Xylazine addiction is a substance use disorder characterized by growing physical and psychological dependence on a veterinary sedative increasingly used in illicit drug mixtures. It leads to tolerance, withdrawal symptoms, and persistent drug-seeking behavior despite severe health risks like tissue damage and respiratory depression.
According to Jiang, X.’s 2024 study, ‘Reported Xylazine Use Among Adults Aged ≥18 Years Evaluated for Substance Use Treatment – United States, July 2022-September 2023.’, study of 43,947 adults in substance use treatment, 12.7% (817 people) of primary IMF or heroin users reported using xylazine, with 8.3% (443 people) reporting recent use. Xylazine users showed higher overdose rates, averaging two nonfatal overdoses compared to one among non-users.
Signs of xylazine addiction include relentless cravings, loss of control, and a tendency to neglect essential responsibilities. These symptoms accompany withdrawal challenges and risky behaviors that endanger physical health and social well-being.
Xylazine side effects include profound sedation, dizziness, altered consciousness, and a range of cardiovascular complications such as bradycardia. Its use produces severe issues like skin wounds, confusion, and in extreme cases, life‐threatening coma or seizures.
Treatment for xylazine addiction involves medical detoxification to manage withdrawal and stabilize health, followed by rehabilitation programs. Options consist of inpatient and outpatient care, cognitive‑behavioral therapy, support groups, and harm-reduction strategies to promote lasting recovery.
What is Xylazine Addiction?
Xylazine addiction is a type of substance use disorder characterized by physical and psychological dependence on xylazine, a potent sedative, and muscle relaxant primarily used in veterinary medicine. The addiction typically develops from regular exposure to xylazine, either alone or more commonly as an adulterant in other illicit drugs like heroin or fentanyl, leading to tolerance, withdrawal symptoms, and compulsive drug-seeking behavior despite negative consequences. The condition has become particularly concerning as xylazine increasingly appears as a cutting agent in the illegal drug supply, causing severe health complications including deep tissue wounds, respiratory depression, and potentially fatal overdose.
What is Xylazine?
Xylazine is a veterinary sedative and muscle relaxant that belongs to the class of drugs known as alpha-2 adrenergic agonists. Xylazine is referred to as a “zombie drug,” suggesting severe addiction and behavioral changes in users.
This potent medication is primarily used in veterinary medicine to sedate animals during surgical procedures and medical treatments. The drug functions by targeting specific receptors in the brain and spinal cord, leading to decreased sympathetic nervous system activity. This results in reduced heart rate, blood pressure, and respiratory function, while providing sedation and pain relief.
The FDA has not approved xylazine for human use. Despite this, it has emerged as an illicit recreational substance, especially in South America. Drug users combine xylazine with other substances, such as cocaine, to intensify their effects. It has also gained popularity as a substitute for opioids due to its similar euphoric properties.
What are the Signs and Symptoms of Xylazine Addiction?
The signs and symptoms of xylazine addiction manifest through persistent urges, impaired self-regulation, and severe withdrawal effects. Users experience intense cravings, struggle with daily responsibilities, and show behavioral changes like risk-taking and social withdrawal.
Here are the key signs and symptoms of Xylazine addiction:
- Overwhelming Cravings: Persistent and intense urges to use xylazine, making it difficult to think about anything else.
- Loss of Control: Struggling to regulate or limit xylazine use despite attempts to cut down or quit, indicating escalating dependency.
- Withdrawal Challenges: Experiencing significant physical and/or psychological distress—including shaking, anxiety, or other symptoms—when stopping or reducing use.
- Neglected Responsibilities: Prioritizing xylazine use over social, professional, and personal obligations, leading to decreased performance and commitments.
- Persistent Use Despite Harm: Continuing to use xylazine even when confronted with clear negative outcomes (such as health issues, legal problems, or interpersonal conflicts).
- Risky Behaviors: Engaging in dangerous activities—such as unsafe drug procurement methods or risky administration practices to access or consume xylazine.
What Are The Xylazine Side Effects in Humans?
The xylazine side effects in humans include severe central nervous system depression, dangerous respiratory compromise, altered consciousness, and gastrointestinal disturbances. Common manifestations range from lightheadedness and mental confusion to life-threatening complications like seizures and deep unconsciousness.
Some of the common side effects of xylazine include:
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- Sedation: Sedation is a state of reduced alertness and responsiveness characterized by drowsiness or sleepiness. Xylazine causes sedation by activating alpha-2 adrenergic receptors, which decreases noradrenergic neurotransmission in the central nervous system and leads to diminished arousal. According to Spadaro, A.’s 2023 study, ‘Self-reported Xylazine Experiences: A Mixed-methods Study of Reddit Subscribers.’, prolonged sedation was the most commonly reported adverse effect, affecting 81% of the users who participated in the study.
- Skin Wounds: Skin wounds are injuries to the skin characterized by lesions, ulcers, or necrosis that disrupt the normal barrier function. Xylazine contributes to skin wounds by causing vasoconstriction and tissue necrosis at injection sites, which impairs healing and increases the risk of local infections. According to Spadaro, A.’s 2023 study, ‘Self-reported Xylazine Experiences: A Mixed-methods Study of Reddit Subscribers.’, 43% of participants reported increased skin wounds as a significant adverse effect of xylazine use.
- Drowsiness: A state of reduced alertness and sleepiness. Xylazine causes drowsiness by activating central alpha‑2 adrenergic receptors, which inhibit norepinephrine release and diminish arousal signals.
According to Forrester M. B.’s 2016 study, ‘Xylazine Exposures Reported to Texas Poison Centers.’, the most frequently observed clinical effects in patients included drowsiness or lethargy affecting 47% of cases, bradycardia in 20%, hypotension in 11%, hypertension in 9%, and both puncture or wound and slurred speech were observed in 8% of cases. These findings suggest that xylazine primarily impacts the cardiovascular and neurological systems when humans are exposed to it.
- Dizziness: A sensation of lightheadedness or unsteadiness. Xylazine induces dizziness by lowering blood pressure and reducing cerebral blood flow through central nervous system depression.
- Nausea and Vomiting: A queasy feeling leading to expulsion of stomach contents. Xylazine stimulates the chemoreceptor trigger zone and disrupts gastrointestinal motility, triggering nausea and vomiting.
- Confusion: A state of mental disorientation and difficulty concentrating. Xylazine disrupts normal neurotransmitter signaling—especially dopamine and norepinephrine—which impairs cognitive function and leads to confusion.
- Seizures: Episodes of uncontrolled electrical brain activity. Xylazine disturbs the inhibitory and excitatory balance in neuronal circuits, potentially triggering abnormal, excessive firing that leads to seizures.
- Euphoric Effects: Misuse of Xylazine is associated with opioid-like euphoric effects, contributing to its abuse potential.
- Coma: A state of deep, prolonged unconsciousness. Xylazine’s profound central nervous system depression, through extensive alpha‑2 receptor activation, overwhelms neural activity and results in coma. When Xylazine is mixed with opioids, increasing the risk of fatal overdose due to enhanced CNS depressant effects.
- Bradycardia: A slower-than-normal heart rate. Xylazine causes bradycardia by reducing sympathetic nervous system activity through alpha‑2 receptor stimulation, which decreases norepinephrine release and slows cardiac conduction.
What Are The Treatment Options Available For Xylazine Addiction?
Xylazine addiction is a difficult and complex problem to overcome. However, there are several treatment options available to help individuals break free from addiction and rebuild their lives. Some of the treatment options for xylazine addiction include:
Medical detoxification
Medical detoxification removes xylazine from the body and manages withdrawal symptoms. Detoxification stabilizes individuals with severe addiction or health complications and lays the groundwork for recovery.
According to Debnath, R., & Chawla, P. A.’s 2023 study, ‘Xylazine addiction turning humans to zombies: Fact or myth?’, treatment of xylazine addiction begins with naloxone to address opioid co-intoxication, accompanied by supportive measures such as wound care and electrolyte monitoring. Atropine has been used to reverse xylazine-induced bradycardia and hypotension, while agents like atipamezole and yohimbine show promise as reversal drugs. For skin complications, interventions range from antibiotic ointments and debridement to, in severe cases, amputation or skin grafting.
Inpatient rehabilitation
Inpatient rehabilitation is a structured, residential program where individuals live at the facility while receiving intensive care and therapy. This inpatient rehabilitation program provides a controlled environment focused on medical, psychological, and behavioral therapies essential for recovery.
According to Jiang, X.’s 2024 study, ‘Reported Xylazine Use Among Adults Aged ≥18 Years Evaluated for Substance Use Treatment – United States, July 2022-September 2023.’, reducing harm among xylazine users requires four essential interventions: nonjudgmental care, naloxone provision, wound care, and linkage to and retention in effective substance use treatment.
Outpatient rehabilitation
Outpatient rehabilitation allows individuals to maintain daily routines while attending scheduled therapy sessions and support meetings. This flexible outpatient rehabilitation option supports those with less severe addiction or as a follow-up to inpatient care.
Cognitive-behavioral therapy (CBT)
Cognitive-behavioral therapy helps individuals identify and change harmful thought patterns and behaviors related to addiction. Engaging in cognitive-behavioral therapy (CBT) provides coping skills and strategies to handle triggers and reduce relapse risk.
Support groups
Support groups are gatherings where individuals in recovery share experiences and encourage. Participating in support groups fosters community and mutual support in the recovery journey.
What Are The Symptoms Of Xylazine Withdrawal?
The symptoms of xylazine withdrawal include depression of the central nervous system, cardiovascular system, and respiratory functions. The stimulation of alpha-2-receptors during withdrawal leads to serious cardiovascular and respiratory effects, including bradycardia (slow heart rate), hypotension (low blood pressure), and severe respiratory and CNS depression.
How Long Is Xylazine Withdrawal?
Xylazine withdrawal varies in duration and severity depending on the individual’s history of use and the specific treatment approach taken. According to Ehrman-Dupre, R.,’s 2022 study, ‘Management of Xylazine Withdrawal in a Hospitalized Patient: A Case Report.’, xylazine withdrawal symptoms are resolved within 4 days with appropriate medical treatment, as demonstrated in a case where 29-year-old female patient was treated using a combination of dexmedetomidine infusion, phenobarbital, and tizanidine, later transitioning to clonidine.
How Long Does Xylazine Stay In Your System?
Xylazine stays in your system for roughly 2-4 days, similar to fentanyl which it’s commonly mixed with. According to Korn, W. R.’s 2021 study, ’High prevalence of xylazine among fentanyl screen-positive urines from hospitalized patients, Philadelphia, 2021.’, 78% of fentanyl-positive urine samples also contained xylazine in their hospital study. While fentanyl is detected for up to 72 hours (3 days) and its metabolite norfentanyl for up to 96 hours (4 days), xylazine presence is testable at levels above 10 ng/ml during this period. However, exact detection times vary based on individual factors like metabolism, amount used, and frequency of use. For the most accurate information specific to your situation, consult with a healthcare provider.
Is Xylazine an Alternative to Opioids?
Xylazine is not an alternative to opioids; it’s a veterinary sedative with different effects and risks. While opioids are used for pain relief in humans, xylazine is primarily used in animals for sedation and muscle relaxation. Its use in humans can lead to severe side effects, including respiratory depression and potential overdose, making it an unsafe alternative to opioids.
What Are The Similarities And Differences Between Xylazine And Fentanyl?
Xylazine and fentanyl share important similarities but also have distinct differences in their properties and effects. Fentanyl is a synthetic opioid developed for medical pain management, while xylazine was created as a veterinary sedative. Both substances act as central nervous system depressants and cause severe respiratory depression, but they differ in their chemical structure and primary mechanisms of action. Xylazine is an α2-adrenergic agonist, whereas fentanyl works by binding to opioid receptors. These substances are particularly dangerous when combined, as both are lethal in small amounts and their combined depressant effects dramatically increase overdose risks.
