Barb Williamson, a longtime advocate for drug addiction services in the Pennsylvania area, remembers when xylazine first showed up in her community. She said it was just over a year ago when patients started displaying new symptoms.  

“People would be coming in to Detox,” she said. “And the medication that was given to them wasn’t working.”

Xylazine, sometimes referred to as “tranq” or “tranq dope”, is a powerful animal sedative that is approved for veterinary use, but increasingly the substance has been added to illegal drugs like Fentanyl. It causes an intense, long-lasting high, which leaves users sedated, lethargic and often motionless in a trance-like state.

The sedative, which is not approved for human use, can lead to serious medical complications, including a slowed heart rate, dangerously low blood pressure, and labored breathing, according to the Centers for Disease Control and Prevention. Xylazine can also cause severe wounds that may lead to amputation.

And according to the Drug Enforcement Administration, because Xylazine is not an opioid, naloxone -- a crucial medicine used to treat overdoses -- does not reverse its effects.

“It’s so sad to see,” Williamson said. “They’re just waiting to die.” 

Williamson runs the "Way of Life," a network of recovery and sober living homes in the Philadelphia area. On a recent afternoon, she walked through the Kensington neighborhood in Philadelphia, recording herself in a video, in which she tried to raise the alarm on this growing problem of Xylazine.

“We come down here monthly and we try to feed the people,” she said in the video. “We try to help them get wound care. And we try to get them into treatment.”

The issue is personal for Williamson. She was an addict for years, before she got clean a dozen years ago. She said it’s hard not to see herself in the many patients she helps on a daily basis. 

“I know that if I can get sober, anyone can,” she said. 

While Philadelphia was hit hard by xylazine early on, the sedative has become a national problem, according to government data. The DEA has reported that the substance has been found in 48 states and D.C. 

And xylazine is becoming the dominant substance being mixed with fentanyl. New figures from the DEA shared with Spectrum News show that in 2023, xylazine was found in 30% of all the fentanyl powder that was seized and tested by the DEA compared to 25% just one year earlier.

Xylazine was also found in 6% of all DEA-tested Fentanyl pills, a slight reduction from 7% in 2022. 

“Xylazine is making the deadliest drug threat our country has ever faced, fentanyl, even deadlier,” said DEA Administrator Anne Milgram in a public safety alert. 

The substance is also increasingly being found in drug mixes that have caused deadly overdoses. Preliminary numbers from the CDC show that in the 12-month-period ending in September 2023, there were 5,640 overdose deaths involving xylazine, a jump of nearly 30% from one year prior. More research is needed to figure out if this spike is the result of better testing for xylazine or if the substance creates new dangers. 

The increased prevalence of xylazine has gotten the attention of lawmakers in Washington, including at the White House. Dr. Rahul Gupta, the Director of the National Drug Control Policy declared the mix of Fentanyl and Xylazine as an "emerging threat" in April, 2023, saying he was "deeply troubled" about the trend line. 

One year later, Gupta met up with Spectrum News to share what progress has been made in combating this developing threat.

“If we thought Fentanyl was dangerous, the combination of Fentanyl with xylazine or tranq has made it much more lethal and much more destructive,” Gupta said. 

Gupta’s office released a National Response Plan in July, to coordinate a "whole-of-government" response. The plan focused on six main pillars:

• Testing: The White House has worked to develop more Xylazine diagnostic tests, and has unlocked more funds to support the purchase of test strips to quickly identify the substance in the supply. 

• Data Collection: The White House has used data from death certificates, medical examiner and coroner reports and toxicology reports to identify trends in overdose deaths caused by Xylazine. 

• Evidence-Based Prevention, Harm Reduction, and Treatment: The White House has developed a health care guide to model treatment methods for patients that have been exposed to Xylazine, and has also released guidance on Xylazine wound care. The White House has also focused on educating young people about preventing overdose and substance use. 

• Supply Reduction: The White House has been collaborating with law enforcement to ‘identify the source of Xylazine and detect and intercept shipments” and has worked to make it easier to confiscate the product if not for a legitimate use.

• Scheduling: The White House is ‘undergoing a scientific and medical evaluation’ to determine whether the substances needs to be rescheduled. It is currently approved for veterinary use. 

• Research: The White House has been supporting research into Xylazine and has worked to unlock funding for research opportunities. 

“There’s definitely more work to go,” said Gupta. “But I could tell you that without the designation, we would not be where we are today.” 

There have been efforts to address this xylazine threat on Capitol Hill as well. Late last year, the TRANQ Act was signed into law, which increased the amount of research on xylazine. The measure directed the National Institute of Standards and Technology to study Tranq to ‘detect, identify, and better understand synthetic opioids.’ 

The measure was sponsored by Sens. Ted Cruz , R-Texas, and Peter Welch, D-Vt., in the Senate and Rep.s Mike Collins, R-Ga., and Rep. Yadira Caraveo, D-Co., in the House. Collins, a freshman lawmaker, spoke with Spectrum News about the legislation in January.

“It was a common sense bill,” he said. “Hey man, I’ll take a common sense bill any day of the week.”

“It was a common sense bill,” he said. “Hey man, I’ll take a common sense bill any day of the week.”

This year, there’s a new bill being proposed by a bipartisan pair of senators: Sens. Tim Kaine, D-Va., and Ted Cruz, R-Texas, have teamed up to sponsor the “STOP TRANQ ACT”. This bill would require the State Department to include xylazine in its annual reporting so investigators will have more clear information about where the dangerous substance is coming from. 

Back in Philadelphia, Williamson is hopeful that all of these efforts in Washington will pay off with solutions in her community. 

“There needs to be more help,” she said.