Xylazine and Opioid Overdosing:
What You Need to Know

Learn about xylazine and opioid overdosing to understand the dangers and symptoms, and find ways for long-lasting recovery at Black Horse Health.

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The Dangers of Xylazine and Opioid Overdosing

At Black Horse Health, we recognize the growing concerns surrounding xylazine, which is a dangerous drug increasingly found in the illicit opioid supply. Its presence heightens the risks of overdose and complicates traditional harm reduction efforts.

Our team of skilled and compassionate specialists has over 100 years of combined experience of helping individuals heal from substance use and other co-occurring disorders.
We are committed to providing education, resources, and evidence-based treatment options to support you or your loved one in navigating the dangers of opioid use and overdose prevention.
With comprehensive services including medication-assisted treatment (MAT), harm reduction strategies, and medical detox, we work with you to create a path toward safety and recovery.

What Is Xylazine?

Xylazine is a potent sedative primarily used in veterinary medicine. Veterinarians administer xylazine to animals such as horses, cattle, and other large livestock. It provides sedation, muscle relaxation, and pain relief.

Xylazine is not approved for human consumption due to severe and unpredictable effects.
Xylazine and Opioid Overdosing

How Does Xylazine Work?

Xylazine acts directly on the central nervous system by binding to specific receptors in the brain. This binding slows nerve signals, reducing overall brain activity.1
As a result, the drug induces profound sedation and drowsiness, significantly lowering heart rate, blood pressure, and respiratory rate. Due to these powerful effects, human exposure carries a high risk of overdose and severe complications.

The Emerging Threat of Xylazine in the Opioid Crisis

The growing presence of xylazine in the opioid supply presents a complex and dangerous new dimension to the ongoing opioid crisis.
Xylazine is increasingly found in illicit drug supplies, particularly in fentanyl and heroin. Street names include “tranq” or “tranq dope,” referring to its tranquilizing effects.
Xylazine is commonly detected in:
  • Powdered fentanyl
  • Pressed pills marketed as opioids
  • Injectable heroin supplies

The Need for Awareness

Awareness of xylazine’s dangers is necessary to prevent overdoses and improve treatment outcomes. Many individuals with an opioid substance use disorder (SUD) may not know the substance contains xylazine, which increases their vulnerability to severe health consequences.

However, testing for xylazine in street drugs is limited, making early detection difficult.

Xylazine Harm Reduction

Harm reduction strategies help minimize risks associated with xylazine exposure. Safe-use education, supervised consumption sites, and drug-checking programs can reduce the likelihood of severe overdoses.
Black Horse Health offers tailored treatment programs that address the unique challenges of xylazine-related overdoses.

The Dangers of Xylazine and Opioid Overdosing

Xylazine and opioids are a dangerous mixture that complicates one’s overdose response and poses unique challenges for both individuals and healthcare providers.

Increased Risk of Fatal Overdose

Xylazine significantly amplifies respiratory depression when combined with opioids such as fentanyl. Opioids alone slow down breathing by acting on the brain’s respiratory centers.2

Adding xylazine increases this suppression, reducing breathing rates even further. This combination rapidly decreases oxygen levels, quickly leading to unconsciousness and dramatically increasing the likelihood of fatal overdose.

Why Standard Opioid Overdose Treatments May Be Less Effective

Standard opioid overdose responses involve administering naloxone (Narcan), a medication that reverses opioid effects. However, naloxone has no impact on xylazine’s sedative properties.3
In cases of xylazine and opioid overdosing, naloxone may restore breathing temporarily by reversing opioid effects, but the victim often remains heavily sedated and at risk due to the xylazine.
This incomplete reversal complicates emergency treatment and requires immediate professional medical intervention.

The Link Between Xylazine and Tissue Damage

Additionally, individuals who take substances containing xylazine frequently develop severe skin ulcers and tissue necrosis.4
Injection sites become infected easily, leading to deep, painful wounds that resist normal healing processes. These necrotic ulcers can rapidly progress, causing extensive tissue death and serious infections, severely compromising physical health.

Xylazine Infections: Severity and Outcomes

Xylazine-related skin infections often progress to sepsis, a life-threatening response to infection. Without rapid medical intervention, sepsis can lead to widespread organ failure.

Additionally, severe infections and tissue death associated with xylazine SUD frequently require surgical interventions, including amputations. Individuals may face chronic pain, permanent disability, and ongoing medical issues requiring prolonged care and rehabilitation.

The Need for Advanced Medical Intervention in Overdose Cases

Cases involving xylazine and opioid overdosing require advanced medical intervention. Emergency treatment often includes respiratory support, intravenous fluids, and medications to stabilize heart rate and blood pressure.
Black Horse Health offers specialized care for xylazine and opioid overdosing or detox needs. Our medical team provides continuous monitoring and advanced treatment for overdose complications. We help clients recover from both immediate health risks and long-term effects of xylazine exposure.

The Signs of Xylazine and Opioid Overdosing

Distinguishing between opioid and xylazine overdosing is crucial for effective intervention, as the symptoms present with notable differences that necessitate tailored responses.
For each person experiencing an overdose, the symptoms can vary depending on the amount of the substance taken, duration, and when medical treatment is sought out. However, some common symptoms for each situation include:

Opioid Overdoses

Understanding the classic signs of an opioid overdose is essential for timely intervention, as these symptoms directly reflect the drug’s impact on critical bodily functions.
Opioid overdoses typically cause symptoms like:
  • Severely slowed or stopped breathing
  • Pinpoint pupils
  • Loss of consciousness
  • Pale or clammy skin
These symptoms occur because opioids depress the body’s respiratory and nervous systems.

Xylazine Overdoses

Xylazine overdoses share several symptoms with opioid overdoses.
Shared symptoms can include:
  • Slowed breathing
  • Loss of consciousness
  • Reduced heart rate
However, xylazine introduces additional symptoms, including profound sedation and severely lowered blood pressure.

How to Respond Effectively in an Overdose Situation

Responding effectively to suspected xylazine and opioid overdosing situations involves clear, prompt actions.
The following steps should be followed:
  1. Call emergency services immediately: Dial 911 right away. Inform emergency personnel that you suspect xylazine involvement if you know. 
  2. Administer naloxone (Narcan): If available, administer naloxone to reverse opioid effects; while it may not fully reverse the overdose due to xylazine, naloxone can temporarily restore breathing.
  3. Check breathing and responsiveness: If the person is not breathing or responding, provide rescue breathing or CPR if trained to do so, until emergency help arrives.
  4. Positioning: Lay the person on their side in the recovery position to prevent choking if they vomit.
  5. Stay with the person: Remain present to monitor their condition until professional help arrives; provide medical responders with detailed information about substances the person may have taken, including mentioning xylazine specifically.
These direct actions can significantly impact survival chances and recovery outcomes during a xylazine and opioid overdosing incident.
Xylazine and Opioid Overdosing

Harm Reduction Strategies for Xylazine-Contaminated Opioids

Harm reduction practices can help individuals identify xylazine contamination in opioids before any potential danger.
Some harm reduction strategies and practices that individuals can utilize include:

Test Strips and Drug-Checking Practices

Regular testing provides critical information that can reduce the risk of unexpected xylazine and opioid overdosing. Harm reduction organizations distribute these test strips widely, encouraging individuals to test substances before consumption.
Harm reduction can also include laboratory testing, which provides detailed analyses of drug samples submitted by individuals or organizations. These tests confirm exact contents and concentrations of substances, offering precise warnings about dangerous contaminants like xylazine.
Making drug-checking more accessible contributes significantly to reducing overdoses linked to xylazine.

Safe Use Practices and Overdose Prevention Education

Safe use practices focus on additional strategies to reduce harm, including:
  • Taking opioids with others present, as having someone nearby increases the chance of receiving medical help in time.
  • Avoiding mixing the opioid with other depressants, as this can amplify sedation and respiratory depression, increasing overdose risk.
  • Recognizing overdose symptoms by educating people about the differences between opioid and xylazine overdosing can improve emergency response.

Education on xylazine and opioid overdosing should also include training on administering naloxone and performing rescue breathing.

Access to Harm Reduction Centers

Harm reduction centers provide medical supervision, overdose prevention tools, and education on safer drug use.

These centers offer sterile supplies, testing services, and connections to treatment programs. Expanding these resources can lower the number of fatal overdoses and improve access to medical care.

These centers also provide access to healthcare professionals who can help treat xylazine-related complications.

Treatment Approaches for Xylazine and Opioid Addiction

Addressing the complex challenges of xylazine and opioid addiction requires specialized treatment approaches to mitigate the severe withdrawal symptoms associated with these substances.

The Need for Medically Supervised Detox

Xylazine withdrawal is different from opioid withdrawal.
When individuals attempt to stop taking opioids, they often experience opioid withdrawal symptoms like sweating, muscle pain, nausea, and cravings. However, xylazine withdrawal adds extreme agitation, anxiety, high blood pressure, and a rapid heart rate.
Because xylazine is a sedative, stopping it suddenly can overstimulate the nervous system. Without medical supervision, this can lead to dangerous complications, including heart problems and severe dehydration.

Medically Supervised Detox

Medically supervised detox provides 24/7 monitoring and symptom management. Clinicians may use medications to stabilize the heart rate, control agitation, and manage withdrawal discomfort.
Since xylazine does not respond to naloxone, people experiencing xylazine and opioid overdosing may need additional respiratory support and extended medical care during detox.

Addressing Opioid and Xylazine Dependency

Individuals with opioid or xylazine dependency need a treatment plan that addresses both substances.
This includes:

Medication-Assisted Treatment (MAT)

Opioid addiction is managed with medications like methadone or buprenorphine, which reduce cravings and withdrawal symptoms. However, MAT does not treat xylazine withdrawal, requiring additional medical and psychological support.

Behavioral Therapy

Cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) can help clients understand addiction patterns and develop coping strategies. Since xylazine increases withdrawal distress, therapy plays a role in preventing relapse and improving emotional stability.

Dual Diagnosis Treatment

Many people exposed to xylazine and opioid overdosing have underlying mental health conditions, such as PTSD, anxiety, or depression. Treatment plans should include psychiatric care and therapy to address these co-occurring disorders.

Education on Xylazine

Comprehensive treatment also includes education about xylazine-contaminated opioids, helping people recognize risks and adopt harm reduction strategies. Many individuals unknowingly consume xylazine, making awareness a key part of long-term recovery.
At Black Horse Health, we provide specialized care for people affected by xylazine and opioid overdosing. Our medical team offers detox and long-term treatment to help clients recover safely and reduce future health risks.
Xylazine and Opioid Overdosing

Our Approach to Treating Xylazine and Opioid Addiction

Black Horse Health provides specialized care for people struggling with addiction involving xylazine and opioid overdosing.

Our experienced medical team understands the unique challenges these substances present. We offer targeted treatments that address both drugs, ensuring safe, effective withdrawal management and lasting recovery.
Our facility combines medical expertise with compassionate care. Treatment plans are customized to your personal needs. This personalized approach helps you manage withdrawal safely and comfortably.

Integrated Mental Health Support

At Black Horse Health, we recognize that mental health and substance abuse often occur together. Treating xylazine and opioid addiction also involves addressing underlying mental health concerns like anxiety, depression, or trauma.

Our team includes experienced mental health professionals offering CBT, DBT, and trauma-informed counseling.

We focus on your individual needs, developing treatment plans that address mental health conditions alongside addiction. This integrated approach supports lasting recovery from xylazine and opioid overdosing.

Holistic Approach for Physical and Psychological Health

Black Horse Health also emphasizes physical health by providing wellness through nutrition support and supervised physical activities. These practices help rebuild your physical strength and overall well-being.
Combining medical care with emotional and psychological support provides the best pathway to lasting recovery from xylazine and opioid overdosing.

Harness the Power of Wellness

People struggling with xylazine and opioid overdosing face severe health risks without medical intervention.

Detoxing without supervision can lead to extreme withdrawal symptoms and an increased likelihood of relapse. Seeking professional treatment provides a safer and more effective path to recovery.

Black Horse Health offers individualized care to support each step of the recovery process. Our team works with clients to build a treatment plan that addresses both physical health and long-term sobriety.

Recovery is possible with the right support, medical care, and harm reduction strategies. Together, we can create a future you love.
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  • © Black Horse Health 2025