What Is Xylazine, and Why Is Its Use Growing in Chicago?

Xylazine is among the most dangerous illicit drugs circulating in Illinois and the United States, and the number of xylazine-associated deaths is growing. This potent substance is naloxone-resistant, increasing the risk of overdose deaths. An opioid and xylazine combination is known as tranq, and sellers distribute it because it’s more potent and costs less than other illegal and nonprescription drugs.

Immediate medical care is crucial when an individual overdoses on opioids and xylazine because cardiovascular and respiratory support can save an individual’s life. The right treatment program can help individuals recover from substance use and prevent xylazine-related health complications and death.

Why Xylazine Use Is Growing in Chicago

Xylazine is a growing public health threat in Chicago and across the United States. It’s a harmful substance that dealers often mix with other drugs, increasing their potency and health risks. Consider the following information to learn more about xylazine.

What Is Xylazine?

Xylazine is a non-opioid animal tranquilizer the U.S. Food and Drug Administration (FDA) approved for veterinary use. It is not approved for human consumption, but some individuals use it to feel effects similar to those elicited by substances like misused prescription and illegal drugs.

Xylazine’s Increased Use in Chicago

Xylazine use is a growing trend in Cook County, Illinois. The Cook County Health Department and Medical Examiner’s Office studied substance-related deaths between 2017 and 2021 to track the growth of xylazine use. The analysis recorded each of Cook County’s unintentional or undetermined substance-related deaths that tested positive for xylazine serum. Forensic analysts also conducted routine postmortem toxicology tests for other substances such as cocaine, fentanyl, fentanyl analogs, and naloxone.

The Centers for Disease Control and Prevention (CDC) reviewed Cook County’s analysis of xylazine-related overdose deaths to ensure it was consistent with CDC policies and federal laws. Cook County reported that a total of 210 people died from xylazine-related overdoses during the analysis period. The study revealed that xylazine-related deaths gradually increased between 2017 and 2021, and they peaked at the end of the study in October 2021. 

The percentage of deaths involving fentanyl and xylazine reached 12.2% by 2021. Forensic analysts found fentanyl or fentanyl analogs in 99.1% of xylazine-related deaths, revealing that most people who died from xylazine use had taken a mixture of xylazine and fentanyl. Analysts also detected the following substances in the xylazine-associated deaths:

Cocaine: 41.9% of the xylazine-related deaths also involved cocaine.
Diphenhydramine: Diphenhydramine showed up in 78.1% of the xylazine-related deaths.
Quinine: 33.8% of the overdose death analyses also revealed the presence of quinine.
Naloxone: 33.3% of people who died from xylazine use also had naloxone in their systems, revealing that the naloxone did not reverse xylazine’s effects.

Why Is Xylazine Use Growing in Chicago?

Xylazine is involved in Illinois’ increasing overdoses and health complications because it is a large part of the illicit drug supply. Drug trafficking operations distribute a growing amount of fentanyl and xylazine due to the substances’ potencies and low costs. In some cases, people use xylazine to induce sleep during drug-facilitated crimes.

What Is Tranq?

Tranq is a slang term for a xylazine and opioid mixture that typically contains fentanyl. The U.S. Drug Enforcement Administration (DEA) has found fentanyl and xylazine mixtures in 48 of the country’s 50 states, making it a widespread challenge. Illicit drug distributors often add xylazine to other drugs, such as benzodiazepines, cocaine, and methamphetamine, but fentanyl is the most common opioid in this mixture.

Dealers typically mix xylazine with fentanyl because both substances are cheaper and stronger than others. Individuals who develop addictions to opioids such as heroin or morphine gradually build tolerance and seek stronger drugs such as tranq to feel the same effects. Some individuals may use tranq unknowingly if they believe a drug contains only opioids, and some people intentionally use tranq because xylazine can extend an opioid’s euphoric effects.

Dealers can increase their profits by selling cheaper, more potent substances such as xylazine and fentanyl, and they typically lack concern for how it may affect the individuals consuming the drugs. Individuals use tranq for its sedation effects, but it also causes severe health risks and complications.

The Dangers of Consuming Xylazine

Xylazine is harmful because it causes the following effects:

Low or high heart rate and blood pressure: Lowered or increased heart rate can cause fainting or dizziness, while high blood pressure can lead to a stroke or heart disease.
Respiratory depression: Respiratory depression is when an individual stops breathing, and it’s the main cause of opioid-related deaths. Opioids stimulate receptors in the brain, releasing chemicals that tell the body to slow or stop breathing. 
Skin ulcers: Xylazine causes skin ulcers, which are severe skin wounds that can grow and develop dead skin or tissue. Xylazine-related skin ulcers can develop at injection sites or other areas on the skin, and they can develop infections. Skin ulcers require complex wound care, and the healing process is usually slow and challenging. Untreated or severe skin ulcers can lead to amputation.
Low blood sugar: An individual’s blood sugar level can rapidly drop when they use xylazine, and they may feel tired, dizzy, confused, or weak.
Coma or death: Because of its strong effect on the brain and nervous system, xylazine can cause a person to enter a comatose state. Since drugs such as xylazine and fentanyl slow breathing, they can limit the amount of oxygen the brain receives. Inadequate oxygen levels in the brain can cause a coma, death, or brain damage.
Severe withdrawal: Individuals may experience stronger withdrawal symptoms after using xylazine than they would after using other drugs. It’s essential to seek treatment and withdrawal management services to recover from substance use and maintain sobriety.

The Risks of Using Xylazine With an Opioid

Using xylazine or opioids individually is dangerous, and combining them increases the risk of health complications and death. Professionals refer to the simultaneous use of multiple drugs as polysubstance use. It’s a significant public health concern because it can enhance and lengthen each drug’s effects. The DEA previously considered fentanyl the country’s deadliest drug threat, and lacing it with xylazine makes it even more fatal.

Mixing opioids with xylazine is dangerous because xylazine does not respond to overdose medications like opioids do. A life-saving medication such as naloxone can reverse the effect of opioids such as fentanyl and heroin, but it cannot reverse the effect of xylazine. 

Despite its ineffectiveness in reversing xylazine’s effects, you should still administer naloxone if you encounter someone experiencing an overdose because there might also be opioids in their system. For example, if a person consumes fentanyl and xylazine, naloxone can reverse the effects of the fentanyl in their system and increase their chances of survival with medical treatment.

Signs of a Xylazine and Opioid Overdose

A person can overdose on xylazine, opioids, or both. Understanding common overdose signs can help you respond when necessary and potentially save a life. An individual may be experiencing an overdose if you notice the following signs:

Constricted or small pupils
Slow breathing or signs of trouble breathing
Unresponsiveness
Rapid or decreased heart rate
Low blood pressure
Nausea or vomiting
Cold, clammy skin
Blue fingernails and lips
Confusion
Dizziness

Efforts to Reduce Xylazine and Opioid Use

Illinois continuously works toward reducing xylazine and opioid use and the harm each causes. The state and city implemented the following efforts to help decrease xylazine use and overdose deaths:

Education: Education about the harmful effects of xylazine and opioids raises awareness and encourages people to avoid harmful substances.
Increased monitoring: Increased monitoring and surveillance in Cook County and surrounding jurisdictions can help reduce xylazine and opioid distribution. Law enforcement officials focus on areas with high fentanyl use because dealers often mix this substance with xylazine.
Test strips: Xylazine test strips can help individuals detect the harmful substance. People who use substances can purchase the strips commercially and test drugs for xylazine before consuming them. While avoiding all drugs is the best way to stay safe, the strips can help reduce xylazine-related deaths if individuals do consume substances.

The U.S. government also works toward reducing xylazine-related deaths. The White House’s Office of National Drug Control Policy considers xylazine and fentanyl mixtures an emerging threat because they significantly affect the country’s opioid crisis. 

In July 2023, the U.S. government formed a National Response Plan to help mitigate the threat of xylazine and fentanyl mixtures. This plan emphasizes efforts such as testing, data collection, evidence-based prevention, treatment, and supply reduction.

What to Do if Someone Uses Xylazine With an Opioid

Learning important overdose response measures can help you react quickly in an emergency. If you suspect someone has overdosed on xylazine, opioids or both, you can help them with the following steps:

1. Call 911

Calling for emergency response services is crucial when an overdose occurs because medical treatment is necessary. Individuals require respiratory and cardiovascular support to manage xylazine toxicity, so medical response is essential. 

Provide emergency responders with the individual’s location and explain their symptoms and any substances they may have taken. A 911 operator may stay on the phone with you and provide instructions until help arrives.

2. Administer Narcan 

Narcan is an over-the-counter brand of naloxone that can help reverse opioid effects in an individual’s system. While it cannot reverse xylazine’s effects, it is safe to use on someone with xylazine in their system. You should use Narcan when you suspect any type of overdose.

3. Provide CPR if Necessary

If an individual loses consciousness or stops breathing after using xylazine and opioids, administer cardiopulmonary resuscitation (CPR) until help arrives. CPR can help prevent cardiac arrest, reduce negative outcomes, and keep an individual alive until emergency responders arrive. You can provide CPR with the following steps:

Use an AED if possible: An automated external defibrillator (AED) provides an electric shock to restart a heart if it stops beating. If this portable machine is available, follow its instructions to restart the individual’s heart safely.
Give chest compressions: Place the heel of your hand in the center of the individual’s chest with your other hand on top of it. Keep your arms straight and push down hard and fast, pressing on the chest 100-120 times per minute. Continue performing CPR until emergency responders arrive.

4. Turn the Individual on Their Side

Ensure the individual’s airway is clear, and turn them on their side if they don’t require CPR. Turning them on their side prevents choking if they vomit.

5. Help a Loved One Seek Treatment

Helping a loved one seek treatment following an overdose is essential. People experience intense withdrawal symptoms following substance use, which causes them to continue seeking and using more drugs. The proper treatment can help them manage withdrawal symptoms safely, learn healthy coping skills, recover from substance use disorder, and transform their life to maintain sobriety.

How to Help a Loved One Recover From Substance Use

Treatment is crucial for an individual who has a substance use disorder. You can help a loved one seek treatment with compassion, support, and helpful resources. Consider the following tips to support a loved one experiencing a substance use disorder:

Use a Compassionate Approach

Avoid accusations or a judgmental tone because these can push an individual farther away and discourage them from seeking treatment. Instead, approach your loved one with empathy and compassion. Let them know that you are worried about them and want to help. 

Perform an Intervention

An intervention with your loved one’s closest friends and family members can help them recognize they need help. Plan an intervention where everyone can share openly and honestly to help your loved one see why their habits are harmful and dangerous. Inviting a professional counselor or interventionist can help maintain a constructive, helpful conversation.

Collect Helpful Resources

Navigating treatment options can feel overwhelming to someone experiencing a substance use disorder. You can offer support by providing helpful resources and helping them contact a quality treatment center. Research available treatment programs and communicate how they can help your friend or family member. 

Encourage your loved one with a positive outlook and help them look forward to a new, healthy life. Offer to sit with them while they call a treatment center and speak with a compassionate professional about how to get started.

Offer Continued Support Throughout the Recovery process

Individuals need support during recovery. Visit your loved one when appropriate, and attend family therapy if recovery specialists recommend it. A family therapy program helps family members learn how to support their loved ones in recovery and help them meet their goals. It also helps family members process their feelings and heal as a loved one recovers from substance use.

Contact Gateway Foundation for Effective Treatment

Xylazine increases the opioid epidemic’s risks and harmful effects. Whether intentional or unintentional, consuming xylazine with fentanyl or another opioid can significantly harm the body. These potent substances can slow a person’s breathing until they enter a comatose state, incur permanent brain damage, or pass away. 

Substance use treatment can help individuals escape the detrimental addiction cycle and start a new, joyful life. With the right treatment, people can manage withdrawal symptoms, heal, maintain sobriety, and protect themselves from illicit drugs such as xylazine. 

If you or a loved one needs treatment for xylazine use, Gateway Foundation can help. Gateway Foundation offers inpatient, outpatient, and aftercare addiction treatment to help people heal physically, emotionally, and mentally. We offer personalized treatment tailored to each individual’s needs, and we can work with you to create the most beneficial treatment plan. Our recovery professionals understand how to address all aspects of substance use and co-occurring conditions.

When you recover at Gateway, you can receive medical care from compassionate staff, individual counseling with a therapist, and group therapy with an excellent support system. We also support individuals with services such as 12-step facilitation, cognitive behavioral therapy (CBT), motivational interviewing, family support, and recreational activities. Submit an online form to learn how we can help you or a loved one begin the path to recovery and return to a happy, healthy life.