Xylazine (“Tranq”) Explained: Risks, Response, and Wound Care Basics

Quick take

Xylazine is a veterinary sedative that is not an opioid. It is often found mixed with fentanyl in the unregulated drug supply. Naloxone does not reverse xylazine, yet you should still give naloxone in a suspected overdose because fentanyl may be present. Always call 911. Xylazine can cause prolonged sedation, slow breathing, low blood pressure, and difficult‑to‑heal skin wounds. CDC+1

How to respond to a suspected overdose

1. Check and call. If the person is unresponsive or breathing slowly or not at all, call 911. SAMHSA Library

   
   

2. Give naloxone. Use it right away. If there is no response in a few minutes, give a second dose. Naloxone will not reverse xylazine itself, but it can reverse opioids in the mix and will not cause harm if no opioids are present. CDC+1

   
   

3. Rescue breathing. Provide breaths if the person is not breathing or is breathing poorly. Expect possible ongoing sedation even after naloxone works. Stay with the person until EMS arrives. CDC

Truth check: Some overdoses now involve non‑opioid sedatives like medetomidine. Naloxone may not reverse those drugs either, but you should still give naloxone because opioids are often present, then support breathing and call 911. AP News

Wound care basics you can use today

Xylazine‑associated wounds can occur even away from injection sites. If you have wounds, seek clinical care. While you arrange that, these basics help reduce harm: gentle cleaning with clean water or saline, use of non‑adherent dressings, and light securement that avoids tight compression. Watch for signs of infection like spreading redness, heat, swelling, pus, fever, or severe pain. Get medical care promptly if those appear. hip.phila.gov+1

Testing and safer‑use steps

• Xylazine test strips (XTS). XTS can detect the presence of xylazine in a dissolved sample. Follow the brand’s instructions. NYC provides clear, printable directions for XTS. SAMHSA+1

• Limits. A negative result does not guarantee safety. Supply is uneven and other sedatives may be present. Keep your safety plan. SAMHSA

  
  

• Core safeguards. Avoid using alone, go slow with a small test dose, avoid mixing drugs, and keep naloxone on hand. NYC guidance reinforces these steps. NYC.gov

  
  

Why naloxone still matters

Even though xylazine is not an opioid, overdoses that involve xylazine almost always involve fentanyl. Naloxone reverses opioid effects and buys time for EMS. It remains the standard community response. CDC+1

NYC resources

• Naloxone in NYC: Where to get kits, trainings, and communal access guidance. NYC.gov

  
  

• Xylazine test strip instructions (PDF): Step‑by‑step, with pictures. NYC.gov

  
  

• Drug checking and harm‑reduction services: City overview and locations. NYC.gov

  
  

• For programs and housing sites: Overdose prevention checklist and test strip implementation tips. NYC.gov

  
  

FAQs

Does narcan work on xylazine?

Naloxone does not reverse xylazine. Still give it because opioids like fentanyl are often present. Then support breathing and call 911. CDC

What do xylazine wounds look like?

They can start as tender areas and progress to ulcers with dead tissue. They may appear away from injection sites. Seek clinical care; use gentle cleaning and non‑adherent dressings in the meantime. hip.phila.gov+1

Can I get xylazine test strips in New York?

Yes. New York State and NYC support access to fentanyl and xylazine test strips through overdose prevention programs and ordering portals. Follow instructions closely. Addiction Services Support+1

If naloxone does not wake someone up, should I stop?

No. Continue rescue breathing and wait for EMS. Xylazine can keep someone sedated even after naloxone reverses opioids. CDC

Safety note: This article supports but does not replace medical care or emergency services.