Drug used as horse tranquilizer increasingly seen in cases of opioid overdose deaths
By Deborah Jeanne Sergeant
Since 2021, a newcomer to substance abuse disorder has been making inroads in the area: xylazine. Known as “tranq” on the street, the horse tranquilizer is not FDA approved for use in humans and is not under the jurisdiction of the Controlled Substance Act. It is available as a veterinary sedative under the brand names of Rompun, Sedazine and AnaSed.
“Tranq or xylazine is not routinely tested for in toxicology testing or by medical examiners, so we are not able to speak to its overall prevalence in New York state,” said Evan Frost, assistant director of Communications and public information with the New York State Office of Addiction Services and Supports in Albany. “We do now that it has been found in testing conducted in New York City and there have been instances of wounds/skin ulcers related to xylazine in other regions of the state, so we know it is also outside of New York City in some capacity.”
Xylazine is most often used as a “cutting agent” for illegal fentanyl mixes. A cutting agent is a cheap and readily available drug—xylazine in this case—mixed with the more expensive and harder to obtain drug such as fentanyl.
Sometimes cutting agents heighten the effect of the more expensive drug. With xylazine, the unintended effects can include bradycardia (slow heart rate), blurry vision, central nervous system depression, unsteady gait, slowed or stopped breathing, low blood pressure, hypothermia, high blood glucose levels, severe withdrawal, pinpoint pupils, necrotic skin ulcerations (may occur at other areas beside injection site with repeated exposure), coma and death. Because xylazine is a sedative, it is sometimes combined with stimulants like methamphetamine and cocaine to counteract the sedative effects.
“There were some cases in Syracuse, but I haven’t heard of any in Oswego County yet,” said Eric A. Bresee, licensed mental health counselor and executive director of Farnham Family Services in Oswego.
Mariah Senecal-Reilly, coordinator of the Mental Health and Substance Use Initiatives Program with the Onondaga County Health Department, said that the first discovery of xylazine in the county’s illicit drug supply occurred in November.
“We have been monitoring it pretty closely and haven’t found similar situations since November,” she added. “I’m not going to say we won’t see it again because it’s been very prevalent in Philadelphia.”
Recent reports indicate that more than 90% of illicit drugs in Philadelphia contain xylazine and in New York City, it’s 25%, which appears to indicate that xylazine is making inroads into New York. Because of the many equine businesses and farms in Oswego and Onondaga counties, it may be easier to access xylazine. However it is speculative at this point to assume that it will become more widespread in rural areas.
“It’s particularly insidious because it causes terrible skin infections, not just at the injection location but throughout a person’s body,” Senecal-Reilly said. “They have some really harmful abscesses. It complicates things further for someone who’s using substances.”
Xylazine reduces blood flow to the skin.
Since xylazine is often used to cut fentanyl and other drugs, it may be even more dangerous than a single, known drug in case of an overdose. Healthcare providers in these cases have little idea of what the patient has taken. Xylazine is not an opioid drug.
“Narcan works on opioid reversal, but doesn’t work on the xylazine tranquilizer part of what the person has consumed,” Senecal-Reilly said. “Narcan won’t do anything for xylazine. It’s important to perform rescue breathing for these patients because there’s lack of oxygen.”