Quick Facts:
- Xylazine is a sedative used in veterinary medicine and is not approved for human use.
- It is increasingly found mixed with fentanyl and other illegal drugs.
- Xylazine exposure can cause heavy sedation, breathing problems, low blood pressure, and serious wounds.
- Naloxone does not reverse xylazine itself, but it should still be given during a suspected overdose because fentanyl or another opioid may be involved.
- Treatment can address the fentanyl or other substance use that continues to put someone at risk of xylazine exposure.
- Forward Health Ohio provides drug and alcohol rehab in Columbus, Ohio, including treatment for fentanyl and opioid addiction.
Xylazine, commonly called “tranq,” has become another concern in the illegal drug supply. The biggest problem is that many people are not intentionally looking for xylazine. Instead, it may be mixed with fentanyl or other drugs without their knowledge. That makes xylazine particularly important for people using fentanyl in Ohio. Exposure can increase the risk of overdose and cause serious skin wounds, while also making withdrawal and recovery more complicated.
Recent Ohio data confirm that xylazine is present in the state. A January 2025 Ohio Substance Abuse Monitoring Network report found that 1.7% of 119,110 urine samples tested statewide were positive for xylazine. In the Columbus region, 0.5% of 19,042 samples tested positive. Understanding what xylazine is and how it changes the risks of fentanyl use can help people recognize when it is time to seek medical care and addiction treatment in Ohio.
What Is Xylazine?
Xylazine is a non-opioid sedative used in veterinary medicine. It slows activity in the brain and body and can cause heavy sedation, slowed breathing and heart rate, and dangerously low blood pressure. The drug has become especially concerning because of its connection to fentanyl. Signs and effects of xylazine use or exposure can include:
- Extreme drowsiness or difficulty staying awake
- Slowed or shallow breathing
- Slower heart rate
- Low blood pressure
- Confusion or difficulty responding
- Skin sores or wounds that are slow to heal
- Withdrawal symptoms after repeated use or exposure
The DEA’s 2025 National Drug Threat Assessment identified xylazine as the leading adulterant found in fentanyl powder. By the first quarter of fiscal year 2025, xylazine was found in approximately 38% of fentanyl powder exhibits analyzed by DEA laboratories. That does not mean every dose of fentanyl contains xylazine. It does mean that drugs purchased illegally can contain substances a person did not expect, making it difficult to know exactly what they are taking.
Why Are Xylazine and Fentanyl Dangerous Together?
Fentanyl and xylazine are different types of drugs, but both can heavily sedate the body and interfere with breathing. This combination also creates a challenge during an overdose. Naloxone can reverse the opioid effects of fentanyl, but it does not reverse xylazine because xylazine is not an opioid. Even so, naloxone should always be given when an opioid overdose is suspected. Fentanyl may still be involved, and reversing its effects can save a person’s life. Emergency medical help should also be called because the effects of xylazine may continue after naloxone is given.
Recent CDC toxicology data show how often fentanyl appears alongside other substances. The CDC’s Fentalog Study, updated in June 2026, found fentanyl and xylazine together in 17% of samples from patients treated for suspected opioid-involved overdoses at participating hospitals. The CDC notes that these study sites are not representative of the entire United States.
Why Does Xylazine Cause Serious Wounds?
One of the most concerning complications associated with xylazine is severe skin damage. Xylazine-associated wounds can become large, difficult to heal, and vulnerable to infection. They are also not necessarily limited to the area where someone injects drugs. That means people should not assume they are safe from xylazine-related wounds simply because they do not inject substances.
These wounds should be taken seriously, especially if they are growing, changing color, producing drainage, becoming more painful, or showing signs of infection. Fever or feeling seriously ill alongside a wound also requires prompt medical attention. Xylazine-related wounds can become severe enough to cause tissue death and, in extreme cases, require amputation. The DEA’s 2025 National Drug Threat Assessment specifically warns about severe infections and necrosis associated with injecting mixtures containing xylazine.
Treating the wound is important, but it only addresses one part of the problem. If someone continues using fentanyl or other drugs that may contain xylazine, they may continue being exposed. Addiction treatment can help address the substance use that is creating that ongoing risk.
What About Xylazine and Fentanyl Withdrawal?
Stopping fentanyl can cause significant opioid withdrawal, including nausea, vomiting, diarrhea, sweating, muscle aches, anxiety, insomnia, and intense cravings. Regular xylazine exposure can make the situation more complicated because xylazine works differently from opioids. Someone using drugs from the illegal supply may not even know how much xylazine they have been exposed to.
For that reason, significant withdrawal should be medically assessed rather than assuming every symptom is caused by fentanyl alone. Some people may need medical detox or another higher level of care before they are ready to begin outpatient treatment. Once someone is medically stable, the focus can shift from getting through withdrawal to understanding the addiction itself and preventing a return to use.
How Can Addiction Treatment Help?
Xylazine exposure is often connected to a larger problem: continued use of fentanyl, heroin, or other drugs from an unpredictable supply. Addiction treatment addresses that underlying cycle. Depending on the person’s needs, treatment may include individual therapy, group therapy, relapse prevention, medication-assisted treatment, psychiatric care, and dual diagnosis treatment for co-occurring mental health conditions.
For someone who is medically stable but still needs significant structure, a Partial Hospitalization Program (PHP) can provide intensive daytime treatment without requiring the person to live at a facility. An Intensive Outpatient Program (IOP) provides another step of structured care with greater flexibility for work, family, and other responsibilities.
The appropriate level of care depends on factors such as current substance use, withdrawal risk, physical health, mental health, previous relapses, and the person’s home environment. A clinical assessment can help determine the severity of the addiction, identify any co-occurring mental health concerns, and recommend the level of care that best fits the person’s current needs.
Does Insurance Cover Addiction Treatment in Ohio?
Cost should not automatically prevent someone from asking for help. Both private health insurance and Ohio Medicaid can provide coverage for substance use disorder treatment, although benefits vary by plan and level of care. Private insurance may cover services such as PHP, IOP, outpatient therapy, medication management, and treatment for co-occurring mental health conditions. Deductibles, copays, coinsurance, network requirements, and prior authorization can affect what someone pays out of pocket.
Ohio Medicaid also covers addiction treatment. Forward Health Ohio accepts Ohio Medicaid and most major private insurance plans. Its current insurance information specifically identifies outpatient levels of care such as PHP and IOP as services that may be available through Medicaid coverage. Before treatment begins, benefits can be verified by our team to determine which services are covered and whether there are expected out-of-pocket costs.
Fentanyl and Drug Addiction Treatment at Forward Health Ohio
Forward Health Ohio provides drug and alcohol addiction treatment in Columbus, Ohio, for adults struggling with fentanyl, heroin, opioids, cocaine, alcohol, and other substances.
Our outpatient programs are designed for people who are medically stable enough to live outside a residential facility but still need structured support throughout recovery. Treatment options include PHP, IOP, outpatient care, dual diagnosis treatment, medication-assisted treatment, individual and group therapy, relapse prevention, and recovery housing support. Treatment is personalized around more than the drug someone has been using. Our clinical team can also address underlying mental health concerns, triggers, cravings, relationships, and patterns that may contribute to repeated substance use.
If xylazine exposure has caused a serious wound, severe withdrawal, or another medical complication, immediate medical care may need to come first. Once you are medically stable, Forward Health Ohio can help you continue the recovery process and reduce the risk of returning to an unpredictable drug supply. Forward Health Ohio accepts Ohio Medicaid and most major private insurance. Contact our admissions team today to verify your benefits and learn more about addiction treatment in Columbus.
