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Richard has an extensive background in Admissions, Facility Operations, and Clinical outreach. He has developed robust networks of relationship with therapists, hospitals, physicians, treatment centers, and other community resources to provide them with access to behavioral healthcare. Richard has also operated as the CEO of several different treatment facilities over the course of his career.
Richard is passionate about ensuring the client finds the best fit for their treatment needs. His focus is on maintaining relationships with quality providers across the country, so that he can help whoever he comes across get the help they truly need. Equally, Richard focuses on ensuring the treatment provided at Legacy Recovery Center is of the highest quality, and that the team is doing all they can to serve those who come to Legacy Recovery Center for care.
Richard finds his work extremely rewarding, but his biggest joy is his family and helping his wife raise their child.
Over the past few years, xylazine has become more common in the illegal drug trade in the U.S. This is part of a larger trend toward drug mixtures that are more complicated and hard to predict. People on the street often call xylazine “tranq” or “tranq dope.”
It first appeared in overdose investigations in the late 2010s in the Northeast and spread nationwide. There was a big increase in public health and toxicology data around 2019–2021, when medical examiners and emergency departments started finding it more often with fentanyl and other synthetic opioids [1].
One reason xylazine began appearing more often is that it can intensify or prolong sedation, which some suppliers and users perceive as extending the effects of fentanyl or other opioids. Because fentanyl is fast-acting but shorter in duration than heroin, adding a long-lasting sedative may create a longer “high,” making the product more appealing to some users.
Another factor driving its spread is how easily it can be hidden within the existing illicit market. Xylazine may be mixed into powders, pressed into counterfeit pills, or sold in combination with opioids and stimulants without the user’s knowledge [2].
Read on to learn more about this growing, dangerous drug and how communities are addressing the emergence of Xylazine.
What Is Xylazine?
Xylazine is a muscle relaxant and sedative that was first made for animals, not people. Veterinarians often use it to calm or sedate large animals such as horses, cows, and deer when they are getting medical care. Xylazine is an alpha-2 adrenergic agonist, which means it slows down the activity of the central nervous system and lowers the release of some neurotransmitters that affect stress and alertness [3].
Although not FDA-approved for human use, it has increasingly appeared in the illicit drug supply in recent years, often mixed with fentanyl or other substances without a person’s knowledge.
In the body, xylazine produces intense sedation, slowed breathing, reduced heart rate, and lowered blood pressure. Because it acts differently from opioids, its effects can look similar to an opioid overdose but may last longer or respond differently to treatment.
Effects of Taking Xylazine
Xylazine can hit the body like a heavy shutdown. Instead of a quick wave of relaxation, it can push the nervous system into a slow, deep sedation where staying awake becomes difficult. Breathing may become shallow, the pulse slows, and blood pressure can drop.
Over time, some develop serious skin wounds and tissue damage, such as ulcers and abscesses, that don’t always match the pattern of typical injection-related infections [4]. The exact mechanisms are still being studied, but reduced circulation, pressure injury during prolonged unconsciousness, and slowed healing are all thought to be contributors.
Since naloxone doesn’t address xylazine itself, emergency response often depends on airway support, rescue breathing, and rapid medical care rather than a single “reversal” fix.
Effects people may experience with xylazine include [5]:
- Heavy sedation or “can’t stay awake”
- Slowed, shallow, or irregular breathing
- Low heart rate and reduced blood pressure
- Mental fog, confusion, or delayed thinking
- Poor balance and slowed reaction time
- Longer periods of unconsciousness than expected
- Higher risk of injury from falls or being immobile for too long
- Skin wounds or tissue breakdown with repeated exposure
- Increased overdose danger when mixed with fentanyl, alcohol, benzos, or other downers
Overdose Risk and Xylazine
In 2019, the CDC identified 826 xylazine-related overdose deaths (1.8%) of all drug deaths, and from January 2019 to June 2022, it was reported that the monthly share of illicitly manufactured fentanyl (IMF)-involved deaths with xylazine detected rose from 2.9% to 10.9% across 21 jurisdictions [6].
Xylazine raises overdose risk because it doesn’t behave like an opioid in the brain. Opioids mainly act on opioid receptors, while xylazine acts on alpha-2 adrenergic receptors, which slow down the central nervous system. When xylazine shows up in fentanyl (or other opioids), the danger is stacking depressant effects that can quickly reduce respiratory function.
This receptor difference is also why naloxone (Narcan) doesn’t “work” on xylazine the way people expect. Naloxone only blocks opioid receptors; it cannot reverse xylazine-related sedation. In a real-world overdose, you still give naloxone because fentanyl is commonly involved and does respond, but the person may stay deeply sedated or continue to have breathing problems because xylazine is still active.
Call 911 and provide breathing/airway support rather than assuming a rapid reversal after Narcan.
Arizona and Xylazine: Why the State Is Being Hit Hard
Arizona’s experience with xylazine is tied closely to the same forces driving its broader overdose crisis: a high-volume trafficking corridor as a border state, widespread fentanyl availability, and an increasingly mixed drug supply. Because Arizona sits along major southwest distribution routes, large amounts of fentanyl and methamphetamine pass through or remain within the state [1].
Law enforcement seizures in recent years have involved millions of fentanyl pills, and some tested positive for xylazine, showing how new additives enter the local supply as trafficking patterns evolve. When large quantities of synthetic drugs are moving quickly through a region, adulterants like xylazine can spread fast before public health systems fully catch up.
Arizona toxicology and poison control teams started warning providers as early as 2022 after xylazine began showing up more frequently in autopsies and forensic testing across the state.
How Communities Are Addressing Xylazine
Testing Strips
Xylazine testing strips do exist, and some harm-reduction programs and community health organizations have started distributing them. These strips can help detect the presence of xylazine in a sample before use. However, availability varies by region, and they are not yet as widely accessible as fentanyl testing strips.
It’s important to remember that testing strips are screening tools, not laboratory tests. A negative result does not guarantee safety, especially because street drugs may contain multiple substances or unevenly mixed compounds. Using fentanyl and xylazine testing strips together can provide more information about what may be present.
Naloxone Distribution
Although naloxone does not reverse xylazine itself, it can still reverse opioids that are commonly mixed with it, such as fentanyl. Administering naloxone may restore breathing enough to keep someone alive until emergency services arrive.
Tracking and Monitoring
Many public health departments are also expanding drug supply monitoring. This tracks what’s showing up in toxicology reports, EMS calls, and emergency department trends. In some areas, harm-reduction teams share real-time updates with outreach workers, shelters, and recovery programs.
Medical Support
Some programs are also offering or referring to wound care and basic medical support, since xylazine has been linked to skin injuries in certain regions. At the same time, treatment providers are strengthening pathways into care, especially medications for opioid use disorder, telehealth appointments, and “warm handoffs” from EMS or the ER.
Integrated Drug & Alcohol Treatment in Arizona at Legacy Recovery Center
Legacy Recovery Center is a highly rated, premier addiction and mental health treatment center in Arizona. Legacy is owned and operated by two psychiatrists with over 40 years of combined experience, complemented by a robust therapeutic team.
We’re unique among residential treatment centers thanks to our ability to help people suffering from mental health and substance abuse issues. Our expert psychiatric team is equipped to treat multiple issues concurrently, focusing on your specific needs.
Sources
[1] Shover, C. et al. (2022). Xylazine spreads across the US: A growing component of the increasingly synthetic and polysubstance overdose crisis. Drug and alcohol dependence, 233, 109380.
[2] CDC. 2024. What You Should Know About Xylazine.
[3] National Institute of Drug Abuse. 2024. Xylazine.
[4] Schneider, E. (2025). “It always needs a higher level of care than what I can provide”: Practical, ethical, and administrative tensions arising from the integration of wound care services into syringe service programs in Maryland. The International journal on drug policy, 135, 104685.
[5] CDPH. 2023. XYLAZINE Wound Care Fact Sheet.
[6] CDC. 2023. Illicitly Manufactured Fentanyl–Involved Overdose Deaths with Detected Xylazine.
