Xylazine is a non-opioid tranquiliser used in veterinary medicine as a sedative, muscle relaxant and painkiller. It has been detected in overdoses and deaths in Scotland.

People who take drugs may not be aware of the potential presence of xylazine in the supply. It is most likely to be consumed unintentionally and is usually found as an adulterant in brown powders sold as heroin. In the UK, it has also been detected in the wider drug supply, including in counterfeit opioid painkillers (codeine and tramadol) and in liquids sold as tetrahydrocannabinol (THC) vapes.

Xylazine is a central nervous system depressant. It reduces breathing, heart rate and blood pressure. Other adverse effects include: sudden collapse, unconsciousness, drowsiness, confusion, loss of coordination, memory loss and nausea. Xylazine use is associated with the development of severe wounds and skin damage, regardless of how it is administered. The highest risk of wound damage is seen among people who inject drugs. Wounds can appear as spots, blisters or open sores anywhere on the body, and may need medical attention.

As with other new synthetic drugs, the harms associated with xylazine should be considered in the context of polysubstance use (mixing drugs), where the risk of adverse effects is significantly increased.

Sections:

• Xylazine
• Wound care
• Recognising and responding to an overdose
• Information for people who take drugs and community members
• Actions for high-risk settings
• Actions for drug and alcohol service staff
• Actions for emergency service, clinical and healthcare staff
• Recommendations
• Legal status
• More information