Xylazine Use and Abuse: What SUD Counselors Need to Know

It is important to approach this issue with empathy and understanding, while also prioritizing safety and harm reduction. With the right tools and strategies in place, counselors can help clients navigate the challenges of substance use disorder and move towards a path of recovery and wellness.

In recent years, the opioid crisis has been a major public health concern in the United States. While the majority of attention has been focused on prescription opioids and illicit drugs such as heroin and fentanyl, there has been a growing concern about the emergence of a new substance, Xylazine. Xylazine is a veterinary sedative that has been increasingly used in conjunction with opioids by people who use drugs. This article will explore the effects, risks, and best practices for working with clients who may be using Xylazine.

What is Xylazine?

Xylazine is a sedative and muscle relaxant that is primarily used in veterinary medicine. It is commonly used to sedate large animals such as horses and cattle for surgical procedures. Xylazine belongs to a class of drugs known as alpha-2 agonists, which means it works by stimulating receptors in the brain that control the nervous system. When used in animals, Xylazine can cause sedation, muscle relaxation, and a slowing of the heart rate and breathing.

However, when used by humans, Xylazine can produce a range of effects. When used alone, Xylazine can cause drowsiness, dizziness, and disorientation. However, when used in combination with opioids, it can enhance the effects of the opioid, leading to more intense feelings of euphoria and relaxation.

Xylazine Abuse and the Opioid Crisis

In recent years, there has been a growing concern about the use of Xylazine in conjunction with opioids by people who use drugs. According to the Drug Enforcement Administration (DEA), Xylazine is not approved for human use in the United States, and is not considered a controlled substance. However, it is commonly smuggled into the country from Mexico and other countries, and has been detected in a growing number of drug seizures.

Xylazine is often mixed with opioids such as fentanyl and heroin to increase the potency of the drug. This practice has been dubbed “gray death” due to the danger it poses to users. The combination of Xylazine and opioids can lead to a range of adverse effects, including respiratory depression, coma, and death. In addition, the use of Xylazine can complicate overdose treatment, as it can interfere with the effectiveness of naloxone, the medication used to reverse opioid overdoses.

Risks and Side Effects of Xylazine Use

While Xylazine is not approved for human use, it can be obtained from veterinary supply stores or smuggled into the country from other countries. The use of Xylazine can lead to a range of adverse effects, including:

• Drowsiness
• Dizziness
• Disorientation
• Confusion
• Slowed heart rate and breathing
• Coma
• Death

In addition, the use of Xylazine can complicate overdose treatment, as it can interfere with the effectiveness of naloxone, the medication used to reverse opioid overdoses. This means that people who use Xylazine and opioids may require higher doses of naloxone, and may require longer observation periods after receiving naloxone.

Best Practices for Working with Clients who may be using Xylazine

As substance use disorder counselors, it is important to be aware of the risks and effects of Xylazine use, and to be prepared to work with clients who may be using it. Here are some best practices for working with clients who may be using Xylazine:

1. Screen for Xylazine use: As part of your intake process, it is important to ask clients about their drug use history, including their use of Xylazine. Be aware that clients may not be familiar with the drug, so be prepared to provide information about its effects and risks.
2. Provide harm reduction education: It is important to provide clients with information about harm reduction strategies to reduce the risks associated with Xylazine use. This may include education about the risks of combining Xylazine with opioids, and the importance of using drugs in a safe and controlled environment with someone who can assist if an overdose occurs.
3. Encourage regular check-ins: Regular check-ins with clients who may be using Xylazine can help identify any changes in their drug use patterns, as well as any potential signs of overdose or other adverse effects. This can help ensure that clients receive timely interventions if necessary.
4. Work with clients to develop a treatment plan: For clients who are using Xylazine, it is important to work with them to develop a treatment plan that addresses their substance use disorder, as well as any potential medical or mental health issues that may be present. This may include referrals to other providers, such as medical doctors or psychiatrists, as well as medication-assisted treatment (MAT) for opioid use disorder.
5. Monitor for signs of withdrawal: For clients who are using Xylazine and opioids, it is important to monitor for signs of withdrawal if they decide to stop using. Withdrawal from Xylazine can cause a range of symptoms, including anxiety, insomnia, and tremors. These symptoms can be managed with medication and other support, so it is important to work with clients to develop a plan for managing withdrawal.

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