Xylazine is a sedative medication approved only for use in animals. In recent years, it has been increasingly found mixed with street drugs, particularly opioids like fentanyl and heroin, and is often referred to as tranq or tranq dope. Xylazine is typically abused for its sedative and euphoric effects, often being mixed with opioids to enhance their impact. Its availability as a veterinary tranquilizer makes it more accessible to illicit users.
Xylazine may lead to addiction and dependence, which can cause unpleasant withdrawal symptoms, such as headaches, body pain, and mood changes. Managing xylazine withdrawal may require medications and professional treatment.
- Xylazine withdrawal symptoms can include body aches, headaches, changes in mood, and cravings.
- Managing xylazine withdrawal may include medications to reduce withdrawal symptoms and associated effects.
- Treatment for xylazine abuse may include inpatient rehab, medications, and therapy.
Understanding xylazine withdrawal
Xylazine is an alpha-2 adrenergic agonist, commonly used as a sedative in veterinary medicine. It is not approved for use in humans, although it is increasingly being found in the US recreational drug supply. Xylazine is often mixed with substances, particularly opioids such as fentanyl, and sold on the streets. [1]
Because of this, increasing numbers of people are using xylazine, intentionally or unknowingly, and experiencing its effects, including withdrawal. Xylazine is potent and fast-acting, with effects that can result in addiction and dependency. Once dependence develops, individuals are at risk of withdrawal symptoms if they stop using xylazine, as the body adjusts to changes in brain chemistry. [2][3]
The severity and duration of substance abuse involving xylazine will impact the manifestation of withdrawal symptoms. As xylazine is often combined with opioids, people may develop an addiction to both the opioid and xylazine, thus experiencing withdrawal symptoms of both. [3][4]
Some reports indicate that the presence of xylazine may alter withdrawal symptoms of opioids such as fentanyl and heroin, potentially worsening their impact. For example, during withdrawal, people may experience more headaches and a burning sensation, particularly when naloxone is administered. [5]
As its use in humans is still fairly new, Xylazine withdrawal is not yet completely understood. The effects of xylazine dependency and withdrawal are not yet extensively reported or documented in scientific literature. Routine toxicology screens currently do not include xylazine, so it can go undetected in those requiring treatment. [2]
Xylazine withdrawal timeline
Xylazine reportedly has a half-life of 23-50 minutes in humans, which means that half of the drug is cleared from the body within this time. As such, xylazine can completely leave the body within 4-5 hours after the last dose, at which time withdrawal symptoms may commence. [1]
Withdrawal may be altered or prolonged by concurrent substance use, particularly opioid use, and may be more severe in those who have been using xylazine in large doses for a long time. If xylazine is the only substance in the body, withdrawal symptoms may not be as severe. However, this can vary from person to person. [4][6]
Currently, it is not clear how long xylazine withdrawal persists. One report details an individual withdrawing from opioid and xylazine use with medically-assisted treatment. This case shows an alleviation of withdrawal symptoms within four days. [7]
Xylazine withdrawal symptoms
As xylazine withdrawal is currently not well understood, the symptoms that are likely to occur are not clearly documented or defined. According to self-reports and case studies, some of the potential symptoms of xylazine withdrawal include: [2][4][8]
- Aches and pains in the body
- Cravings
- Anxiety
- Agitation
- Low mood
- Headaches
- Nausea and vomiting
- Increased blood pressure
- Rapid heart rate
Treatments may be available to help reduce or manage xylazine withdrawal symptoms.
Xylazine withdrawal management
There are not yet any evidence-based treatments for xylazine withdrawal, due to the limited understanding about how this manifests. As research and understanding about xylazine dependence and withdrawal expands, new treatment options will likely be developed and utilized. [3]
Case studies and reports indicate that some medicinal treatments may prove beneficial in managing xylazine withdrawal symptoms, such as: [1][7]
- Clonidine: Clonidine is structurally similar to xylazine and is often used to help withdrawal symptoms from substances such as opioids and alcohol and is relatively safe. It can help reduce symptoms such as nausea, anxiety, insomnia, and pain.
- Dexmedetomidine: Dexmedetomidine is also a similar drug, commonly used as a sedative and analgesic. As such, it may help reduce withdrawal symptoms such as pain and agitation and may help reduce cravings.
Concurrent opioid withdrawal management
Xylazine is commonly taken alongside opioids as it is becoming routinely mixed with street drugs such as fentanyl and heroin. As such, individuals reducing or stopping their drug use may require treatment for opioid withdrawal symptoms as well. Helpful treatments for opioid detox and withdrawal symptoms include: [9]
- Opioid-replacement therapy: Medications such as buprenorphine and methadone are commonly used in opioid withdrawal and can reduce cravings and withdrawal. However, some self-reports indicate that these treatments are less effective when xylazine has been used alongside opioids. [4]
- Non-opioid pain relief: Paracetamol (acetaminophen) and ibuprofen might be used to help reduce aches and pains, headaches, or other pain symptoms.
- Nausea management: Clonidine, loperamide, or metoclopramide can be used to help reduce nausea, vomiting, or diarrhea.
- Benzodiazepines: Benzodiazepines such as diazepam or temazepam can be used to reduce agitation, anxiety, and insomnia.
Alongside these treatments, it is recommended for people going through xylazine withdrawal to ensure proper hydration and nutrition, particularly if they are experiencing vomiting or diarrhea.
Where to find treatment for xylazine addiction
Some people may require professional treatment to help reduce xylazine abuse, concurrent substance use, and addictive behaviors. Xylazine abuse poses serious risks. It is not approved for human use and can cause dangerous side effects, such as respiratory depression, severe hypotension, bradycardia, and even death. Additionally, chronic use can lead to skin ulcers and other tissue damage, often referred to as “skin rot.”
Various treatments are available, including:
- Inpatient rehab (find local centers here)
- Outpatient treatment programs
- Medications to assist with withdrawal, detox, and symptom management
- Support groups, such as SMART Recovery and Narcotics Anonymous
- Counseling or therapy to help reduce addictive behaviors, manage underlying trauma or mental health issues, and learn positive coping skills
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