.

Each individual who is addicted to a drug must have access to a drug rehab program that works. Youth must be sufficiently educated on the real dangers of drugs and addiction so they can make the right decisions when they are on their own, away from safe friends or family. The nation as a whole, its legislators, leaders, and celebrities must support drug-free lives. Entertainment must not glorify drug use and then omit any mention of the consequences.

We are still losing more than 100,000 of our friends, family members, and neighbors to drug overdoses. Xylazine is only the latest chapter in this tragic story. We need to work shoulder-to-shoulder to write a better end to the tale.


  • DEA and DHS Issue Joint Update on Sources of Illicit Xylazine. Drug Enforcement Administration, 2023. DEA
  • What is xylazine? Office of Addiction Services and Supports of New York, 2023. OASAS
  • State and Territory Report on Enduring and Emerging Threats. Drug Enforcement Administration, 2024. DEA
  • NFLIS Data: Reported Xylazine Exhibits 2010-2022. NFLIS, 2023. NFLIS
  • Perspectives of people in Philadelphia who use fentanyl/heroin adulterated with the animal tranquilizer xylazine. National Library of Medicine, 2022. NLM
  • Tranq has become a bigger part of Philly’s street fentanyl supply. CNN, 2023. CNN
  • Xylazine Basics: Overdose Prevention, Harm Reduction, and Wound Care. Office of Addiction Services and Supports of New York, 2023. OASAS


Karen Hadley

For more than a decade, Karen has been researching and writing about drug trafficking, drug abuse, addiction and recovery. She has also studied and written about policy issues related to drug treatment.