The New “Tranq” Threat: Xylazine, Fentanyl, and the Growing Risk in Today’s Drug Crisis
The drug addiction and overdose crisis continues to evolve — and unfortunately, it’s evolving in one of the most dangerous ways possible. In recent years, most people have become familiar with fentanyl and how it has reshaped overdose risk. But a new substance is increasingly being found alongside fentanyl across the U.S., raising major health concerns for individuals, families, treatment providers, and recovery communities:
Xylazine, often referred to on the street as “tranq.”
At Design for Change, our mission is to support individuals and families impacted by substance use disorder (SUD) through education, treatment resources, and recovery support. A major part of prevention and healing is staying informed — because today’s drug supply is unpredictable, and many people are unknowingly exposed to extremely dangerous combinations.
This blog post explains what xylazine is, why it’s becoming more common, and what families and communities can do to protect lives and encourage recovery.
Xylazine is a veterinary sedative. It is not approved for human use. In veterinary medicine, xylazine is used to sedate animals like horses and cattle during medical procedures.
However, xylazine has entered the illegal drug supply and is increasingly being mixed with fentanyl and other substances. The combination is especially concerning because xylazine is not an opioid, which means it behaves differently in the body — and it complicates overdose response.
The CDC provides an overview of xylazine’s emergence in the drug supply here:
https://www.cdc.gov/drugoverdose/deaths/other-drugs/xylazine/index.html
This question is important: Why would drug manufacturers or sellers add something like xylazine at all?
One reason is that fentanyl is extremely short-acting. It causes a powerful and quick effect, but it doesn’t last as long as other opioids. Xylazine, on the other hand, is a sedative that can extend the “down” feeling.
Some reports suggest that xylazine may be used to:
But the result for the person using the drug is clear: increased overdose risk, deeper sedation, and more physical harm.
The DEA has also issued alerts regarding xylazine’s growing presence:
https://www.dea.gov/sites/default/files/2022-12/Xylazine%20Factsheet.pdf
Xylazine is trending for a reason — it represents the next wave of danger in the overdose epidemic.
Overdose prevention strategies were already challenged by fentanyl. But xylazine introduces additional complications because:
Communities across the country are seeing higher rates of overdoses and medical complications tied to fentanyl + xylazine combinations — and many people using substances aren’t even aware it’s present.
Naloxone (Narcan) has saved countless lives. It reverses opioid overdoses by blocking opioid receptors in the brain. But because xylazine is not an opioid, Narcan does not remove xylazine from the system.
This can create a scary situation:
Here’s the key message families need to know:
✅ You should still use naloxone in any suspected overdose, because fentanyl or other opioids may be present.
✅ Always call 911, even if naloxone is given.
✅ If the person remains unconscious, they may still be in danger due to xylazine sedation or mixed substances.
Learn more about naloxone from the U.S. FDA:
https://www.fda.gov/drugs/information-drug-class/naloxone
One of the most heartbreaking and visually distressing effects linked to xylazine exposure is the development of severe skin wounds, sometimes called:
These wounds may appear even when injection happens in a different part of the body, and they can worsen rapidly, leading to infection and tissue death.
This isn’t meant to shock — it’s meant to inform: xylazine doesn’t just increase overdose risk, it increases long-term physical suffering.
It can contribute to:
NIH and public health sources have documented these rising wound cases:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498928/
It’s easy to feel overwhelmed by the changing drug supply. Many families ask:
The truth is: the drug supply is more unpredictable than ever. People may think they are taking one drug, but the substance may contain:
Even experienced users cannot “manage” this risk consistently.
That’s why one of the most important trends in addiction recovery today is the shift toward:
At Design for Change, we believe that every life is worth fighting for — including people who are still actively using substances.
This is where harm reduction becomes essential.
Harm reduction includes strategies that reduce the most dangerous outcomes while helping people move toward treatment. Examples include:
Harm reduction does not “encourage drug use.” It acknowledges that addiction is complicated and that recovery often takes time — and survival must come first.
A great overview of harm reduction is available through SAMHSA:
https://www.samhsa.gov/substance-use/harm-reduction
Xylazine presents challenges for treatment providers because it may intensify withdrawal symptoms. Withdrawal from opioids is already extremely uncomfortable — and when sedatives are involved, it can create additional physical and mental distress.
People withdrawing from xylazine exposure may experience:
There is ongoing research into best practices for managing xylazine complications in clinical settings.
The National Institute on Drug Abuse continues tracking new drug trends:
https://nida.nih.gov/research-topics/trends-statistics
With all this information, it’s crucial to say this clearly:
Recovery is still possible.
Treatment still works.
Lives can still be rebuilt.
The rise of fentanyl and xylazine does not mean people are “too far gone.” It means the risks are higher, and recovery needs to be supported with:
For opioid addiction, medications like buprenorphine and methadone reduce overdose risk and improve survival.
NIDA info on medications for opioid use disorder:
https://nida.nih.gov/research-topics/medications-to-treat-opioid-addiction
If you’re personally struggling with substance use, please know this:
You deserve help and healing, not shame.
Some steps that can help immediately:
Even if relapse has happened, it is not failure — it is a signal that additional support is needed.
Families often feel stuck between two painful extremes:
There is a third way: support with boundaries.
Helpful family steps:
✅ learn about addiction as a brain disease
✅ avoid shame-based language
✅ build strong boundaries (financial, housing, behavior expectations)
✅ encourage treatment
✅ attend family support groups
✅ seek counseling or family workshops
✅ keep naloxone accessible
When families become educated and supported, they stop operating in panic — and start acting strategically.
At Design for Change, we understand that substance use disorder impacts the entire family system, not just the individual.
As the drug crisis evolves, so must community support. Our approach centers on:
Xylazine may be the latest dangerous trend — but it does not define the future.
The future is defined by:
The emergence of xylazine (“tranq”) in the fentanyl supply is one of the most concerning developments in the current addiction crisis — but knowledge is power.
When communities understand:
…more lives are protected, and more people have the opportunity to reach recovery.
At Design for Change, we believe in second chances, family healing, and changing lives one step at a time.