HIPAA-compliant · Same-day admissions available
Robin Campbell, LMFT, PHD Xylazine, a veterinary tranquilizer, is increasingly being found alongside fentanyl and other drugs in the illicit drug market, creating new challenges during the ongoing overdose crisis.
Maverick
Clinical Editorial Team
Xylazine, a veterinary tranquilizer, is increasingly being found alongside fentanyl and other drugs in the illicit drug market, creating new challenges during the ongoing overdose crisis. As the presence of xylazine grows in counterfeit pills, fentanyl powder, and other illegal drugs, families across East Tennessee are hearing more about drug overdose deaths, overdose prevention, fentanyl test strips, and harm reduction strategies. Understanding xylazine fentanyl overdose signs can help people recognize a life-threatening emergency, know when to seek medical attention, and understand why tools like naloxone, drug testing strips, and recovery support services remain important.
Xylazine is a non-opioid sedative used in veterinary medicine, and it is not approved for human use. Fentanyl is a powerful synthetic opioid that can slow breathing and raise the risk of fatal overdose. When xylazine and fentanyl are mixed, the effects can be more dangerous because xylazine can cause deep sedation, low blood pressure, slowed heart rate, and severe skin wounds.
This combination can make an overdose harder to recognize and harder to reverse with naloxone alone. Naloxone can still reverse the fentanyl part of the overdose, so families should give it during a suspected overdose and call 911 right away. Early action matters because xylazine fentanyl overdose signs can include extreme sleepiness, weak breathing, blue lips, and loss of consciousness.
Families should watch for:
These xylazine fentanyl overdose signs need fast action. Call 911, give naloxone, and stay with the person until help arrives.
People exposed to xylazine and fentanyl often experience severe sedation, confusion, dizziness, and poor coordination. These drug effects may make them appear unusually tired, have difficulty speaking clearly, struggle to stay awake, or become less aware of their surroundings. As these drug effects become stronger, breathing may slow and affect heart rate and blood pressure as the risk of overdose increases. These symptoms can become more severe when other substances are involved.
Naloxone remains a critical overdose response tool because it can reverse the opioid effects of fentanyl. While naloxone does not reverse xylazine itself, many overdoses involving xylazine also involve fentanyl or other opioids. Administering naloxone may help restore breathing and buy valuable time until emergency responders arrive. Families should always give naloxone during a suspected overdose and call 911 immediately, even if they believe xylazine is involved.
Xylazine use has been linked to skin ulcers, open wounds, infections, and tissue damage. These wounds may appear near injection sites, but they can also show up on other parts of the body.
Wounds may start as red, painful, swollen, or darkened skin. Without medical care, they can worsen and lead to serious infection.
Xylazine is being found in fentanyl and other illicit drugs, often without the person knowing it. It may appear in powders, pressed pills, heroin, cocaine, methamphetamine, and counterfeit opioid pills.
This makes drug use more unpredictable because a person may not know what substances are present. Mixing xylazine with fentanyl, alcohol, benzodiazepines, or other sedatives can raise the risk of overdose, injury, and death.
Fentanyl can rapidly suppress breathing and cause fatal overdose, while xylazine adds another layer of central nervous system depression. In an overdose involving xylazine, together they can cause deeper sedation, slower breathing, lower blood pressure, and prolonged unconsciousness. This combination can make it harder for bystanders to recognize an overdose and more difficult for emergency responders to stabilize the person.
The main danger is that the person may stop breathing or remain unconscious for a long time. Delayed care can increase the risk of brain injury, wound infection, medical crisis, severe injury, or death. Families should treat any suspected overdose as a medical emergency because fast action can reduce harm and create a path toward addiction treatment.
Fentanyl acts on opioid receptors in the brain, reducing pain signals while also slowing breathing and heart function. Xylazine works differently by depressing activity in the central nervous system, leading to profound sedation and reduced alertness. Together, these substances can lower oxygen levels, impair judgment, slow circulation, and increase the likelihood of loss of consciousness. Repeated exposure can contribute to worsening physical and behavioral health problems.
Xylazine wounds can damage skin and soft tissue. Open wounds can allow bacteria to enter the body and cause infection.
Signs of infection may include redness, swelling, warmth, pus, fever, bad odor, or spreading pain. Severe wounds may need urgent medical care, antibiotics, wound care, or hospital treatment.
Xylazine has been detected in the illicit drug supply across the United States, including Tennessee. Fentanyl remains a major driver of overdose deaths, and xylazine can make fentanyl exposure more dangerous. East Tennessee families should know that xylazine exposure can happen without a person planning to use it. Research from the National Institute, Disease Control agencies, the National Drug Control Policy, the Philadelphia Medical Examiner’s Office, post mortem toxicology tests, and drug seizures shows xylazine often appears with illicit opioids and multiple substances. Health care professionals, harm reduction organizations, syringe services programs, emergency department teams, and people who use drugs now promote xylazine detection, test drugs, more than one dose of opioid overdose reversal medication, and awareness of drug alcohol and drug alcohol depend risks linked to this central nervous system depressant.
Short-Term:
Long-Term:
Xylazine and fentanyl can make an overdose harder to spot because the person may look asleep, heavily sedated, or hard to wake. Fentanyl can slow or stop breathing, while xylazine can cause deep sedation, low blood pressure, and a slow heart rate. Even after naloxone is given, xylazine may keep the person unconscious, which can confuse bystanders and delay emergency care.
Together, these effects raise the risk of respiratory failure, low oxygen, brain injury, falls, aspiration, severe infection, and death. Families should treat any suspected overdose as an emergency and call 911 right away.
Many people struggling with opioid use disorder also live with mental health conditions that affect recovery and overdose risk. Common co-occurring disorders include generalized anxiety disorder, major depressive disorder, post-traumatic stress disorder (PTSD), bipolar disorder, panic disorder, and personality disorders. Some people use opioids in an attempt to manage emotional pain, trauma symptoms, or persistent mental health symptoms. Without treating both conditions together, the risk of continued substance use and relapse often increases.
During a suspected overdose, do not assume the person will simply sleep it off or recover without help. Do not leave the person alone, put them in a cold shower, force them to walk, or give them food or drinks. Avoid delaying a 911 call while trying home remedies or waiting to see if symptoms improve. Immediate emergency response, naloxone administration, and close monitoring provide the best chance of survival.
Call 911 immediately if someone is unconscious, difficult to wake, breathing very slowly, not breathing, or showing signs of a possible overdose. Blue or gray lips, gurgling sounds, a limp body, and a lack of response to touch or voice are all warning signs that require emergency medical attention. Even if naloxone is given and the person appears to improve, emergency care is still necessary because xylazine effects may continue after opioid effects begin to reverse.
Families should call 911 immediately, administer naloxone if available, and monitor the person’s breathing. If the person is breathing but unconscious, place them on their side in the recovery position to help prevent choking. Stay with the person until emergency responders arrive and provide information about any substances that may have been used. Quick action can save a life and may create an opportunity to connect the individual with treatment afterward.
Families should seek help when drug abuse leads to repeated overdoses, worsening health, withdrawal symptoms, increased opioid use, or changes in mood and behavior. Treatment may also be needed when substance use affects work, school, relationships, physical health, or mental health. Early support can reduce overdose risk and prevent more serious medical problems.
Many health insurance plans cover addiction treatment when care is medically necessary. Coverage may include detox, MAT, residential treatment, outpatient programs, therapy, psychiatric care, and dual diagnosis treatment. Benefits vary by plan, provider, level of care, and authorization rules, so families should verify coverage before admission.
Xylazine combined with fentanyl and other drugs can increase the risk of opioid overdose, dangerously low blood pressure, soft tissue infections, and other life-threatening health consequences. Recognizing overdose signs, carrying naloxone, contacting emergency services immediately, and connecting with treatment resources can help reduce the risk of unintentional overdose deaths. Whether someone is struggling with substance abuse, injection drug use, or repeated drug overdose events, early intervention and support from healthcare providers can be an important step toward long-term recovery. This article is for informational purposes only and is not a substitute for clinical guidance from qualified healthcare professionals.
At New Hope Healthcare, as an in-network provider we work with most insurance plans, such as:
If you or a loved one are struggling with mental health challenges or substance abuse, seeking treatment and emotional support is crucial. Consulting a doctor can provide the necessary support and guidance for your teen. Reach out to New Hope Healthcare today. Our team of compassionate professionals is here to support your journey towards lasting well-being. Effective medication management is a crucial part of the treatment process to ensure safety and success. Give us a call at 866-799-0806.
Visit SAMHSA for more information.
Common signs include extreme drowsiness, slowed or stopped breathing, unresponsiveness, low blood pressure, and blue or gray lips or fingertips.
Naloxone does not reverse xylazine, but it can reverse the opioid effects of fentanyl. It should always be given during a suspected xylazine and fentanyl overdose while waiting for emergency help.
Yes. Xylazine use has been linked to severe skin ulcers, infections, and tissue damage that may develop even in areas away from injection sites.
Xylazine is often added to fentanyl to increase sedation and extend its effects, making overdoses more difficult to recognize and treat.
Call 911 immediately if a person is unconscious, difficult to wake, breathing slowly, or not breathing at all.
Yes, survival is possible with rapid emergency response, naloxone administration, rescue breathing when needed, and immediate medical care.
](https://www.cdc.gov/overdose-prevention/about/what-you-should-know-about-xylazine.html)
](https://nida.nih.gov/research-topics/xylazine)
](https://www.tn.gov/behavioral-health/substance-abuse-services/prevention/emerging-substances.html)
](https://www.tn.gov/content/dam/tn/health/documents/pdo/EmergingTrendsXylazine.pdf)
In This Article
Tags
Clinically Reviewed by: Dr. Robin Campbell, LMFT, PHD Many parents are concerned about youth vaping, especially as vaping devices, e cigarettes, marijuana products, and other tobacco products become more common among high school students and other young people.
Clinically Reviewed by: Dr. Robin Campbell, LMFT, PHD Alcohol use disorder affects people from all backgrounds and can range from risky drinking patterns to severe alcohol use disorder.
Clinically Reviewed by: Dr. Robin Campbell, LMFT, PHD Teen vaping has become a growing concern for families across Knox County. Many parents worry about nicotine addiction, THC use, e cigarettes, and the long-term effects of tobacco and nicotine exposure on adolescents and young adults.
Clinically Reviewed by: Dr. Robin Campbell, LMFT, PHD Opioid addiction can affect health, work, family, and daily life. Many patients who start with prescription pain relievers may develop substance use disorders that are hard to stop without support.
Clinically Reviewed by: Dr. Robin Campbell, LMFT, PHD A benzo taper can be an important part of recovery for people who have become dependent on Xanax, Klonopin, Ativan, or other benzodiazepines.
Clinically Reviewed by: Dr. Robin Campbell, LMFT, PHD Meth and cocaine addiction can be difficult to treat because there are no FDA-approved medications specifically for stimulant use disorder.
New Hope Health offers client-centered services. Reach out for a confidential consultation and see exactly how we'd apply these strategies to your facility.
