Have you heard of “tranq” or “tranq dope”? These terms refer to xylazine and illicit opioids (e.g., fentanyl, heroin) mixed together. The end result is a powerful tranquilizer that can put people into a zombie-like state.
The rate of overdose deaths involving xylazine increased across all age groups in 2020 and 2021. In 2020, the rates were highest for those aged 25-34 and 35-44, and in 2021, rates were highest for 35-44-year-olds. While xylazine is not as prevalent in Arizona as it is in other states, the substance is still in our drug supply, putting people at risk, often unknowingly.
If you or a loved one has come into contact with xylazine, it’s important to take this matter seriously and reach out for support. Wolf Creek Recovery treats xylazine use disorders, and we recognize that many people going through this are also dependent on illicit opioids as well. We can treat both disorders using evidence-based therapies. Let’s learn more about xylazine withdrawals and how to manage this process safely and effectively.
Xylazine Withdrawals
Xylazine has made its way into our nation’s drug supply, putting people at risk for dangerous and even life-threatening complications. Individuals who use xylazine regularly can develop physical dependence, leading to withdrawal symptoms when they stop the substance.
Because xylazine is not an opioid, standard opioid withdrawal treatments like naloxone (Narcan) will not reverse its effects. This makes xylazine withdrawal especially challenging, requiring medical supervision and a tailored approach to detox and recovery.
Let’s look closer at the withdrawal timeline for xylazine so that you know what to expect and the type of support that will help make this process manageable.
Xylazine Withdrawal Timeline
Regular xylazine consumption can lead to physical dependence and withdrawal symptoms when the substance is stopped. Symptoms typically begin within 12-24 hours from the last dose, peak within 1-3 days, and gradually subside over 1-2 weeks. However, it is possible to experience prolonged withdrawal symptoms, such as anxiety, sleep disturbances, and cravings, for several weeks or months. This is the body’s way of letting you know that it’s still healing from the xylazine use.
Physical Withdrawal Symptoms
Due to its effects on the nervous system, xylazine can cause a number of physical withdrawal symptoms such as extreme anxiety and agitation, high blood pressure, insomnia, muscle stiffness or spasms, vomiting or diarrhea, and tremors. It’s also common for people to develop flu-like symptoms like cold sweats, hot flashes, and fevers, similar to opioid withdrawal. And, if the person is injecting xylazine, they might notice that existing skin ulcers and wounds worsen during withdrawal.
Mental Withdrawal Symptoms
The mental withdrawal symptoms from xylazine can be particularly intense and long-lasting. It’s common for individuals to experience severe anxiety and panic attacks, intense cravings, depression, emotional numbness, irritability and mood swings, and cognitive fog. In severe cases, people might feel like they’re being watched or judged, even when they are safe, or they might see or hear things that aren’t there. These symptoms happen because the brain’s neurotransmitters are disrupted and the central nervous system is overly active.
What Factors Affect the Timeline
While xylazine withdrawals follow a somewhat predictable pattern, there are still factors that can impact the timeline. Understanding what they are can help you better prepare for this process. First is frequency and duration of use. The longer someone uses xylazine, the more their body adapts to it. Chronic use leads to greater physical dependence, making withdrawal longer and more severe.
The dosage and method of use also play a role. Higher doses cause greater physical dependence, leading to stronger withdrawal symptoms. Injecting xylazine delivers the substance faster and more intensely, which also increases withdrawal symptoms. Other factors that can affect the timeline include using xylazine with opioids, individual health and metabolism, underlying mental health disorders, and a lack of medical support.
The Stages of Xylazine Withdrawal
- Stage 1: Early withdrawal (6-12 hours from the last use). In the first stage, the body begins to react to the absence of xylazine. Since the substance suppresses the central nervous system (CNS), it leads to a rapid rebound effect. Symptoms include anxiety, restlessness, insomnia, muscle stiffness, and elevated blood pressure and heart rate.
- Stage 2: Acute withdrawal (12-48 hours). This stage is considered the “peak stage,” as it’s when symptoms intensify. The nervous system is overstimulated, leading to severe withdrawal symptoms like severe anxiety, panic attacks, shaking or tremors, agitation, paranoia, muscle spasms, and flu-like symptoms.
- Stage 3: Post-acute withdrawal (3-7 days). During this stage, symptoms begin to improve, but fatigue and mood issues remain. The symptoms that are most likely to linger include anxiety, depression, insomnia, muscle weakness, body aches, fatigue, and cravings.
- Stage 4: Extended withdrawal (1-4 weeks). The body is recovering in this stage, but psychological symptoms can persist. Some individuals experience PAWS (post-acute withdrawal syndrome), where withdrawal symptoms last for weeks or months. This includes trouble sleeping, emotional numbness, mental fog, cravings, and a lack of pleasure (anhedonia).
Cold Turkey vs Weaning
“Cold turkey” means stopping xylazine use at once without tapering down. The body is forced to adjust quickly leading to intense withdrawal symptoms. This approach is best done under medical supervision because of the risk of complications. Weaning off xylazine involves slowly reducing the dose over time. This allows the body to adjust gradually, reducing withdrawal symptoms. Tapering can be done under medical supervision or alongside harm reduction strategies.
There are risks and benefits to each method. Cold turkey leads to more intense withdrawal symptoms, but you get through the process faster (usually within 3-7 days). Medical supervision is strongly recommended, and there is a higher risk of return to use because the withdrawal symptoms can be so intense. On the other hand, weaning off xylazine might take longer (sometimes weeks or months), but the withdrawal symptoms are milder and return to use is less likely.
While each situation is unique, medical professionals often recommend gradually weaning off xylazine because it reduces withdrawal intensity and helps prevent serious consequences. However, since there is no FDA-approved treatment, individual cases are left up to the discretion of the overseeing doctor.
Why Xylazine Withdrawals Occur
Xylazine withdrawal occurs because the body and brain become dependent on the substance over time. When someone stops ingesting the substance, their body struggles to function normally, leading to severe withdrawal symptoms. Specifically, xylazine depresses the central nervous system, so when the substance is removed, the CNS becomes overactive. This is what causes symptoms such as severe anxiety, agitation, and high blood pressure.
Xylazine also affects neurotransmitters like dopamine and norepinephrine, which control mood, energy, and stress responses. When xylazine is stopped, neurotransmitter levels are low, leading to depression, cravings, and anxiety. Additionally, there are rebound effects that can occur with xylazine, causing the body to act in opposite ways.
Get Treatment for Xylazine Withdrawals in Prescott, AZ
Xylazine withdrawal can be severe and dangerous, often requiring medical detox and professional xylazine addiction treatment. Since this substance is not an opioid, traditional opioid withdrawal medications do not fully treat its symptoms. Instead, the best option is to start with a medically managed detox program that provides medication, fluids, nutritional support, and 24/7 medical supervision. Since xylazine is often mixed with fentanyl or heroin, many people going through withdrawal are also experiencing opioid withdrawal symptoms. Medication-assisted treatment (MAT) can treat these symptoms and decrease cravings.
To address the emotional aspects of xylazine use, individuals can participate in a residential or outpatient rehabilitation program that offers structured therapy, group counseling, coping skills, and medication management. Cognitive behavioral therapy can help manage cravings and triggers, while dialectical behavior therapy supports emotional regulation and coping strategies. Additionally, peer support groups provide accountability and prevent isolation, making them an important part of ongoing treatment.
Wolf Creek Recovery can help you or a loved one recover from substance use. We have staff in recovery, which means we can relate to the situation you are in today—and the thoughts and feelings you are having. Things can feel dire, but with the right support, you can start paving the way forward. Between individual and group therapy, holistic practices, peer support, and an engaging outdoor therapy program, we can help you lay the foundation for a healthy and complete recovery. Build a life you love. Contact Wolf Creek Recovery at 833-732-8202 to start the healing process.
FAQs About Withdrawing From Xylazine
What are the symptoms of xylazine withdrawal?
The main symptoms of xylazine withdrawals include anxiety, agitation, insomnia, elevated heart rate, high blood pressure, and flu-like symptoms like sweating, chills, and fever. Since xylazine is routinely laced into opioids like fentanyl or heroin, it’s common to experience opioid withdrawal symptoms at the same time.
Why do withdrawal symptoms happen when stopping xylazine?
The reason why a person experiences withdrawal symptoms when stopping xylazine is because the body thinks it needs the substance to function. When xylazine is removed, the central nervous system becomes overactive and neurotransmitter levels drop, resulting in symptoms like anxiety and agitation.
How can I make xylazine withdrawals more manageable?
It’s recommended to detox from xylazine under medical supervision. You will be given medical support (e.g., fluids, medication) to manage your symptoms and make the process more manageable. Tapering off xylazine can also be better than stopping cold turkey.
