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Understanding Xylazine: From Usage to Addiction

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Medically Reviewed By: Diana Vo, LMFT

February 29, 2024

Table of Contents

Xylazine use in the United States is a growing public health concern. Using xylazine – a drug used to anesthetize animals – can trigger serious problems with breathing, the CNS (central nervous system), and the heart. Xylazine abuse is also associated with severe skin ulcers, sometimes referred to as xylazine wounds. Read on to learn more about this deadly substance and find out how to connect with compassionate treatment for xylazine addiction.

What is Xylazine?

Xylazine is a non-opioid sedative that is not approved for human use. The German pharmaceutical company Bayer developed xylazine in 1962. An analog of clonidine, xylazine was intended as a medication to lower blood pressure. It was never approved for this purpose in humans, though, as it proved to trigger dangerously low blood pressure alongside pronounced drowsiness.

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Resultantly, xylazine found a place in veterinary medicine during the late 1960s. The drug is used to sedate animals, as well as to induce vomiting, provide pain relief, or relax muscles in animals. Xylazine is still used worldwide as a non-opioid tranquilizer for veterinary applications.

The legal form of xylazine for animals comes in an injectable liquid form of varying strengths. The liquid may also be turned into a powder or salt form colored either white or brown.

Increasingly, xylazine is used as an adulterant for illicit drugs like heroin and fentanyl. The drug is challenging to identify when used as an adulterant. Regrettably, acute poisoning from street drugs laced with xylazine can lead to severe health problems, including:

  • Deep sedation
  • Slowed breathing
  • Dangerously slow heart rate
  • Low blood pressure
  • Heart failure

The sustained use of xylazine or drugs laced with xylazine can bring on lasting damage, such as persistent skin wounds and ulcers.

Mixing xylazine – a CNS depressant – with other drugs like opioids or alcohol that depress the central nervous system, significantly increases the risk of a fatal overdose.

What is xylazine used for?


Xylazine is primarily used as a sedative, analgesic, and muscle relaxant in veterinary medicine. It is commonly administered to large animals such as horses and deer to facilitate handling and medical procedures

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Xylazine Drug Epidemic

The fentanyl and xylazine epidemic captured the attention of the White House’s Office of National Control Policy, which has labeled it an emerging threat. A National Response Plan was unveiled on July 11, 2023 to combat this growing menace.

The xylazine epidemic presents a complex challenge for public health officials, law enforcement, and healthcare providers across the United States. As the presence of the drug has rippled outward beyond the initial hotspots of use, the impact of xylazine is becoming felt in communities and fueling the already critical opioid epidemic. The drug’s ability to induce extreme sedation and prolong the effects of opioids makes xylazine a particularly dangerous addition to the street drug landscape, prompting an uptick in overdose deaths and complicating efforts to provide effective treatment and support to those struggling with substance use disorders.

Efforts to combat the xylazine epidemic require a multi-pronged approach that includes prevention, education, and intervention strategies. More public health campaigns are required to raise awareness about the dangers of xylazine without sensationalizing the drug, highlighting the risks of fatal overdose and skin ulcers.

Law enforcement agencies face the challenge of curtailing the illegal distribution of xylazine. As with fentanyl, though, this remains an uphill struggle.

At the same time, healthcare providers must develop an awareness of xylazine exposure and adapt treatment protocols to manage the unique and severe withdrawal symptoms and addiction effectively.

Is xylazine a controlled substance?


As of now, Xylazine is not classified as a controlled substance by the U.S. Drug Enforcement Administration (DEA). However, its misuse, particularly in combination with other drugs, is monitored due to potential health risks

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The Health Risks of Xylazine Drug Addiction

Any use of xylazine is potentially dangerous. Some effects of xylazine and health risks include:

  • Respiratory and central nervous system effects: One of the gravest risks of xylazine use is its ability to heavily sedate the CNS, provoking potentially life-threatening slowing of breathing and overall CNS depression. This can result in respiratory failure or profound sedation, where the person cannot be awakened.
  • Cardiovascular complications: Xylazine’s impact on the heart and blood vessels is pronounced, causing slow heart rates (bradycardia), low blood pressure (hypotension), and in severe cases, a risk of the heart stopping (cardiac arrest). These effects can be acute, posing immediate danger to life.
  • Skin and soft tissue damage: Regular use of xylazine, especially when mixed with other illicit drugs, can cause severe skin ulcers and abscesses. These wounds are not only disfiguring but can also become life-threatening if not properly treated, leading to long-term health complications and challenges in wound care. The impact on blood vessels and the resulting reduced blood flow to the skin occurs regardless of how xylazine is used – research shows that sores can develop in areas far from where the drug was injected.
  • Addiction and complicated withdrawal: The misuse of xylazine can rapidly lead to physical and psychological dependence on the drug, characterized by an overwhelming urge to continue its use despite obviously adverse outcomes . Withdrawal symptoms from xylazine are especially challenging due to their severity and the current lack of a well-defined protocol for management. Symptoms may include anxiety, restlessness, and potentially dangerous increases in blood pressure.
  • Increased risk of overdose: The combination of xylazine with other CNS depressants amplifies the risk of overdose. These overdoses are particularly dangerous because of xylazine’s powerful effects on breathing and heart function, often triggering fatal outcomes.

Absence of an antidote: There is no antidote specifically designed to counteract the effects of xylazine poisoning, making the management of overdoses complex and less effective. For a future antidote to be effective, it would need to be not only safe and easy to produce but also effective in treating the symptoms of xylazine intoxication and the effects of any opioids it might be mixed with.

Is xylazine addictive?


Xylazine itself is not considered addictive. However, it is often mixed with other drugs like fentanyl, which can lead to addiction and other serious health issues. The combination of Xylazine with addictive substances raises concerns about its potential role in substance abuse​

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Treatment for Xylazine Addiction

For those suffering from skin ulcers, wounds, or abscesses caused by xylazine, specialized wound care may be necessary, including daily changes of dressings and evaluating the need for hyperbaric oxygen therapy. An infectious disease team may be required to provide advice on antibiotic treatments. In cases where tissue removal (debridement) or amputation is needed, the expertise of a surgical team is required.

Withdrawal from xylazine can include symptoms like anxiety, irritability, and restlessness, with severe cases potentially leading to very high blood pressure. Xylazine withdrawal can be managed alongside opioid withdrawal if necessary. Treatments may include benzodiazepines or alpha-2 adrenergic agonists like clonidine, dexmedetomidine, tizanidine, and guanfacine.

If opioid withdrawal presents, this should be addressed early using FDA-approved medications. This helps avoid worsening xylazine withdrawal symptoms or premature discharge from rehab.

For individuals where xylazine use indicates a larger problem with substance abuse, or in cases of intentional overdose, consultation with a psychiatrist specializing in addiction is advised. This step helps tackle the root cause of the issue and enables the development of an appropriate treatment plan.

Medication-assisted treatment typically used to treat substance use disorders does not directly address xylazine addiction due to its unique properties and effects. That said, various forms of behavioral therapies have shown effectiveness in treating this condition. These may include:

  • CBT: CBT (cognitive behavioral therapy) helps people understand the connection between their thoughts, emotions, and behaviors, providing strategies to manage cravings and avoid triggers for xylazine use.
  • Motivational interviewing: Motivational interviewing is a counseling approach that addresses ambivalence about substance use and enhances motivation toward recovery.
  • Group therapy: Group therapy offers a supportive environment where individuals can share experiences and strategies for dealing with addiction.
  • Family therapy: Involving family members in the treatment process helps to repair and strengthen family relationships and provides a robust support system for those grappling with xylazine abuse
  • One-to-one counseling: Individual counseling allows for personalized attention to address the underlying causes of addiction and develop coping mechanisms.
  • Holistic treatments: Evidence-based treatment for xylazine may be supplemented with holistic therapies like mindfulness, meditation, yoga, and acupuncture, promoting whole-body recovery.

 

These therapies aim to build a comprehensive treatment plan that not only addresses the physical aspects of xylazine withdrawal but also the psychological, social, and emotional challenges associated with recovery from addiction. Aftercare may include ongoing support groups, continued therapy sessions, and sometimes sober living environments to help maintain sobriety and prevent relapse from xylazine addiction.

Get Xylazine Addiction Treatment at Renaissance Recovery

Xylazine drug addiction is aggravating, disruptive, and potentially lethal. Fortunately, it’s also treatable. We can help you achieve and maintain ongoing abstinence from this deadly drug, even if xylazine abuse has been triggering health problems.

By choosing outpatient treatment at Renaissance, you can fulfill your daily commitments while engaging with weekday therapy sessions at our treatment center in Huntington Beach, CA.

Although xylazine does not respond to the medications used to treat opioid overdose and addiction, treatment programs at Renaissance help people address the psychological aspect of substance abuse. Therapy is targeted and may include:

  • Talk therapies
  • Motivational therapies
  • Counseling (one-to-one and group)
  • Holistic interventions
  • Family therapy
  • Aftercare planning

Call Renaissance today at 866.330.9449 and begin your recovery from xylazine drug addiction right away.

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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country. Connect with Joe on LinkedIn.

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