Xylazine is a strong sedative that has been found mixed into illegal drugs. This page explains what it is, why it is a risk, and what you can do to keep yourself and other people safer.
What is xylazine?
Xylazine is a sedative and painkiller used by vets on large animals. It is not approved for use in people. It is sometimes called “tranq”.
Xylazine is not an opioid, but it is most often found mixed with opioids such as heroin, fentanyl or nitazenes. In the UK it has also been found in fake tablets sold as codeine or diazepam, and in THC vapes.
Xylazine is a Class C drug.
Why is it a risk?
You may not know you are taking it. Xylazine is rarely sold on its own. It is added to other drugs, and you cannot see, smell or taste it.
It causes heavy sedation. Xylazine can leave people unconscious for hours. It slows breathing and heart rate and lowers blood pressure. Mixed with opioids, the risk of a fatal overdose is higher.
Naloxone does not reverse it. Naloxone only works on opioids. It is still vital to give it, because xylazine is nearly always mixed with an opioid, but the person may stay sedated after their breathing returns.
It can cause serious wounds. Xylazine is linked to painful skin ulcers that heal slowly and can become badly infected. They can appear anywhere on the body, not only where someone injects, and can also affect people who smoke or snort.
Being unconscious for a long time carries its own risks. People can be injured by lying in one position for hours, get dangerously cold, or be robbed or assaulted.
It can cause dependence. Regular use can lead to withdrawal symptoms such as anxiety, restlessness and a racing heart.
Reducing the risk
The only way to avoid the risk completely is not to take drugs that could contain xylazine. If you are going to use, these steps can lower the risk:
- Try not to use alone. If you are with others, take turns so someone is always able to respond.
- Start low and go slow. Take a small test dose first and wait before taking more, especially with a new batch or a new supplier.
- Carry naloxone. It will not reverse xylazine, but it will reverse the opioids it is usually mixed with, and that can save a life.
- Use somewhere safe. Choose a place where you will be warm, out of harm’s way, and found quickly if you become unconscious.
- Look after your skin. Check your body regularly for wounds. Keep any wound clean and covered, and do not inject into or near it.
- Get wounds checked early. Do not wait for a wound to get worse. Come and see us for wound care advice and support, or speak to your GP or a pharmacist. Go to A&E if a wound is spreading, turning black, smells, or you feel feverish or unwell.
- Avoid mixing. Using xylazine or opioids with alcohol, benzodiazepines, pregabalin or gabapentin greatly increases the risk of overdose.
- Only take tablets that came from a pharmacy, and only use vapes from a legal retailer. Products bought online or from a dealer may not contain what the packaging says.
Test your drugs. Xylazine test strips are available free from Wirral Ways. They can show if xylazine is present, but they are not a guarantee. A strip only tests the small sample you put on it, and it will not detect fentanyl or nitazenes (we have separate test strips for those). Even after a negative result, start low, go slow, and keep naloxone close.
Signs of an overdose
Someone may be overdosing if they:
- cannot be woken, or do not respond to your voice or touch
- are breathing very slowly, shallowly, or not at all
- are making snoring, gurgling or choking sounds
- have blue or grey lips and fingertips
- have pale, cold or clammy skin
- have a very slow pulse
What to do if someone overdoses
- Call 999 and ask for an ambulance. Say the person is unresponsive and not breathing properly.
- Give naloxone if you have it. Follow the instructions in the kit. Anyone can give naloxone in an emergency.
- If they are breathing, put them in the recovery position (on their side, with their head tilted back to keep the airway open).
- If they are not breathing, follow the instructions from the 999 call handler. They will talk you through what to do.
- Watch their breathing, not whether they wake up. If breathing has not improved after 2 to 3 minutes, give another dose of naloxone. If they are breathing normally but still unconscious, that may be the xylazine. Keep them in the recovery position and keep checking their breathing.
- Stay with them until help arrives. Naloxone wears off, and the overdose can return.
Do not put the person in a bath, give them anything to eat or drink, or leave them to sleep it off.
Get support
You do not have to be ready to stop using to talk to us. We offer free, confidential support, including harm reduction advice, drug test strips, wound care advice and support, and naloxone kits with training on how to use them.
Phone: 0151 556 1335
Email: wirral.services@cgl.org.uk
Website: www.wirralways.org.uk
If you are worried about someone else’s drug use, we can support you too.
Last Updated on 2 October 2026