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1 chart shows why you should care about the silent epidemic of deaths from street drug 'tranq'

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  • A new CDC report shows there has been a 276% increase in xylazine in opioid-related overdoses.
  • Xylazine, a veterinary tranquilizer, is increasingly added to street drugs to create an euphoric effect.
  • The CDC recommends using xylazine testing strips to check street drugs for contamination prior to use.
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Xylazine — also known as "tranq" or "zombie drug" — is exacerbating fentanyl related opioid overdoses, the Centers for Disease Control and Prevention reported last week. The data is grim: Between January 2021 and June 2022, there was a 276% increase of xylazine found in fentanyl-related overdose deaths in the US.

Xylazine is a veterinary tranquilizer approved by the Food and Drug Administration for use in large animals, but it is not approved for use in humans. When taken by people, xylazine can create a "euphoric, semi-conscious state,"  Insider previously reported.

Xylazine is especially dangerous because while the medication naloxone can reverse an opioid overdose, there is no known reversal medication for xylazine.

"These data show that fentanyl combined with xylazine is increasingly dangerous and deadly," President Biden's drug policy advisor, Dr. Rahul Gupta, stated in White House press releaseon June 29 about the new data.  In April, The White House declared that fentanyl in combination with xylazine is an emerging threat to the United States.  

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This chart shows how xylazine is worsening overdose deaths

Graph shows increase in xylazine in fentanyl-related overdose deaths from 2.9% in January 2019 to 10.9% in June 2022 — a 276% increase.
Number and percentage of drug overdose deaths involving illicitly manufactured fentanyl by month and xylazine detection or co-involvement from January 2019–June 2022 CDC MMWR

In 2022, drug overdose deaths nationwide hit a new record breaking high of 107,081, according to the CDC report. More than 68% of these deaths involved synthetic opioids - primarily fentanyl. The rise in xylazine is worsening that number.

This chart from the CDC report shows that in January 2019, xylazine was detected in only 2.9% of fentanyl-related opioid overdoses. By June of 2022, xylazine was detected in about 1 in 10 (10.9%) fentanyl-related opioid overdoses. Xylazine isn't just showing up alongside fentanyl, but is increasingly linked to death as well. Xylazine was listed as a cause of death in 12 cases in January of 2019, but by June of 2022 it was listed as a cause of death in 188 cases — an increase of 1,467%.

The highest instances of xylazine-fentanyl overdoses occurred in the northeast, particularly in Maryland, Connecticut and Pennsylvania. 

Everyone should care that tranq is on the rise

According to the National Institute on Drug Abuse, Xylazine is thought to slow breathing and heart rate, and reduce blood pressure to dangerously low levels, leading to a coma or even death. Chronic use is thought to lead to severe withdrawal symptoms as well as skin ulcerations.

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Although Xylazine is most commonly found in opioids, it can also be added into other drugs like cocaine and counterfeit prescriptions. Public health officials warn that any drug not purchased directly from a pharmacy could contain xylazine or fentanyl.

The CDC recommends carrying naloxone, especially if you or someone you know uses opioids.  The life-saving opioid reversal medication should be used anytime of a suspected overdose, and will not harm someone even if it turns out the person is not experiencing an overdose. 

The CDC report emphasized that newly approved xylazine testing are also critical to reducing fatalities. Xylazine test strips are "the exact same concept as fentanyl test strips," Alex Krotulski, a forensic toxicologist, said to STAT.

The test strips work by mixing a sample of the drug with water and then dipping the test strip in for several seconds to see if any xylazine is detected.  

Drugs CDC Science
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