Xylazine in the New Jersey Drug Supply

Xylazine — known on the street as "tranq," "tranq dope," or "sleep cut" — is a veterinary sedative that has become an increasingly common adulterant in New Jersey's illicit fentanyl supply. It is not an opioid, which means naloxone (Narcan) cannot reverse its effects. It causes severe, difficult-to-treat skin wounds. And it is changing what overdose response looks like in New Jersey — including right here in Camden County and South Jersey.

What Is Xylazine?

Xylazine (pronounced ZYE-lah-zeen) is a veterinary alpha-2 adrenergic agonist — a type of sedative used in large animals like horses, cattle, and deer for anesthesia and analgesia. It has never been approved for human use by the FDA.

In humans, xylazine causes:

• Deep sedation and loss of consciousness
• Slowed breathing (respiratory depression)
• Decreased heart rate and blood pressure
• Severe vasoconstriction — narrowing of blood vessels
• Necrotic skin wounds, even at sites distant from injection

Xylazine is not scheduled under the Controlled Substances Act at the federal level, which historically made it easier to obtain and harder to regulate. Legislative and regulatory efforts to address xylazine are ongoing at the federal and state levels.

Why Is Xylazine in the Drug Supply?

Xylazine entered the illicit drug supply for economic and pharmacological reasons. Dealers mix it into fentanyl because:

• It extends the duration of the high — xylazine is longer-acting than fentanyl, so the combined product keeps users sedated longer, reducing how often they need to re-dose
• It is cheap — relative to fentanyl, xylazine is inexpensive, reducing the dealer's cost per dose while maintaining or enhancing perceived potency
• It creates deeper physical dependence — the combination of fentanyl and xylazine is more difficult to stop than fentanyl alone, which some suppliers exploit to retain customers

Xylazine was first detected at high rates in Philadelphia's drug supply, then spread throughout the Delaware Valley region — including Camden County and South Jersey — and has since been found across New Jersey and nationally.

The Narcan Problem: Why This Matters for Overdose Response

When someone overdoses on a fentanyl/xylazine mixture:

• Naloxone WILL reverse the fentanyl component — breathing may improve
• Naloxone will NOT reverse the xylazine component — sedation may continue even after Narcan
• The person may appear partially conscious or may re-enter deep sedation as the Narcan wears off
• Because xylazine is longer-acting than fentanyl, it may outlast even multiple doses of naloxone

The correct response is always to give naloxone (you need to reverse the opioid component), call 911, perform rescue breathing if trained, and stay with the person until EMS arrives. Do not assume the overdose is resolved because the person appears to be breathing again.

The Wound Crisis: Xylazine's Most Visible Harm

One of the most alarming features of xylazine is its tendency to cause severe necrotic skin wounds. These are open, slow-healing sores that can appear at injection sites — but also, strikingly, at sites entirely separate from where injection occurred. The exact mechanism is not fully understood, but vasoconstriction (narrowing of blood vessels) and xylazine's effect on tissue perfusion appear to be central factors.

These wounds can:

• Become severely infected, including with antibiotic-resistant bacteria
• Progress to requiring debridement (surgical removal of dead tissue)
• In extreme cases, require amputation when infection spreads to bone

Wound care is now a critical component of harm reduction for people using xylazine-contaminated fentanyl. NJ Harm Reduction Centers provide wound care supplies and wound assessment. Cooper University Health Care's harm reduction network in Camden County is a key local resource.

New Jersey's Response: Test Strips and Harm Reduction

New Jersey enacted legislation in January 2024 to begin distributing xylazine test strips at Harm Reduction Centers. This was part of a broader NJ Department of Health response to the xylazine contamination problem in the state's drug supply.

Source: NJ Department of Health, January 2024 legislation. nj.gov/health

Xylazine test strips work similarly to fentanyl test strips — a small amount of the drug sample is dissolved in water and the strip is dipped to detect the presence of xylazine. Like fentanyl test strips, they are not 100% sensitive and a negative result does not guarantee safety.

Free xylazine and fentanyl test strips are available at NJ Harm Reduction Centers. For information on obtaining free fentanyl test strips, see: Fentanyl Test Strips in New Jersey.

Xylazine Withdrawal: Different from Opioid Withdrawal

For people who have been using xylazine-contaminated fentanyl regularly, withdrawal involves both opioid withdrawal symptoms AND xylazine-specific withdrawal symptoms. Xylazine withdrawal is less well-characterized than opioid withdrawal, but includes:

• Agitation and anxiety (often more intense than opioid withdrawal alone)
• Elevated blood pressure and heart rate
• Sweating and tremors
• Rebound hypertension (because xylazine's alpha-2 agonist effects lower blood pressure)

Standard opioid withdrawal protocols (COWS scale, buprenorphine induction) address the opioid component but may not fully manage xylazine withdrawal. Detoxification from xylazine-contaminated fentanyl requires specialized medical detox protocols that account for both substances — not simply standard opioid detox.

If you or someone you know needs help stopping xylazine-contaminated opioids in South Jersey, professional medical detox is essential. See: Xylazine addiction treatment in South Jersey and Medical detox in Cherry Hill, NJ.

Related Resources

• The Fentanyl Crisis in South Jersey
• Xylazine Addiction Treatment South Jersey
• How to Get Free Narcan in New Jersey
• Fentanyl Test Strips in New Jersey
• Overdose Prevention Resources South Jersey