Xylazine, often referred to as ‘tranq’ in the street language, is a powerful sedative originally designed for anesthetizing large animals during veterinary surgeries. It’s now finding its way into the hands of drug dealers who use it to intensify drugs and prolong the users’ state of intoxication.

However, blending this tranquilizer with stimulants and opioids, some of which induce a state of alertness, can result in a condition termed ‘dope lean.’ This involves the user remaining upright but unconscious, resembling a bent-over stature.

Xylazine targets the adrenergic receptors in the brain that produce neurotransmitters such as norepinephrine and dopamine. The sedative blocks these receptors, reducing the neurotransmitters’ quantity.

Usually combined with substances like fentanyl or heroin, xylazine is typically administered via injection. However, it can also be consumed orally, smoked, or snorted.

Dr. Kelly Johnson-Arbor, a medical toxicologist with the National Capital Poison Center, indicated to DailyMail.com, “When xylazine is injected, it’s going to start having effects within minutes” and “the effects can last for hours, or longer in some cases.”

If xylazine is ingested orally, it needs to pass through the digestive system and be metabolized, a process that can take over an hour. On the other hand, smoking drugs containing xylazine is a quicker route for the sedative to enter the bloodstream due to the rapid absorption in the lungs, which are lined with numerous tiny blood vessels.

The initial effects of xylazine may include elevated blood pressure, decreased heart rate, irregular respiration, and fatigue.

Over time, users may experience disorientation, confusion, shallow breathing, urinary incontinence, muscle relaxation, or even a comatose state. However, Dr. Johnson-Arbor highlights that the symptoms vary greatly depending on individual factors, drug quality, mixtures, and dosages.

Approved doses by the FDA for animals include 20 mg/ml and 100 mg/ml, which are typically administered via intramuscular injection. Determining how much of the illicit xylazine someone has consumed is challenging due to its mixtures with other substances in varying quantities.

Dr. Johnson-Arbor adds, “That’s one of the very frightening things about the illicit drug supply in this country is you just never know what you’re getting.”

The DEA notes that for animals, xylazine takes about 10 to 15 minutes to induce a numbing, sleep-like state. However, when used by humans, it can cause decreased motor activity, unconsciousness, reduced reflexes, impaired judgement, and difficulties in perception.

When used with other opioids, “including fentanyl, it depresses the central nervous system to a point where there can be little movement,” said Pat Aussem, a vice president of the nonprofit Partnership to End Addiction.

This drug’s sedative properties, combined with other stimulants, might result in users appearing statue-like instead of collapsing, putting them in a state of unconscious vulnerability to dangerous situations.

According to Ms. Aussem, “Individuals using Xylazine may black out or experience a loss of memory, placing them at a greater risk of sexual assault or robbery.”

There have also been reports of xylazine causing internal skin rot. More research is required to determine why this occurs. A prevailing hypothesis suggests that xylazine may constrict blood vessels, thereby limiting or stopping the flow of oxygen-rich blood in the body.

“You could have minor traumatic wounds that can enlarge significantly because the blood vessels that go to the skin are not carrying a significant amount of oxygen and are very narrow,” said Dr. Johnson-Arbor.

Even minor bumps or bruises might enlarge into severe wounds due to the reduced blood flow caused by xylazine.

The reasons behind xylazine’s more extreme effects on humans compared to animals remain largely unknown.

Dr. Johnson-Arbor noted, “It was initially developed as a drug for potential use in humans, but those effects were abandoned because of basically the drug’s side effects. It was found to not safe for use in humans.”

The nation witnessed almost 107,000 overdose deaths from August 2021 to August 2022, with 66% of these involving synthetic opioids like fentanyl. However, data on fatalities directly caused by xylazine is not readily available as the CDC does not routinely collect such information.

Despite being a sedative mixed with opioids such as fentanyl, xylazine resists conventional opioid treatment methods like naloxone, or Narcan. Nonetheless, Narcan may be effective in mitigating fentanyl or other opioids in the user’s system. As of now, there are no FDA-approved treatments specifically for xylazine withdrawal.

Image Credit: ANGELA WEISS/AFP via Getty Images

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