Xylazine: A Zombie Drug Affecting Humans

Abstract

Xylazine, an alpha-2 adrenergic agonist exhibiting sedative, analgesic, and muscle-relaxant characteristics, is a veterinary medication predominantly utilized in large animals for anesthesia and pain alleviation. Chemically designated as C₁₂H₁₆N₂S, it was originally formulated as an antihypertensive drug but was repurposed for veterinary applications owing to its significant central nervous system depressant properties. Notwithstanding its therapeutic advantages in animals, xylazine has permeated illegal drug markets, especially as an adulterant in opioids such as fentanyl and heroin, acquiring monikers such "tranq"or"zombie Drug." Xylazine serves multiple purposes, but its misuse poses significant public health challenges, particularly because it does not respond to naloxone, the standard treatment for opioid overdoses. Its misuse is linked to significant health hazards, such as respiratory depression, necrotic skin ulcers, hyperglycemia, bradycardia, and cardiac necrosis. Incidents of xylazine-contaminated medications have increased, affecting overdose response and substance use treatment. This review explores xylazine's pharmacokinetics, toxicology, and clinical implications, with emphasis on its unique challenges in polysubstance overdose management. Furthermore, it underscores its essential veterinary applications. Comprehending xylazine's multiple functions is essential for tackling its abuse and alleviating its effects on public health during the persistent opioid epidemic.