Xylazine: Signs of overdose and how to respond

What is xylazine? 

Xylazine (sometimes called “tranq” or “tranq dope”) is a drug intended for veterinary use as a sedative and pain reliever. 

Xylazine works as a sedative, causing low blood pressure, slow heart rate, reduced breathing and drowsiness. It may also increase the effects of other drugs, which can lead to overdose and complicate overdose response and treatment. 

Repeated use – especially through injection – can lead to painful skin infections and wounds, such as ulcers (open sores) and abscesses. If untreated, these wounds can lead to serious health complications. 

Signs of a xylazine overdose 

The risk of overdose is much higher when xylazine is taken with other drugs that slow breathing, such as alcohol, benzodiazepines or opioids. 

Signs of overdose may include: 

• Loss of physical sensation 

• Feeling faint or dizzy (low blood pressure) 

• Heavy sedation or loss of consciousness / not responding 

• Difficulty breathing and slow heart rate 

• Blue / pale or grey / ashen lips or fingertips 

How to respond to a xylazine overdose 

If you think someone has overdosed, knowing how to respond could save a life. 

Check for vital signs: 

• A – Alert: Not responding to voice, touch or pain 

• B – Breathing: Noisy, shallow, slow, stopped, or unusual snoring or gurgling 

• C – Colour: Blue or pale lips and fingertips (lighter skin) or grey/ashy colouring (darker skin) 

If you see any of these signs, act immediately. 

Before you act: Check for danger (sharp objects, chemicals, traffic, etc.). 

Try to wake the person by calling their name, squeezing their shoulder firmly or rubbing knuckles firmly across the sternum (chest bone). 

• If not responding but breathing: Place them in the recovery position, keep the airway open and monitor their breathing and colour closely. 

• If not responding and not breathing: Even though xylazine is not an opioid, most experts recommend giving naloxone (Narcan®) in case opioids have also been used. If you do not have naloxone, rescue breathing may be required. 

Call an ambulance, follow instructions and stay on the line. 

Rescue breathing 

• Roll the person onto their back, supporting their head. 

• Tilt their head back to open the airway (one hand on forehead, one under the chin). 

• Clear any blockages. 

• Pinch their nose and create a mouth-to-mouth seal. 

• Give 2 quick breaths every 5 seconds, checking for the chest to rise after each breath. 

Continue until: 

• The person starts breathing normally 

• An ambulance arrives 

• Someone else takes over 

Important: Naloxone (Narcan) will not reverse the effects of xylazine or other non-opioid drugs, but it will not cause harm if opioids may also have been used. 

What NOT to do 

• Do NOT allow the person to “sleep it off” (they may stop breathing). 

• Do NOT leave the person alone – always stay until help arrives. 

• Do NOT give medicine, drugs, food or drink. 

• Do NOT try to induce vomiting, shower them or slap them to wake them up.