The Growing Threat of the Tranquilizer Xylazine, Also Known as Tranq

The animal tranquilizer xylazine has become the latest scourge in the American addiction crisis. The substance often pushed under the names “Tranq” or “Tranq dope” is a non-opiate sedative, analgesic, and muscle relaxant only authorized in the United States for veterinary use, according to the federal Food and Drug Administration.

Xylazine—currently not a controlled substance—“was first noted as an adulterant in Puerto Rico in the early 2000s,” reported the Drug Enforcement Administration (DEA) in October. “Xylazine, reported as an adulterant in an increasing number of illicit drug mixtures, has also been detected in a growing number of overdose deaths. It is commonly encountered in combination with fentanyl but has also been detected in mixtures containing cocaine, heroin, and a variety of other drugs.”

“The drug causes dangerously low blood pressure, slow heart rates, blackouts, and skin wounds so severe they can lead to amputations,” reported Axios Denver on March 15. “The sedative, which makes the effects of fentanyl even deadlier, is also unresponsive to common overdose-reversal treatments, like naloxone.” The reason: naloxone (Narcan) only counteracts the effects of opioids and not of other psychoactive substances.

Tranq started to appear in Philadelphia about three years ago. The more powerful synthetic opioid fentanyl has edged out heroin in the Pennsylvania city, but the fentanyl high fades more quickly than heroin, so xylazine is being added to make the effects of fentanyl last longer. Exposure to xylazine is common among people addicted to heroin, fentanyl, and cocaine, as the tranquilizer is often added without the knowledge of the addicted user.

Misusing xylazine can have serious consequences. CNN recently reported that “the drug has side effects like ‘tranq walk,’ where people seem unaware of their surroundings, along with sores and wounds.” The sores frequently turn into horrific ulcers on the extremities and are associated with copious purulent drainage and foul smell. Necrosis of subcutaneous tissues and abscesses are common.  

Local police told Axios Denver that xylazine has now arrived in Denver. Authorities detected 18 cases in 2022 through a fentanyl-monitoring project that tests drugs. Authorities say that figure is likely higher, even though Denver has nowhere near the levels seen in the Northeast, where the drug is prevalent.

“The emergence of xylazine across the United States appears to be following the same path as fentanyl, beginning with white powder heroin markets in the Northeast before spreading to the South, and then working its way into drug markets westward,” reported the DEA. “This pattern indicates that use of xylazine as an adulterant will likely increase and be commonly encountered in the illicit fentanyl supply.”

Fentanyl and xylazine are just the latest chemical weapons in America’s seemingly endless battle with addiction. Over 110,000 people died of drug overdoses last year, according to the CDC—a new terrible record. Once again, we are largely blaming a substance (fentanyl) and its merchants (foreign cartels) while ignoring the deeper reasons why so many Americans are willing to ingest and inject dangerous, addictive substances. Once again, cities and states are pushing for much harsher sentences for people caught with the deadly substance-de-jour.

Critics are already calling “the new crackdown a ‘War on Drugs’ 2.0,” reported NPR’s Jasmine Garsd in March, but many experts warn that further criminalization is not going to fix the problem.

"There's no doubt in my mind that law enforcement should be involved. There's no doubt in my mind that the court system should be involved," Adam Scott Wandt, assistant professor of public policy at John Jay College of Criminal Justice, told NPR. "But we cannot law-enforcement our way out of this fentanyl epidemic. It's a public health epidemic. We need to concentrate and focus on public health solutions in order to help people break their habits, break their addictions."

People with addiction need compassion and treatment. They are already continuing with their self-destructive behavior despite severe punishing consequences. More punishment will achieve very little. Addiction is a complex disease, often driven by desperate attempts to self-medicate trauma, anxiety, depression, and other mental health conditions. If the resulting emotional pain is left unaddressed, criminal interdiction is unlikely to achieve much.  

Amber King, a Foundry Steamboat team member who grew up in rural Colorado, is familiar with the relationship between social determinants of health and mental health and addictive disorders. King and colleague Amanda Buckner recently started a free networking event for therapists and other mental healthcare stakeholders in rural Colorado communities. “Addiction has long been viewed as a moral failure or the result of making bad life choices. Despite public education efforts in recent years and the fact that most people today know a friend or family member affected by addiction, this is still a widely held belief. The reality is that addiction is very often the result of terrible life events and cycles of addiction and violence that affect family systems for generations. The roots of this problem, for many people, stem from feeling mitigated, isolated, oppressed, hopeless, and lacking resources to help them address these feelings and experiences. Substances come and go and change. More people are still dying from alcohol misuse every year than from all other substances. We need to acknowledge that addressing the problem of xylazine, or fentanyl, or opioids, or any substance takes more than stopping the supply — it comes from helping reduce the perceived need for people to self-medicate with substances to feel normal,” says King.

Foundry Steamboat offers a men’s residential treatment program in Steamboat Springs and virtual IOP services to adults in Colorado and Wyoming. The program’s clinicians are experienced with people who face financial, legal, and relational challenges and who feel marginalized. The program’s Trauma-Integrated Care model helps clients understand why they develop addictive disorders and how to develop recovery-supportive lifestyles and provides skills to naturally self-regulate the autonomous nervous system to reduce the need for substances.

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