What are Medetomidine and Xylazine. Dangers of Opioids
In the past decade, the scene of illicit drug usage has been constantly changing and becoming more dangerous. One of the first changes with the Opioid Epidemic was with the increase in the use of Fentanyl as an additive into Heroin. Fentanyl also has been increasingly abused more on its own in recent years as well. The Department of Justice (2020) drastic increases in the presence of Fentanyl from 2014 to 2017, showing an increase in Fentanyl production in that three-year period to have increased 946.29%. Not that the addition of Fentanyl was bad enough to the opioid overdose numbers, other additives have been seen in more recent years.
Xylazine (also known as “Tranq”) was first seen in the mixture of other illicit drugs in the early 2000s in Puerto Rico (National Institute on Drug Abuse, 2025). Starting in 2022, a drastic growing number of substances containing Xylazine were noticed. Most commonly Xylazine is mixed with Fentanyl but is also found in Heroin and Cocaine, often in Heroin it is the combination of Fentanyl and Xylazine to increase the perceived potency of that Heroin. Philadelphia was an area where drastic increases of this substance were initially found, with the Northeast part of the United States being the highest cases of Xylazine in the country. This has since spread across the United States affecting people across the country.
At Recover Clarity we treat patients in Pennsylvania and West Virginia in which we have noticed the additive of Xylazine all of which the patients were unaware of this substance being used by them. Recently, in less than the past year an even more dangerous substance is being mixed in with substances, mainly Fentanyl. This is call Medetomidine also known as “Rhino Tranq”. This new substance is even more concerning as it has a potency 200 times that of Xylazine and has severe withdrawal symptoms usually resulting in hospitalization in Intensive Care Units (ICU).
Xylazine – Tranq
What is Xylazine?
Xylazine is a veterinary tranquilizer which will slow heart rate, breathing, and blood pressure to critically low levels in humans (National Institute on Drug Abuse, 2025). This drug is a central nervous system depressant, tranquilizer, and pain reliever that is only approved for veterinary purposes. The sedative purposes of this drug can easily cause a person to stop breathing. The dangers of the use of Xylazine or “Tranq” are that concerning that the Drug Enforcement Administration (DEA) has issues a Public Safety Alert on the widespread threat of Xylazine being mixed with Fentanyl. The main concern with Xylazine is that as it is not an opioid such as that of some of the main substances it is combined with, overdose on this drug is not reversible by Narcan (Naloxone).
Dangers of Xylazine
Overdose and skin infections are the most common dangers of intentional or accidental usage of Xylazine. Many individuals are not intentionally using Xylazine, also called “Tranq” or “Tranq Dope” as this is being mixed into their drugs without their knowledge. The same can even go for with Fentanyl as some many believe they are attempting to use Heroin but end up with a mixture including Fentanyl and/or Xylazine. Even many of the opioid pain medication that is seen on the streets for illegal purchase are just pressed Fentanyl which can also include Xylazine or the new Medetomidine “Rhino Tranq”. Due to the unknown combination of other opioids and substances, the risk of overdose is very concerning and more likely. When it comes to Xylazine as this is not an opioid, the normal opioid overdose reversal medications such as Naloxone, commonly called Narcan, is not effective. Naloxone (Narcan) is an opioid antagonist and only works to reverse the effects of opioids in an overdose.
The Centers for Disease Control and Prevention (2024) states that you still should use opioid reversal agonists such as Naloxone (Narcan) for any suspected overdose. The reason is that Naloxone will not cause a person harm if opioids are not used. If Narcan is not successful and it is believed the person is overdosed on Xylazine or Tranq, immediately call 911 and start rescue breaths (Centers for Disease Control and Prevention, 2024). Because Xylazine will cause the person’s breathing to slow or stop, this is why lifesaving rescue breaths are crucial until first responders show to assist. The same applies for expected overdoses on the newly noticed Medetomidine or Rhino Tranq. Johns Hopkins Bloomberg School of Public Health (2024) reports that Xylazine “Tranq” has contributed to an increase in overdose deaths by 275% between the years of 2019 and 2022.
Another danger of Tranq or Xylazine is skin and muscles sores that can result from usage and are very difficult to treat (National Institute on Drug Abuse, 2025). Thes sores can lead to patches of dead or dying skin and muscle tissue which will be painful to the individual. In some cases, the affected areas require amputation. As many of these skin issues are related to the injection site of the substance they can still appear elsewhere on the body. Researchers have also noticed instances where these skin wounds appear in people that were only snorting or smoking the substances, therefore the concern is still present even without injection of the substance (D’Orazio et al., 2023).
Xylazine also may have its own withdrawal symptoms, however more research is still needed to be definitive on this. Johns Hopkins Bloomberg School of Public Health (2024) states in their initial research that users of Xylazine report that the withdrawal from this substance is more painful than normal opioid withdrawal. The National Institute on Drug Abuse (2025) also reports that withdrawal symptoms from those that have been using Tranq or Xylazine mixed with Fentanyl are more intense than the withdrawal symptoms of Fentanyl alone. More research is currently being conducted on the effects of Xylazine including the effects of Xylazine addiction, withdrawal symptoms, and community-based solutions to assist with this growing threat.
Medetomidine – Rhino Tranq
What is Medetomidine?
A new emerging threat with Substance Use Disorders is that of Medetomidine, also knows as “Rhino Tranq” or “Dex”. As the street name may indicate, if Xylazine “Tranq” was strong then this is strong enough to sedate a rhinoceros. Correctly with the new street name of the drug, Medetomidine is 200 times more potent than Xylazine and can also lead to severe withdrawal symptoms just from the Medetomidine, not including the withdrawal symptoms of the other substances such as Fentanyl and/or Heroin. These withdrawal symptoms often result in the individual needing Advance Critical Care Intervention. Unlike that of Xylazine which is a tranquilizer or local anesthetic, Medetomidine is used in the anesthesia of animals for surgical purposes.
Medetomidine “Rhino Tranq” is now becoming the dominant additive to Fentanyl, replacing that of Xylazine “Tranq” or “Tranq Dope”. Medetomidine was first noticed in May of 2024 as reported by the Drug Enforcement Administration (DEA, 2025). The presence of this new additive to substances was so drastic in the Philadelphia area that the Center for Disease Control (CDC) is already conducting studies on exposed individuals (Centers for Disease Control and Prevention, 2025). Click here to read the article from the Morbidity and Morality Weekly Report.
The DEA reports that as of January 2025 that Medetomidine is currently found in 87% of the drug samples collected in Philadelphia. The Pennsylvania Department of Health (2024) reported shortly after this release by the DEA that the emergence of this new additive substance has been found in the area of Pittsburgh as well as Philadelphia. The Center for Forensic Science Research & Education (2025) has reported, only days before this webpage was created, the presence of Medetomidine in the states of Pennsylvania, Virginia, Ohio, Florida, Illinois, Missouri, Colorado, and California. This is a clear example of how quickly new additive substances to illicit drugs can spread across the United States as only months ago was it found in the Eastern part of the country and now already noticed in California. Xylazine took a similar pattern with emergence in the Northeastern part of the country with a high concentration in the Philadelphia area and is now seen in all 50 states.
How Opioid Treatment Can Assist
The answer here to avoid the dangerous risks associated with both Medetomidine “Rhino Tranq” and Xylazine “Tranq” is simple to say, but not as simple to put into place. This simple answer is to get help with treatment for Opioid Use Disorder and to stop the use of all opioids. By stopping the use of all opioids, it will prevent the potential exposure to these dangerous substances as they are found being mixed with opioids such as Fentanyl, Heroin, and street produced or pressed opioid pain killers. Xylazine is also found in other substances such as cocaine, therefore stopping all illicit substance usage is needed. With the assistance of Online Suboxone Doctors is one level of care using Telehealth to assist in the treatment of Opioid Use Disorder. The presence of Medetomidine is likely to continue to grow in other states but already is seen in the areas of Philadelphia and Pittsburgh, which are areas which Recover Clarity operates and can offer Online Suboxone Treatment. And the presence of Xylazine is seen across the country and Recover Clarity can assist anyone in the state of West Virginia, including the most impacted area of Huntington.