Substance Abuse and Mental Health Services Administration (SAMHSA) is alerting providers and grantees about the risks of xylazine.

Xylazine, also known as "tranq," is a non-opiate sedative, analgesic, and muscle relaxant that is increasingly being found in the illicit drug supply, often in combination with opioids like fentanyl. Xylazine can cause circulatory changes that lead to painful lesions, necrosis, and even limb loss.

The U.S. Drug Enforcement Agency (DEA) has seized xylazine and fentanyl mixtures in 48 out of 50 states. In 2022, approximately 23 percent of fentanyl powder and 7 percent of fentanyl pills seized by the DEA contained xylazine.

Xylazine and fentanyl drug mixtures place users at a higher risk of suffering a fatal drug poisoning. Fentanyl users may not be aware of exposure as xylazine is not dedicated in routine toxicology tests.

To learn more about xylazine, read SAMHSA's recent letter.