Xylazine is turning up in the fentanyl supply, and it has changed what withdrawal looks like at detoxes and rehabs in Florida and across the country. On the street the mix is called “tranq dope”.

It creates risks and complications that treatment providers are still learning to handle, including here in Southern Florida.

Florida detoxes on alert for tranq dope

Detox centers, emergency departments and programs like ours are still working out how to respond. Xylazine isn’t an opioid, so NARCAN, the medication used to reverse an opioid overdose, doesn’t touch it. Xylazine also causes painful skin ulcers, deep sedation and withdrawal symptoms that are still not well understood.

That changes fentanyl detox, and it makes xylazine detox a second problem on top of the first.

What is tranq dope?

Xylazine is a non-opioid sedative used by veterinarians to anesthetize large animals such as horses. It is not approved for human use. However, like ketamine, it has entered the illicit drug supply, sometimes as a cheap cutting agent for fentanyl or heroin.

Xylazine is not a controlled substance at the federal level, though some states have started to regulate it, so traffickers can get it easily and mix it into street drugs. It deepens the sedation from fentanyl and makes the high last longer. Some people use it on its own.

Fentanyl is a powerful synthetic opioid used legitimately in the medical industry to treat severe pain, especially after surgery or in cancer patients. It is 50 to 100 times stronger than morphine.

Pharmaceutical fentanyl is legal and carefully dosed in a medical setting. The fentanyl sold on the street is made illegally, and it is now one of the most common and deadliest drugs in circulation.

Tranq dope is a mix of the two. Sometimes people take it on purpose. More often xylazine is used as a cutting agent in fentanyl and other opiates.

The dangers of xylazine and fentanyl

Fentanyl has been studied well enough that the treatment options are known and they work.

Xylazine is less understood. Its effects include:

• Extreme sedation and blackouts
• Necrotic skin ulcers
• Slow wound healing and increased infection risk
• Suppressed breathing and heart rate
• Increased risk of overdose
  

Narcan is where this gets dangerous. Because xylazine isn’t an opioid, naloxone does nothing for it. Someone revived from the opioid part of an overdose can stay dangerously sedated or unresponsive.

Detoxing from tranq dope

Xylazine on top of fentanyl creates complex medical challenges in detox. Because xylazine isn’t an opioid, standard opioid withdrawal protocols don’t cover it.

Detoxing from both at once changes what the medical team has to watch for:

Xylazine assessment

Many patients don’t know they have been using xylazine. It is usually mixed into fentanyl without them knowing. Routine toxicology screening at intake should include it.

Preparing for a complicated withdrawal

Xylazine withdrawal is still understudied. It can cause:

• Severe anxiety and agitation
• Elevated heart rate and blood pressure
• Tremors
• Intense cravings
• Rebound sedation or hypersomnia
  

There is no FDA-approved medication for xylazine withdrawal, so the care is supportive. When someone is withdrawing from both drugs, the team treats the opioid withdrawal on protocol and manages the xylazine symptoms alongside it.

Wound care and vital signs

Long-term xylazine use leaves necrotic skin ulcers, often far from any injection site. They infect fast. A detox unit has to be able to do advanced wound care and monitor vital signs at the same time.

Call Pines Recovery Life about xylazine or fentanyl

This is treatable, including the complicated version of it. What it takes is a medical team that knows what xylazine does to a body and watches for it.

We provide medical detox and residential inpatient treatment, with the same physician and nurses through both.

Call us today at (954) 250-3274 and we will tell you what detox would look like for you or for the person you are calling about.