Xylazine - New Psychoactive Substance Report
Xylazine is a tranquilizer frequently found as an adulterant in the illicit drug supply, which has CNS-depressant activity and is increasingly identified in overdose death cases.
Aegis is pleased to offer testing for xylazine to aid healthcare providers in better understanding changes in circulating drug supplies and the risks associated with these changes. If you are concerned about exposure to xylazine in individuals you are treating, Aegis provides testing for xylazine in urine and oral fluid to better equip providers with information related to recent use.
- Xylazine is a tranquilizer used in veterinary medicine as a sedative and muscle relaxant, but is not approved for human use. Along with its central nervous system depressant activity, it can cause hypotension. It is often identified as an adulterant in illicit fentanyl preparations. Because it is not an opioid, naloxone is not expected to reverse its effects. In fact, one study found naloxone present in 33.3% of overdose deaths where xylazine was detected.1
- A study of 2019 CDC SUDORS data revealed that xylazine was listed as a cause of death in 64.3% of cases in which it was detected. One or more other drugs was also listed as a cause of death.2
- Aside from overdose concerns, observational studies have described skin lesions which appear as diffuse abcesses or ulcerations in individuals who chronically inject substances containing xylazine. While xylazine has not been definitively linked as the cause of these lesions, it does frequently occur and is a visible signal which can inform harm reduction measures.3
- Xylazine represents an increasing threat to those who use illicit drugs. Steps to address the threat include expanded xylazine testing and education of clinicians and patients, to include risks and promotion of harm reduction strategies.3
In the News
Aegis Novel Psychoactive Testing Resources
CDC Morbidity and Mortality Weekly Reports (MMWR)
Notes From the Field: Xylazine-Related Deaths — Cook County, Illinois, 2017–2021
Notes from the Field: Xylazine Detection and Involvement in Drug Overdose Deaths — United States, 2019
Notes from the Field: Xylazine, a Veterinary Tranquilizer, Identified as an Emerging Novel Substance in Drug Overdose Deaths — Connecticut, 2019–2020.
1. Chhabra N, Mir M, Hua MJ, et al. Notes From the Field: Xylazine-Related Deaths - Cook County, Illinois, 2017-2021 [published correction appears in MMWR Morb Mortal Wkly Rep. 2022 May 06;71(18):641]. MMWR Morb Mortal Wkly Rep. 2022;71(13):503-504. Published 2022 Apr 1. doi:10.15585/mmwr.mm7113a3
2. Kariisa M, Patel P, Smith H, Bitting J. Notes from the Field: Xylazine Detection and Involvement in Drug Overdose Deaths - United States, 2019. MMWR Morb Mortal Wkly Rep. 2021;70(37):1300-1302. Published 2021 Sep 17. doi:10.15585/mmwr.mm7037a4
3. Alexander RS, Canver BR, Sue KL, Morford KL. Xylazine and Overdoses: Trends, Concerns, and Recommendations. Am J Public Health. 2022;112(8):1212-1216. doi:10.2105/AJPH.2022.306881