Mixing Opioids and Xylazine (tranq)
Dangerous
Xylazine deepens the opioid's sedation and slowed breathing, and naloxone can't reverse the xylazine part.
Do not combine. If someone won't wake, give naloxone anyway, then rescue breaths, and put them on their side.
What to do
- Say what was taken and how much.Responders need it, and in most US states Good Samaritan laws protect both of you from drug possession charges when you call for an overdose.
- Unresponsive: put them on their side, tilt the head back, and stay until help arrives.Never leave someone alone to “sleep it off”.
- Give naloxone (Narcan) if you have it.It is sold over the counter in every US state and does no harm if opioids turn out not to be involved.
- Never Use Alone 1-800-484-3731Stays on the line and sends help if you stop responding.
- Full steps: what to do if it is already happeningOverdose signs, the recovery position, what to say on the call, and whether you can be charged for making it.
- Poison Control 1-800-222-1222Free and 24/7, for “is this bad?” before it becomes an emergency.
What “Dangerous” means
High risk of death or life-changing injury. Do not combine.
How the ratings workThe longer explanation
Xylazine is almost never taken on purpose: it is cut into the opioid supply, and fentanyl was found in 98% of the overdose deaths where xylazine was. It deepens and lengthens the sedation and slowed breathing an opioid causes, and drags heart rate and blood pressure down on top. Naloxone reverses the opioid but not the xylazine, so someone can start breathing again and still not wake up. Give naloxone anyway, then rescue breaths, put them on their side, and stay with them.
Sources (4)
- Choi S, Irwin MR, Kiyatkin EA. Xylazine effects on opioid-induced brain hypoxia. Psychopharmacology. 2023link.springer.com
- Watkins JM et al. Xylazine exacerbates fentanyl-induced respiratory depression and prevents rescue by naloxone in mice. Psychopharmacology. 2026pmc.ncbi.nlm.nih.gov
- What You Should Know About Xylazine. CDCcdc.gov
- Friedman J et al. Xylazine spreads across the US. Drug Alcohol Depend. 2022pubmed.ncbi.nlm.nih.gov
Think this is wrong, or know a better source? Send it.
Other names
- Xylazine
- tranq, tranq dope, zombie drug, anestesia de caballo, rompun, medetomidine
- Animal sedative cut into fentanyl, as is its stronger cousin medetomidine — naloxone reverses neither
Related combinations
- KetamineDangerous
- MXEDangerous
- AlcoholDangerous
- BenzodiazepinesDangerous
- ZolpidemDangerous
- GHB / GBLDangerous
Can you mix Opioids and Xylazine (tranq)?
MixSafe rates mixing Opioids and Xylazine as "Dangerous" — high risk of death or life-changing injury. Do not combine. Source: MixSafe research. Educational information, not medical advice.