The Increasing Rate of Xylazine on the Streets of Massachusetts 

Learn about the dangers of xylazine, its presence in Massachusetts’ drug supply, its impact on overdoses and why naloxone remains essential. 

Xylazine, also known as “tranq,” is a veterinary sedative that is not an opioid. It has become widespread in Massachusetts’ illicit drug supply. The use of xylazine has led to spikes in overdose deaths and serious health problems in the state. By 2024, data shows that about one in four to one in three illegal opioid samples contained xylazine. This increase is especially noticeable in western Massachusetts. 

It is vital for residents of the state to understand the signs and dangers of xylazine. Moreover, it is critical that everyone knows what to do if they encounter it. Continue reading to understand the increasing rate of xylazine on the streets of Massachusetts and how to stay safe.  

What is Xylazine? 

Xylazine is a powerful veterinary drug used to sedate animals and reduce pain. It works by activating alpha-2 adrenergic receptors in the brain. This activation reduces the release of neurotransmitters such as norepinephrine and dopamine.  

As a result, it causes sedation and pain relief and significantly depresses the central nervous system. In humans, xylazine can lead to respiratory depression, which can be deadly. It can also slow the heart rate and lower blood pressure to dangerous levels. 

Although this drug is for veterinary use, xylazine has entered the illegal drug market. Researchers discovered it as an adulterant in heroin in Puerto Rico in the early 2000s. Its use as an additive then spread to the mainland United States.  

By the late 2010s, it became common in cities like Philadelphia and Boston. Currently, xylazine is present in illicit street drugs mixed with other substances. It is often combined with heroin and fentanyl, but also with cocaine, methamphetamine and benzodiazepines. 

Is Xylazine in Massachusetts? 

Some quick facts about Xylazine in Massachusetts include:  

Xylazine shows up in a significant percentage of opioid samples in Massachusetts. Studies indicate it was present in over 25-30% of samples tested by the Massachusetts Drug Supply Data Stream as of 2023. 

Xylazine is reportedly involved in many fatal opioid overdoses in the state. In 2023, it was involved in roughly 10% of overdose deaths. 

Although initially limited to certain areas, by 2022, xylazine was present across the state, including in Western Massachusetts and other regions. Some reports indicate the presence in 50% to 75% of samples in specific locations. 

The state has established a specialized commission to study the effects of xylazine. They hope to provide recommendations to address its spread, with reports of its reach continuing into 2026. 

 If you are concerned about Xylazine in your possession, the Massachusetts Substance Use Helpline is available for resources: 800-327-5050. 

What does Xylazine do to Humans? 

 People may smoke, inject or snort substances containing xylazine without knowing it is present. Its illicit use increases health risks because it is not safe for humans and can damage the brain and body. On the streets, xylazine is called “tranq” or “tranq dope.” When combined with heroin or fentanyl, it raises the chances of illness, overdose and death. 

Why is xylazine dangerous? The following are some of the most common effects:  

Extreme Sedation: Xylazine is a potent central nervous system (CNS) depressant, leading to extreme drowsiness, unresponsiveness and “nodding out” for several hours. 

Respiratory Depression: It reduces breathing rate, which can cause dangerously low oxygen levels, especially when used with opioids. 

Cardiovascular Problems: Xylazine significantly lowers blood pressure and slows the heart rate. 

Severe Skin Wounds and Necrosis: Regular use often results in severe, necrotic skin ulcers (a serious wound characterized by dead, blackened, or weakened tissue, often caused by infection, severe ischemia, or injury) and abscesses. These wounds can occur anywhere on the body, not just at injection sites, and may require amputation if untreated. 

Unconsciousness and Memory Loss: Users commonly experience deep, lasting sedation, leading to prolonged unconsciousness and memory issues. 

Physical Dependence and Withdrawal: Long-term use can cause physical dependence, with withdrawal symptoms including agitation, anxiety, restlessness and high blood pressure.  

Tranq has joined the ranks of deadly drugs affecting the opioid epidemic, as people seek stronger sedative effects. Xylazine’s sedative effects are much stronger and last longer than many other depressants. This raises concerns about its role in overdose deaths and public health. 

Signs of a Xylazine-Involved Overdose 

A xylazine-related overdose typically causes prolonged, deep sedation and significant respiratory depression. Other signs include: 

Profound Sedation/Unconsciousness: Severe drowsiness or prolonged unconsciousness that may last up to 8 hours. 

Slowed/Difficulty Breathing: Intense respiratory depression (bradypnea) or apnea. 

Cardiovascular Changes: Critically low blood pressure (hypotension) and a slow heart rate (bradycardia). 

Lack of Response to Naloxone: If a suspected opioid overdose does not improve after one or two doses of naloxone. Or, if the person remains heavily sedated even after breathing resumes, suspect xylazine. 

Skin Wounds/Necrosis: Although not an immediate sign, the presence of unusual, deep, rapidly developing skin ulcers or abscesses is an indication. These are often away from injection sites and strongly indicate chronic xylazine use. 

Other Symptoms: Dry mouth, hypothermia (low body temperature) and confusion. 

If you suspect someone is experiencing an overdose on xylazine mixed with fentanyl, immediately call 911. Stay with the person until paramedics arrive if you can.  

Does Naloxone Work on Xylazine? 

Narcan (naloxone) cannot reverse xylazine effects since xylazine is a non-opioid sedative. However, because xylazine is often combined with fentanyl or other opioids, administering Narcan is essential if an overdose is suspected.  

How to Respond to a Xylazine Overdose 

Responding to a xylazine overdose requires immediate action. Follow these steps if you suspect a xylazine overdose:  

Call 911 immediately and inform the dispatcher that someone is unresponsive and you suspect an overdose involving xylazine. 

Check responsiveness and breathing: do this by shaking the person and shouting. If they are unresponsive and breathing is slow or absent, act without delay. 

Administer naloxone (Narcan): give one dose, even if you suspect xylazine, as it addresses the often-present opioid (fentanyl). 

Perform rescue breathing or CPR: if the person is not breathing or has a faint pulse, this is critical. Xylazine can significantly slow breathing. Provide rescue breaths (one every 5 seconds) or perform CPR. 

Redose naloxone: if, after 2-3 minutes, the person remains unresponsive or is not breathing, administer another dose. 

Place in the recovery position: if breathing but unconscious, turn the person onto their side to prevent choking if they vomit. 

Stay and monitor: remain with the individual until emergency responders arrive. The sedative effects of xylazine can last 4-8 hours. They may be groggy or unconscious even after naloxone has restored breathing. 

Remember that in Massachusetts, the Good Samaritan Law safeguards you. This law shields individuals who offer reasonable, good-faith emergency assistance from civil liability. This also includes a specific law that protects people who call 911 during an overdose. For more information, please refer to the CDC overdose prevention guidelines.  

Support for Opioid Addiction Involving Xylazine at Middlesex Recovery 

 Because xylazine is often mixed with fentanyl and other opioids, treatment may begin by addressing co-occurring opioid addiction and connecting individuals with appropriate medical support for other health concerns. Middlesex Recovery provides evidence-based treatment for opioid use disorder, including medication-assisted treatment and ongoing support tailored to each person’s needs. If you or a loved one is using opioids that may be mixed with xylazine, contact Middlesex Recovery today. Our team can help you explore treatment options for opioid addiction and connect you with additional resources when needed.