Scotland’s drug harms early warning system has issued a new alert for the substance xylazine, which is increasingly being detected in overdoses and deaths across Scotland. 

Xylazine is a non-opioid tranquiliser used in veterinary medicine as a sedative, muscle relaxant and painkiller. It reduces breathing, heart rate and blood pressure. 

People who take drugs may not be aware of the potential presence of xylazine in the supply. It is most likely to be consumed unintentionally and is commonly found as an adulterant in brown powders sold as heroin.  

In the UK, it has also been detected in the wider drug supply, including in counterfeit opioid painkillers (codeine and tramadol) and in liquids sold as THC (a psychoactive component of cannabis) vapes.  

The alert has been issued by Rapid Action Drug Alerts and Response (RADAR), led by Public Health Scotland, and highlights that the unregulated drug supply is becoming increasingly toxic and unpredictable due to an increase in new synthetic drugs. 

Data within the latest RADAR report indicates that nitazenes, new synthetic opioids first identified in Scotland in early 2022, were detected during post-mortem toxicology in 12 deaths between 1 October to 31 December 2023.   Xylazine was detected in five deaths during this time.

Dr Tara Shivaji, Consultant at Public Health Scotland, said: 

“We are very concerned about the emergence of synthetic drugs like xylazine and nitazenes within the unregulated drugs market across Scotland. These drugs pose a significant and increased risk of harm to people who use drugs. 

“Many overdoses involve the use of multiple drugs at the same time. Xylazine has largely been identified alongside other substances including heroin, therefore it’s important that people who are likely to witness an overdose carry naloxone - a medicine that temporarily reverses an opioid overdose. 

“Xylazine use is associated with the development of severe wounds and skin damage. Wounds can appear as spots, blisters or open sores anywhere on the body, and require prompt medical attention to prevent serious infections developing.” 

Read the full RADAR alert, including harm reduction information, on xylazine 

Read the RADAR alert on nitazenes 

Read the latest RADAR Quarterly report 

Last updated: 10 May 2024