The opioid epidemic has been going on for a long time now and was responsible for an estimated 109,000 deaths between March 2021 and 2022 alone.

Now, to add to an already devastating epidemic, there has been an alarming rise in reported cases of Xylazine, a horse tranquilizer, being found in opioids. These cases have been popping up in Philadelphia as well as Chicago.

In some cases, users were unaware of the presence of Xylazine mixed with the opioids, not at all different from the role of heroin when mixed with opioids.

Aside from its own potential lethality, the attention garnered by Xylazine has been mainly due to two of its most predominant and concerning effects.

The first concern stems from Xylazine’s relationship with Naloxone (Narcan), a medication that works to rapidly reverse opioid overdoses. Since Xylazine itself is not an opioid, Narcan does nothing to reverse the effects of a Xylazine overdose, and some even worry it may decrease the effectiveness Narcan has on opioid overdoses.

The second concern revolves around the direct effect of Xylazine on the body. Xylazine is known to cause the development of necrotic skin ulcerations in its users. What this means is that the skin around injection areas begins to die and rot with repeated use. With enough use and lack of treatment, as is typical for the average homeless user, the necrosis can end up claiming entire limbs.

The rotting, most likely combined with the drug’s innate effects as a tranquilizer, has earned it the nickname “zombie drug,” according to a report published by the FDA.

As the opioid crisis continues to plague the country with no end in sight, the seemingly rising new drug mixture remains a horrific and largely uncertain variable.