Trends and Alerts
Xyalazine
- Xylazine, a non-opioid tranquiliser used in veterinary medicine.
- It has been increasingly detected in overdoses and deaths in Scotland since July 2023 (often alongside nitazenes, morphine, benzos and cocaine).
- It is commonly found as an adulterant in brown powders sold as heroin and people may not be aware of the potential presence of xylazine.
- It is most likely to be consumed unintentionally.
- 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 amongst people who inject drugs.
- Xylazine is a depressant that can cause drowsiness, low heart rate and low blood pressure. Xylazine can be smoked, snorted, swallowed or injected.
- Mixing xylazine with other depressants (such as opioids, gabapentinoids, alcohol or benzodiazepines) significantly increases the risk of a life-threatening overdose. Xylazine increases the risk of skin ulceration, infections and other complications and wounds may appear as bruises, spots, blisters, ulcers and black lesions. They are most likely to occur at administration sites but can occur anywhere on the body, including the forearms and lower legs.
For more information on signs of an overdose click here:
For more information on naloxone click here:
Harm Reduction Advice:
In the event of a suspected xylazine overdose, experts recommend giving the opioid overdose reversal medication: naloxone. This is because xylazine is frequently combined with opioids. However, because xylazine is not an opioid, naloxone does not address the impact of xylazine on breathing. If you believe someone is having an overdose you should always contact 999 and request an ambulance immediately.
In Scotland the provision of naloxone is FREE and anyone aged 16 and over can grab a naloxone kit
Click on the titles below to learn more:
Avoid injecting. This route of administration poses the highest risk. If you do inject, use new equipment. You can get this from your local needle exchange service. Wash your hands and injection sites (before and after).
Know the signs of infection: heat, redness, swelling, bad smell, pain, increased size or depth or more yellow, green or black in the wound than before.
If there are signs of infection, get medical help early to prevent further harm and injury. Call 111 for advice. Needle exchanges, GPs, minor injury clinics and pharmacies may also be able to help. In an emergency, visit the emergency department.
Drug testing is the only way to confirm drug contents. To get a sample tested, use the free, anonymous postal service provided by WEDINOS.
Visit wedinos.org and click sample testing.
Print off a sample form.
Follow the instructions to generate a reference code and make a note of the code.
Fill in the form completely or the sample won’t be accepted.
Put the form and drug sample (double wrapped in something leakproof) into an envelope with a stamp on it and post it to WEDINOS.
Results will be posted online a few days later.
Xylazine test strips are available. These can be used to show the presence of xylazine in a sample, but cannot provide information on safety, purity, quantity or other contaminants.
Use drugs in the company of people you trust and take turns to dose.
Tell someone what you have taken, how much and when.
Xylazine is often mis-sold as another drug, like heroin or codeine. Take a test dose – a small amount or part of a pill.
Always use caution, even if someone has used the batch before. The drugs may be unevenly mixed in the product.
If someone who takes drugs regularly has stopped or cut down use, their tolerance will have reduced. This increases the risk of overdose as they will not need to take as much to get the same effect.
Mixing drugs (including alcohol and medicines) can cause unexpected and unpredictable results and significantly increases the risk of overdose.
As xylazine is usually found alongside other drugs, polydrug use may be unintentional. Try to minimise mixing, space out doses of different drugs, ensure you are somewhere safe and take much less than you would if you were only taking one.
Naloxone (see above) is an effective, life-saving medicine that can temporarily reverse the effects of an opioid overdose.
Although xylazine is not an opioid, naloxone should always be administered if the person is overdosing and is unresponsive – many overdoses involve an opioid and reversing the effects of one drug may be enough to bring the person round.
Pick up naloxone from a drug service or order online from Scottish Families Affected by Alcohol and Drugs (SFAD).