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“Tranq dope” is the name for a new mix of street drugs wreaking havoc on drug users across America. It’s a mix of the animal tranquilizer, xylazine, and opioids like heroin or fentanyl. Drug dealers use the xylazine to cut fentanyl because it makes the high last a bit longer, which users like. Tranq dope is cheaper than uncut opioids, too, which makes it sell better. However, tranq dope makes horrific wounds that are shocking the people treating them.
Infections and amputations
Tranq dope tears through muscle, connective tissue, and skin.
This new mixture of xylazine and fentanyl is also called “zombie drug” by users because of the rapid damage it causes. While people who inject drugs normally expect to get infections at the injection sites, xylazine causes problems over large areas of people’s arms. Xylazine tears through muscle, connective tissue, and skin. First, the skin becomes black and blue, then it turns to dark, necrotic ulcers. Many users end up with amputations.
This new mix first saturated the opioid drug supply in Philadelphia in early 2020, but it has rapidly spread to other major cities. In each new zone, rates of admission to emergency rooms for skin and tissue infections have spiked. Wound care clinics are now a crucial component of outreach for people who use drugs like tranq dope. Unfortunately, these wounds can prevent people from getting into rehab facilities or sober living facilities that don’t have wound care resources.
Narcan doesn’t work on tranq dope
Another stumbling block in helping people in these tough situations is that overdoses are much harder to reverse. Narcan (naloxone) is the medication that people rely on to help stop opioid overdoses in their tracks. Opioids normally suppress breathing, so Narcan blocks this and helps people continue to breathe even under massive drug doses.
Even with Narcan, someone who used tranq dope will be unconscious for several hours.
Unfortunately, xylazine is not an opioid. It’s a sedative, and Narcan will not stop its effects. Even with Narcan, someone who used tranq dope will be unconscious for several hours. That puts them at risk of being assaulted, raped, or robbed while they are out. When they finally come to from the xylazine, the fentanyl will have worn off, and they search for another hit.
Treating a tranq dope overdose
Although there are veterinary drugs that can block the effects of xylazine, they are not approved for use in humans. As of now, the only treatment for a high dose of the tranq dope is Narcan for the fentanyl and symptomatic treatment for the xylazine. Xylazine impairs breathing and can dangerously lower blood pressure. People may need a short stay in the hospital if they require medications to treat this.
When people make it past an overdose, they find the regular opioid withdrawal complicated by the new xylazine withdrawal. This includes severe migraines, nausea, body sweats, vision troubles, and powerful anxiety symptoms. These withdrawal symptoms can last twice as long as those of opioids.
Late to the game
Despite aid workers noting the spread of xylazine for years now, state and federal agencies and major healthcare providers have been slow to learn. The FDA only recently issued an alert about tranq dope, and xylazine is still not included in a standard toxicology screen. Doctors have to test for it specifically, instead. Furthermore, xylazine is still not a controlled substance, unlike most other problem drugs. This means it is still easy for dealers to get it, either illegally online or via diversion from sources for veterinary care.