The U.S. Drug Enforcement Administration is warning North Dakota of a sharp increase in the trafficking of fentanyl mixed with tranq that has been seen across the nation.

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According to the CDC, "Tranq," also known as xylazine, is a powerful sedative that the U.S. Food and Drug Administration has approved for veterinary use.

It is not authorized for use by humans. Xylazine has the potential to be fatal, and it becomes even more so when mixed with opioids such as fentanyl.

Xylazine and fentanyl drug mixtures place users at a higher risk of suffering fatal drug poisoning.

Because xylazine is not an opioid, naloxone (Narcan) does not reverse its effects. Still, experts always recommend administering naloxone if someone might be suffering from drug poisoning.

People who inject drug mixtures containing xylazine can also develop severe wounds, including necrosis—the rotting of human tissue—that may lead to amputation.

The White House Office of National Drug Control Policy has designated fentanyl combined (adulterated) with xylazine as an emerging hazard due to its effect on the opioid crisis. A National Response Plan was unveiled by the White House on July 11, 2023, in response to the growing threat posed by fentanyl combined with xylazine.

From 2020 to 2021, xylazine was found in more substances tested in labs across the country, with the South experiencing the biggest increase.

Research in particular fields has discovered comparable rises. According to a study conducted across ten US cities, xylazine contributed to fewer than 1% of drug overdose deaths in 2015 and approximately 7% in 2020.

Almost 80% of drug samples containing opioids from eight Maryland syringe service programs examined between 2021 and 2022 contained xylazine.

In Philadelphia, Pennsylvania, xylazine was discovered in 31% of overdose deaths involving heroin and/or fentanyl in 2019.

According to a recent study by the CDC's State Unintentional Drug Overdose Reporting System, the monthly percentage of deaths containing xylazine and unlawfully manufactured fentanyl identified climbed from 3% in January 2019 to 11% in June 2022 across 20 states and Washington, D.C.  A larger percentage of IMF-related deaths in the Northeastern United States between January 2021 and June 2022 in 31 states and Washington, D.C. included xylazine.

This article provides answers to some frequently asked questions on xylazine, its use, and xylazine overdoses. It is not the purpose of this page to provide clinical recommendations, medical advice, or treatment plans.

What are the symptoms and health risks of Tranq?

  • sedation
  • difficulty breathing
  • dangerously low blood pressure
  • slowed heart rate
  • wounds that can become infected
  • severe withdrawal symptoms
  • death

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