​​What is Xylazine?

Xylazine is an animal tranquilizer which is reaching the US illicit drug supply (“on the street”) where it is known as “tranq” or “tranq dope.”​ Xylazine has been linked to an increasing number of overdose deaths nationwide. Some people who use drugs are taking xylazine knowingly in combination with other drugs, especially fentanyl. Other people who use drugs are not aware their drug supply contains xylazine at all.

Why is Xylazine Dangerous?

Xylazine is not approved for human use. Xylazine is a central nervous system depressant that can cause drowsiness and amnesia and can also slow breathing, heart rate, and blood pressure to dangerously low levels. Taking opioids in combination with xylazine and other central nervous system depressants, like alcohol or benzodiazepines, increases the risk of life-threatening overdose. Xylazine is not an opioid. However, if a xylazine overdose is suspected, experts still recommend giving the opioid reversal agent naloxone (learn more about naloxone on the CDPH Naloxone web​​​page​). This is because xylazine is frequently mixed with fentanyl, which is an opioid. Another concern with xylazine is that it is associated with severe skin wounds which required advanced care.​

What is California doing?

Xylazine is still a new and emerging issue in California, and there is no evidence to suggest that xylazine is common in California’s drug supply at this time (updated March 23, 2023). However, the U.S. illicit drug supply is unpredictable and experts are concerned that xylazine may eventually penetrate the California drug supply, increasing instances of fatal overdose and serious skin infections. CDPH will continue to monitor the issue and make updates to this webpage as more information becomes available.

The CDPH Substance and Addiction Prevention Branch (SAPB) works with many partners throughout the state to monitor and address current trends at the statewide and local level. CDPH works closely with local health departments, coalitions, and other local level partners to support local prevention and intervention efforts. Working closely with local health departments, coalitions, and other local level partners allows CDPH to support local prevention and intervention efforts that address the specific and unique trends and needs of California’s communities. In addition, the CDPH Office of AIDS Harm Reduction Unit provides support to syringe services programs and harm reduction organizations serving people who use drugs across the state.

Xylazine Test Strips

Xylazine test strips (XTS) have recently been developed and are available through B​TNX; additional vendors may be added to this list in the future. CDPH has not evaluated the sensitivity or specificity of the XTS; however, the Center for Forensic Science Research & Education has evaluated the XTS available through BTNX and has determined that the test strips are appropriate for drug checking purposes (PDF, 1.76MB). ​

Resources

• Xylazine Wound Care Fact Sheet (PDF)
  
• Hoja de Cuidado de Heridas Xilacina (en Español) (PDF)​
  
• Xylazine Fact Sheet​ (PDF)​​​
  
• Never Use Alone websit​​e​
• Never Use Alone hotline: 1-877-696-1996​​
• SAMHSA’s National Helpline (Substance Abuse and Mental Health Services Administration website)
• What You Should Know About Xylazine (CDC Injury Center —​ Drug Overdose​ website)​
• California Veterinary Medical Board​
• Emerging Practices in Xylazine Wo​und Care (National Council for Mental Wellbeing webinar)​
• Xylazine: An Introduction for Service Providers Workin​g with Unhoused Individuals ​(Homeless and Housing Resource Center webinar)

​CDPH Alerts on Xylazine​

• All Facilities Letter (AFL): Xylazine in the Illicit Drug Supply and Patient Best Practices​​​​​
• California Health Alert Network (CAHAN): Xylazine in​ Illicit Fentanyl in the ​United States​​
• Issue Brief: Xylazine, Health Risks and Harm Reduction Strategies (PDF)​​​
• Letter to Local Health Officers from CDPH Director and State Public Health Offi​cer, Dr. Tomás J. Aragón​ (PDF)​​

Sources​​

• FDA Warning: Xylazine in Humans (PDF)
• DEA Public Safety Alert: DEA Reports Widespread Threat of Fentanyl Mixed with Xylazine ​
• National Institute on Drug Abuse
• DEA: The Growing Threat of Xylazine and its Mixture with Illicit Drugs (PDF)
• Center for Disease Control and Prevention's Polysubstance Use Facts​​​