The veterinary drug that has been found in Scotland's drug supply - and what it could be doing to people

A powerful tranquiliser linked to horrific side effects is now widespread in Scotland’s illicit drugs market, health chiefs have warned, including in cannabis vapes and counterfeit painkillers.

Xylazine, a non-opioid tranquiliser used in veterinary medicine as a sedative, muscle relaxant and painkiller, has been detected in Scotland, according to Public Health Scotland (PHS).

The drug, which is commonly found as an adulterant in brown powders sold as heroin, has also been found in liquids sold as THC – a psychoactive component of cannabis – vapes and in counterfeit opioid painkillers such as codeine and tramadol. Several reports describe sudden collapse, unconsciousness and memory loss after users unintentionally took the drug.

Xylazine has been detected in illicit drugs

It is also reportedly associated with the development of severe wounds and skin ulcers.

Dr Tara Shivaji, a consultant at PHS, said: “We are very concerned about the emergence of synthetic drugs like xylazine and nitazene 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.”

PHS said the report “highlights that the unregulated drug supply is becoming increasingly toxic and unpredictable due to an increase in new synthetic drugs”, especially the synthetic opioid nitazene.

Data within the latest PHS drugs report shows nitazene, which was first identified in Scotland in early 2022, was detected during post-mortem toxicology in 12 deaths between October 1 and December 31 last year. Xylazine was detected in five drug deaths over the same time period.

Xylazine – known as ‘tranq’ or ‘tranq dope’ when cut with heroin and fentanyl – is causing “widespread” problems in United States, according to King’s College London, as it can dangerously lower breathing and heart rate.

If injected directly into the user’s bloodstream, this reduces the need to re-dose, but can cause large open skin ulcers to form.

Dr Caroline Copeland, from King’s College London, said the presence of xylazine in the UK’s drug market “is cause for alarm” as a much wider population of people who used drugs beyond heroin users would be exposed to its harms.

“There are three simple measures the UK can introduce to prevent the epidemic of xylazine use that has emerged in the USA,” Dr Copeland said.

“Cheap xylazine test strips should be made available, healthcare providers need to be aware of the signs that chronic skin ulcers are due to xylazine use, and pathologists and coroners should specifically request toxicology testing for xylazine in relevant cases to understand the true prevalence of the drug.”