Introduction

Xylazine is a novel and highly lethal medication that has surfaced in the US in recent years. Xylazine was once created as a veterinary sedative, but it is currently being combined with fentanyl and other opioids, which is causing severe overdose deaths and a spike in public health emergencies all throughout the country. The medicine, sometimes known as the “zombie drug,” has become well-known because of its terrible side effects, which include extreme drowsiness, open sores, and, frequently, death.

What is Xylazine?

Mainly used in veterinary medicine, especially for large animals like horses and cattle, xylazine is a non-opioid sedative, analgesic, and muscle relaxant. Although it is not authorized for use in humans, there are significant worries about its growing prevalence in illegal drug markets. In order to amplify the effects of opioids like fentanyl, xylazine is frequently mixed with them; however, this greatly raises the danger of overdose and serious health repercussions.

How Xylazine Works in the Body

Because xylazine slows down brain activity, it serves as a central nervous system (CNS) depressant, resulting in drowsiness, pain alleviation, and muscular relaxation. By acting on alpha-2 adrenergic receptors, xylazine intensifies the euphoric and pain-relieving effects of opioids like fentanyl, which target opioid receptors. Especially when taken with opioids, this combination of actions might result in a deadly mix of sedation, respiratory depression, and other potentially fatal symptoms. Unlike traditional opioids, Xylazine does not respond to naloxone, the standard overdose reversal drug. This makes it even more dangerous, as users may not know they are exposed to it, or they may believe that naloxone will help them when it won’t.

Xylazine’s Role in the Opioid Crisis

For more than 20 years, the opioid crisis in the US has been a serious public health issue; however, Xylazine is making the situation worse. The bulk of overdose deaths are caused by the powerful synthetic opioid fentanyl, but the presence of xylazine is making matters worse.
To save money and enhance the effects of the medicines, drug dealers are increasingly mixing fentanyl with xylazine. Overdosing is more likely when Xylazine is used since it becomes much harder for users to determine how strong their medication is. Some users claim that the medication has a numbing, drowsy effect that makes them want to take more, which raises their chance of dying.

The “Zombie” Effect

The term “zombie drug” is frequently used to describe xylazine because of its visually unsettling effects on users. The development of severe skin ulcers and open sores, which can get infected and result in necrosis (tissue death), is one of the most terrifying side effects of long-term Xylazine use. If left untreated, these skin lesions, which are frequently found on the hands and feet, might lead to amputation.  Xylazine’s sedative effects also make users look almost catatonic, with a sluggish, zombie-like stride and a decreased ability to react to their environment. Heavy drowsiness from the medicine can make people look confused or uncommunicative, which supports the term “zombie” even more.

Rising Cases of Xylazine in the U.S.

The Centers for Disease Control and Prevention (CDC) and other health organizations have recently reported that the number of overdose deaths in the US is rising quickly. In certain areas, Xylazine has been found in drug-related deaths more frequently, especially in East Coast towns like Philadelphia and Baltimore. For instance, Xylazine was implicated in almost 33% of all fentanyl overdose deaths in Philadelphia in 2020, which is a considerable rise over prior years.

As of 2022, xylazine was prevalent in both urban and rural locations, and it was implicated in overdose deaths in 33 states. Concerns about Xylazine’s growth and its contribution to the opioid crisis have grown, according to the National Institute on Drug Abuse (NIDA).

Health and Safety Concerns

The use of xylazine carries serious and complex health hazards. Among the most frequent complications are:

1. Respiratory Depression: Xylazine, like opioids, can decrease breathing, increasing the risk of overdose death or suffocation.

2. Severe Skin Ulcers: As previously indicated, one of the most common adverse effects of Xylazine use is the emergence of excruciating, necrotic sores that may need to be surgically treated.

3. Bradycardia (Slow Heart Rate): Xylazine, particularly when taken with other medications, can cause a substantial reduction in heart rate, which may result in cardiac arrest.

4. Sedation and Coma: Extended usage may result in severe sedation, which increases the risk of coma or brain damage.

5. Infection: If left untreated, the open wounds from using Xylazine may become infected and result in sepsis or other potentially fatal illnesses.

Treatment and Challenges

Xylazine overdose currently has no known particular antidote, and naloxone and other conventional overdose reversal techniques don’t work. For medical personnel who respond to overdose instances, this poses a serious problem. In order to counteract the effects of the drug, people who overdose on fentanyl coupled with xylazine frequently need significant medical treatment, which may include mechanical ventilation and the injection of additional sedatives.

The fact that Xylazine is still mostly utilized in veterinary settings and that the general public is unaware of the medicine has made efforts to stop its spread difficult. However, health organizations are urging further research into possible treatments and increased access to harm reduction programs as the substance continues to permeate the illegal drug market.

Government Response and Harm Reduction

The CDC, DEA, and municipal health departments are among the government organizations that have started to acknowledge the danger that Xylazine poses.

Among the measures under consideration are:

Tighter Regulation: To stop its illicit use, certain states are advocating for tighter regulations on xylazine.

Public awareness campaigns: teaching the general public—particularly vulnerable groups—about the risks posed by xylazine and how it contributes to opioid overdoses.

Improved Harm Reduction Services: Increasing the availability of naloxone distribution programs, safe consumption areas, and other harm reduction resources.

Notwithstanding these initiatives, Xylazine’s expansion still presents serious obstacles, and resolving the issue will call for a concerted effort by federal, state, and local organizations.

Conclusion

Xylazine is potent and hazardous medication that is contributing to the continuing opioid problem in the US. Overdose deaths are alarmingly on the rise due to its combination with fentanyl and other opioids, and its distinct adverse effects, including severe skin ulcers and intense sleepiness, have earned it the ominous moniker of the “zombie drug.” The increasing amount of xylazine in illegal drug markets highlights the urgent need for further study, increased public awareness, and better health interventions to address this rising epidemic, even though remedies are still being developed.