Officials in Massachusetts say a number of people already dealing with addiction have become unwitting victims of a contaminant lacing illicit drugs. What’s been used as a sedative for pets and animals is now having devastating effects state lawmakers want to address.
For years, xylazine has seen plenty of use in the veterinary field as a reliable sedative for animals. But, in Massachusetts and beyond, it’s been showing up in illicit drugs, often paired with fentanyl and thought by some to extend the opioid’s effects while ultimately increasing the risk of an overdose.
Xylazine itself isn’t an opioid, but its heavy, sedative effects are raising alarms amongst health officials and first responders - a number of whom aren’t immediately trained on how to properly treat those with xylazine in their system.
If the knockout effects weren’t dangerous enough, there’s also the matter of wounds.
“From what’s been explained to me is that … animal tranquilizer - the body cannot metabolize it, so the body tries to push it out, wherever it is, and unfortunately, that means pushing it out through the skin,” says Alan Young, a recovery coach at the Worcester-based organization, Everyday Miracles.
Young and other experts spoke to a special state legislative commission addressing xylazine Monday.
Officials say xylazine was first detected in the state’s illicit drug supply around 2020, appearing in more lab-tested samples as time went on. As many as 30 states have also seen the adulterant appear as well, also known as “tranq.”
According to the Massachusetts Bureau of Substance Addiction Services, between 2023 and 2024, xylazine was present in just over 16 percent of opioid-related deaths in the Commonwealth that had a toxicology screening. That’s at least 255 cases, up from 158 a year prior.
Dr. Traci Green, a principal investigator at the Massachusetts Drug Supply Data Stream, the country's first statewide, community drug-checking program, says lab testing has found a notable drop in xylazine's appearances in the drug supply so far in 2025.
As of June, 13 percent of samples have tested positive for it, compared to last year's 26 percent.
Having said that, she added that the veterinary anesthetic drug medetomidine appears to be emerging somewhat in xylazine's place. It doesn’t make xylazine’s dangers any less concerning, especially when it comes to the wounds – something dozens of users attested to in a recent series of interviews Green cited.
“The onset of [symptoms] is quick and the average number of wounds that a person had was 7.8, so quite a few wounds,” Green said, discussing the interviews held with 126 drug users, about half of whom reported experiencing apparent xylazine wounds. “Two-thirds of those wounds became as large as a dime or- a quarter-size… but those locations, as you've been hearing, are in more places than just an injection site … a substantial number of people weren't injecting, but still were experiencing wounds.”
She added that, of the 62 reporting xylazine wounds, 90 percent still had active wounds within a month prior to being surveyed or interviewed.
As Green and others said, many users weren’t even aware they were putting xylazine into their system.
Dr. Raagini Jawa, who’s experience includes time as a Combined Infectious Disease and Addiction Medicine Fellow at Boston Medical Center, says a small, 2023 study she helped lead called on 171 people who had been using substances.
80 percent believed they had been exposed to xylazine, with many not seeking it out or wanting anything to do with it.
“Most realized that they had been exposed to xylazine only after experiencing a harm like a wound or having severe sedation, and if they had access to low-barrier, community-based drug checking, not just DEA-based drug checking, but stuff that they can go to a trusted harm reduction organization [with], give a drug sample … they actually said that they would choose to dispose of the adulterated drug or switch their drug supplier,” Jawa said.
The harmful skin wounds are often necrotic and as speakers stressed to the Special Legislative Commission on xylazine, a number of users find themselves living with them rather than seeking treatment – a consequence of stigma and medical trauma some are said to have faced, among other factors.
Northampton Police Officer Heather Longley has served on the department’s drug addiction and recovery team.
Echoing what several medical experts called for, Longley says some of the best ways to address the drug’s prevalence aren’t all that much different from tactics used in other drug awareness efforts.
“I strongly recommend public education campaigns highlighting the dangers of xylazine and limitations of Narcan on xylazine overdoses, improved, reliable test kits made widely available in non-stigmatizing, public locations such as town halls, public health centers or libraries, increased regulation on the sale and distribution of xylazine, limiting it to only medical and pharmaceutical professionals and increasing penalties for the direct purchase of large quantities and distribution…” Longley listed off. “Continued support and funding for harm reduction programs, especially mobile wound care units and overdose prevention education and lastly, information is power and by equipping our communities, especially our most vulnerable, with accurate information and effective tools, I hope we can also save lives.”
Better access to wound care and rapid response teams came up often during the hearing.
They were all calls acknowledged by the commission’s co-chairs, State Senator John Velis of the Hampden and Hampshire District and State Representative Mindy Domb of Amherst.
It was the commission’s first hearing since its formation, born out of a substance use disorder omnibus bill signed into law by Governor Maura Healey last year.
Both Velis and Domb signaled most all of the subjects raised should be the subject of deeper dives as the commission moves forward – eventually preparing a report with recommendations to address the uptick in xylazine-involved cases.
In a statement sent out to media, Velis said:
“This Commission has a really important task in front of us, as we continue to see the proliferation of xylazine grow in our Commonwealth’s drug supply. Last year, xylazine was found in a record-high 34% of lab-tested samples tested statewide. And in 2023, xylazine was found in 9% of opioid-related overdose deaths. It is clear that our Commonwealth must acknowledge the dangers that xylazine presents and the disturbing increases we are seeing, and I am grateful that the work of this Commission is beginning.”
