Xylazine, often called “tranq,” is an animal sedative that is not approved for use in people and is increasingly mixed into the illegal drug supply, most often with fentanyl. It can cause deep sedation, slowed breathing, low blood pressure and severe skin wounds, and the CDC notes that naloxone will not reverse the effects of xylazine. You should still give naloxone in any suspected overdose, because opioids are usually involved too.
Many people who use drugs do not know tranq is in what they are taking. This guide explains what tranq is, why it is dangerous, what it means for overdose response, and what Pennsylvania is doing about it. It is written for anyone who uses drugs, loves someone who does, or simply wants to understand this growing threat.
What Is Xylazine?
The FDA explains that the drug is approved for use in animals as a sedative and pain reliever and is not safe for use in humans. Veterinarians use it to sedate large animals. In the body, it works as an alpha-2 receptor agonist, which slows down the central nervous system and causes sedation and muscle relaxation, according to a StatPearls clinical review.
The CDC describes it as a non-opioid sedative or tranquilizer. That detail matters: because it is not an opioid, overdose-reversal medications designed for opioids do not undo its effects. When mixed with opioids like fentanyl, the combination is sometimes called “tranq dope,” as the National Institute on Drug Abuse notes.
How tranq entered the drug supply
StatPearls reports that illicit use was first seen in Puerto Rico in the early 2000s and spread to Philadelphia by the mid-2010s, where the name “tranq” took hold. From there it moved into other parts of the country. A CDC study of 10 U.S. cities found that the drug was involved in less than 1% of overdose deaths in 2015 and nearly 7% by 2020, and in one Maryland sample it appeared in almost 80% of drug samples that contained opioids.
Xylazine in Pennsylvania
Pennsylvania has been hit especially hard. According to the Governor’s Office, preliminary 2023 data showed that the sedative contributed to 1,135 overdose deaths across 51 counties, a 22-fold increase from 51 deaths in 2018.
The state has responded in several ways:
- Scheduling. After a temporary scheduling order in 2023, Governor Shapiro signed Act 17 of 2024 (House Bill 1661) in May 2024, which permanently classifies xylazine as a Schedule III drug in Pennsylvania while keeping legal access for veterinary use.
- Free test strips. The Department of Drug and Alcohol Programs (DDAP) says free naloxone, fentanyl test strips and xylazine test strips are available statewide through its Overdose Prevention Program.
- Wide distribution. A 2024 DDAP report found that 84 of the 86 Overdose Prevention Program providers it identified also provide xylazine test strips.
If you live in or near Lancaster County, read more about local care options in our guide to fentanyl addiction treatment in Pennsylvania.
Health Effects and Risks of Tranq
The CDC warns that tranq can cause sedation, difficulty breathing, dangerously low blood pressure, slowed heart rate, infected wounds, severe withdrawal symptoms, and death. When it is combined with opioids, these effects add up. The CDC’s clinical fact sheet notes that it can be life threatening, especially when combined with opioids like fentanyl.
Skin wounds
One of the most distinctive dangers is severe skin wounds. StatPearls describes deep skin ulcers, abscesses and infections that can appear away from the injection site, even in people who do not inject. The FDA has warned about severe, necrotic skin ulcerations from repeated exposure, and the CDC fact sheet cautions that untreated wounds can lead to amputation or become life threatening. Any new or worsening wound deserves prompt medical care, and getting it looked at early can prevent serious infection.
It is hard to detect
The FDA notes that routine toxicology screens do not detect xylazine. That means a person may not know they were exposed, and emergency teams may need special testing to confirm it.
Overdose Response When Tranq May Be Involved
Because tranq is almost always mixed with fentanyl or other opioids, the response to a suspected overdose stays the same, with extra focus on breathing. The CDC recommends these steps:
- Call 911 right away.
- Give naloxone. It will not reverse xylazine, but it can reverse the opioid part of the overdose.
- Give rescue breaths if the person is not breathing well, since xylazine slows breathing.
- Stay with the person until help arrives.
A person may stay heavily sedated even after naloxone restores their breathing. That does not mean naloxone “didn’t work.” Keep supporting their breathing and wait for emergency responders. For a full walkthrough, see our guide on how to use Narcan (naloxone) and our overview of fentanyl overdose signs.
Reducing Harm From Tranq
If you or someone you care about is using drugs, the CDC recommends these steps to lower the risk:
- Never use alone, and carry naloxone.
- Test drugs using both tranq and fentanyl test strips. Learn how they work in our guide to fentanyl test strips.
- Get medical care for skin wounds right away to prevent infection.
These steps can save lives, but they cannot make an unpredictable drug supply safe.
Xylazine Withdrawal and Treatment
People who use tranq regularly can become physically dependent on it. The CDC fact sheet says people may experience severe withdrawal symptoms (e.g., irritability, anxiety, and dysphoria) after abrupt discontinuation. StatPearls notes there is no FDA-approved antidote for xylazine intoxication, and that standard opioid withdrawal treatments do not address this type of withdrawal on their own, so medical teams use other supportive medications.
Because tranq withdrawal often happens at the same time as opioid withdrawal, getting medical help is the safest path. Our guide to fentanyl withdrawal explains what to expect, and our article on medical detox covers when detox is needed before other treatment. After detox, ongoing care with counseling, medication for opioid use disorder when appropriate and peer support helps people build lasting recovery.
Frequently Asked Questions
Why is xylazine called tranq?
“Tranq” is short for tranquilizer. The drug is a veterinary tranquilizer, and when it is mixed with opioids the combination is often called “tranq dope.”
Does Narcan work on xylazine?
No. Naloxone (Narcan) does not reverse this sedative. But you should still give it in any suspected overdose, because tranq is usually mixed with fentanyl or other opioids, and naloxone can reverse the opioid effects.
Is xylazine illegal in Pennsylvania?
Illicit xylazine is a Schedule III controlled substance in Pennsylvania under Act 17 of 2024. Veterinarians can still use it legally for animals.
Can you get xylazine test strips for free in Pennsylvania?
Yes. Pennsylvania residents can get free xylazine and fentanyl test strips, plus naloxone, through DDAP’s Overdose Prevention Program.
Get Help for Tranq and Fentanyl Use in Lancaster, PA
If tranq or fentanyl has become part of your life or the life of someone you love, recovery is possible. The Ranch Pennsylvania Outpatient Services treats opioid and fentanyl use through a partial hospitalization program (PHP) and an intensive outpatient program (IOP), with individual, group and family therapy and medication-assisted treatment when clinically appropriate. PHP clients who need a stable, substance-free place to live can stay at our Outpatient Residence in Lancaster. If medical detox is needed first, it can be coordinated with residential care at The Ranch Pennsylvania. Learn more about fentanyl addiction and treatment, or verify your insurance today. Our admissions team is available 24/7, and calls are free and confidential.
