June is PTSD Awareness Month ... You're not alone... We're here to help...
A veterinary sedative was never supposed to end up in human drug supplies. But xylazine, a drug used to sedate large animals like horses and cattle, has become one of the most alarming developments in the American overdose crisis. Known on the street as tranq, it is increasingly found mixed into fentanyl and other illicit drugs, often without the person using them having any idea it is there. Texas is not immune. Here is what you need to know.
Xylazine is an alpha-2 adrenergic agonist approved by the FDA for veterinary use only. It is used to sedate animals before procedures and has no approved human medical application. It works as a powerful central nervous system depressant, causing sedation, slowed breathing, and a significant drop in heart rate and blood pressure.
It does not produce a high on its own in the way opioids do. Drug suppliers use it as an adulterant because it prolongs and intensifies the sedative effects of fentanyl, and because it is cheap and largely unregulated. The person using the drug rarely knows it is present.
The Drug Enforcement Administration declared xylazine and fentanyl a national threat in 2023. The DEA found xylazine in drug samples from all 50 states. According to the CDC, the presence of xylazine in overdose deaths increased more than tenfold between 2018 and 2021, with the sharpest increases in the South and West.
In Texas, surveillance data from the Texas Health and Human Services Commission has documented xylazine-positive drug samples across major metropolitan areas including Houston, Dallas-Fort Worth, and San Antonio. Because xylazine is not a controlled substance in Texas or federally, it does not appear in standard drug testing panels, which means its true prevalence in the state is almost certainly higher than reported numbers suggest.
The most critical fact about xylazine is this: naloxone, the medication used to reverse opioid overdoses, does not reverse xylazine. Naloxone works by blocking opioid receptors, but xylazine acts on a completely different receptor system. When someone overdoses on fentanyl laced with xylazine, naloxone may partially reverse the opioid component while the xylazine continues to suppress breathing and blood pressure.
This means someone may appear to respond to naloxone and then lose consciousness again. It means bystanders and first responders may believe the crisis has passed when it has not. Emergency medical care is needed even when naloxone appears to work.
Xylazine also causes severe skin wounds at injection sites. These are not ordinary abscesses. The wounds associated with xylazine use can appear even at sites not directly injected, and they can progress rapidly to tissue death. The CDC and addiction medicine specialists have documented cases requiring amputation. Without medical treatment, these wounds are life-threatening.
Naloxone is still essential. Even though it does not reverse xylazine, it reverses the opioid component, which gives someone more time for emergency services to arrive. Anyone who uses drugs or lives with someone who does should have naloxone on hand and know how to use it. Texas pharmacies dispense naloxone without a prescription.
Call 911 immediately. Because xylazine can cause continued deterioration even after naloxone is given, 911 is not optional. Texas has a Medical Amnesty Law that offers limited legal protection for people who call for help during an overdose. Use it.
Fentanyl test strips are legal in Texas and can identify the presence of fentanyl in a substance. Xylazine test strips also exist and are increasingly available through harm reduction organizations. The Texas Harm Reduction Alliance and local syringe service programs can help connect people to these resources.
Skin wounds need immediate medical attention. If you or someone you know has unusual wounds that are not healing or are worsening, seek care right away. Tell the treating provider about drug use so they can look specifically for xylazine-related tissue damage.
There is no medication that specifically treats xylazine dependence. But the presence of xylazine in the drug supply strengthens the case for entering addiction treatment rather than continuing to use substances that become harder to predict and more dangerous every year.
Medication-assisted treatment for opioid use disorder, including buprenorphine and methadone, remains effective even when fentanyl and xylazine are both involved. Entering a supervised treatment program removes the guesswork about what is in the drug supply. For someone whose use has been escalating, the arrival of xylazine in Texas is a real and urgent reason to reach out.
What does tranq do to the human body?
Xylazine acts as a central nervous system depressant. In humans it causes deep sedation, slowed breathing, dangerously low blood pressure, and bradycardia (slowed heart rate). With prolonged or repeated exposure it also causes severe, slow-healing skin wounds that can progress to tissue death even at sites that were not directly injected.
Does Narcan work on xylazine overdoses?
Naloxone (Narcan) does not reverse xylazine. It does reverse the opioid component of a fentanyl-xylazine overdose, which can buy time. But because xylazine continues to act on the body independently, anyone who receives naloxone during a suspected tranq overdose still needs emergency medical care immediately.
Is xylazine in the drug supply in Texas?
Yes. The DEA has confirmed xylazine is present in all 50 states, and Texas surveillance data has documented xylazine-positive drug samples in Houston, Dallas-Fort Worth, San Antonio, and other areas. Because standard toxicology screens do not test for xylazine, the actual prevalence is likely undercounted.
What should I do if I think someone has overdosed on a tranq-laced drug?
Administer naloxone if available and call 911 immediately. Do not leave the person alone even if they appear to respond to naloxone. Continue rescue breathing if needed. Texas's Medical Amnesty Law provides some legal protection for people who call for emergency help during an overdose.
If you or someone you love is struggling with opioid use or fentanyl addiction, the current state of the Texas drug supply makes getting help more urgent than ever. More Than Rehab offers confidential, compassionate care for substance use disorders. Reach out today for a conversation about your options.
