Xylazine, a powerful non-opioid sedative often referred to as “tranq,” “tranq dope,” and “zombie drug” is wreaking havoc across major cities in the United States with its devastating effects. It can literally rot the user’s skin and cause raw wounds that can become severe and spread rapidly with repeated exposure. The crusty ulcerations can even lead to amputation if left untreated. Xylazine is approved for veterinary use but is not safe for humans, and those who overdose on it do not respond to naloxone—the most common overdose reversal treatment.

The drug initially appeared in Philadelphia before migrating westward to San Francisco and Los Angeles, where it has been found mixed with heroin or fentanyl. As frightening as this trend is, what makes it particularly concerning is that xylazine isn’t listed as a controlled substance either for animals or humans, making it an incredibly dangerous gray area. Hospitals usually do not test for it in routine toxicology screenings either.

One example of xylazine’s devastating effects comes from Tracey McCann, 39—a Philly user who suddenly developed xylazine-specific wounds near her opioid injection sites; she said in an interview with the New York Times that she would wake up every morning crying because of the pain inflicted by her arms dying away quickly due to this lethal combination of substances.

What gives xylazine its appeal among users is that its combination with other illicit substances extends their high from opioids like fentanyl. Shawn Westfahl, an outreach worker with Prevention Point Philadelphia, expressed his concern on how far this trend had gone when he said “It’s too late for Philly…Philly’s supply is saturated. If other places around the country have a choice to avoid it, they need to hear our story.”

You could say that the worrying “tranq” trend has come at a particularly alarming time given that 2,668 New Yorkers died of overdoses in 2021 according to data from the New York City Department of Health—a sobering figure which experts believe could worsen significantly due to xylazine’s prevalence in 36 states across America including 25% alone being found in samples from New York City according to the New York Times. This sentiment was echoed by Dr Gary Tsai from the LA County Department of Public Health who believes that should this drug remain prevalent “it would increase deaths from overdoses”, given “the worst overdose crisis in history” we are now facing nationally and locally alike.

This worry was further solidified when earlier this month San Francisco health authorities announced low levels of xylazine were found in the systems of four people who overdosed without their knowledge—which points towards this zombie drug being hidden within drugs unbeknownst to unsuspecting users. Sadly, people already suffering through substance use disorders who get hooked on this zombifying drug claim that it takes away any kind of joy they got out of getting high prior as one user said during an interview “Tranq is basically zombifying people’s bodies”.