Drugs found through Sanguen Health Centre’s Drug Checking Program

Xylazine found in meth

Xylazine

• What is it? A strong sedative. Not an opioid.
• Concerns:
• If someone is very sleepy or hard to wake after using crystal meth, xylazine may be in it.
• Do not use more meth even if sleepy — this can increase overdose risk.
• Effects: can happen minutes after taking the drug and last many hours depending on the dose and other drugs mixed in.
• Deep sleepiness (on the nod, heavily sedated).
• Passing out. People may be hard to wake up for a long time.
• Slow breathing, heart rate, and blood pressure.
• Blackouts and memory loss.
• Confusion (disorientation) and dizziness.
• Skin sores (wounds) that may get worse and last a long time. This can happen if Xylazine is injected, smoked, swallowed, or snorted. Get medical help if you have any sores.

Drugs found in fentanyl

People who use unregulated (street) fentanyl may be at greater risk. Opioids, tranquilizers, or benzodiazepine mixed with any of these drugs increases risk for overdose/ drug poisoning because their dangerous effects become stronger when they are together.

Nefopam

• What is it? A pain reliever. Not an opioid.
• Effects:
• Drowsiness and dizziness.
• Nausea and vomiting.
• Excessive sweating, agitation, fast heart rate.
• At high doses: difficulty peeing, hallucinations, confusion, seizures.

Medetomidine

• What is it? A strong sedative, like xylazine but much stronger. Not an opioid.
• Effects: Last a long time (90 minutes or several hours). Deep sleepiness (on the nod, heavily sedated).
• Passing out. People may be hard to wake up.
• Slow breathing, heart rate, and blood pressure.
• May cause hallucinations or confusion.
• Dizziness, nausea, vomiting.
• Medetomidine Withdrawal: Can start quickly and be very serious. Signs to go to the hospital:
• can’t stop throwing up.
• chest pain.
• going in and out of awareness

Benzodiazepine (“benzo”)

• What is it? A strong sedative. Not an opioid.
• Effects: Deep sleepiness (on the nod, heavily sedated).
• Passing out. People may be hard to wake up.
• Slow breathing, heart rate, and blood pressure.
• Blackouts (memory loss).

Carfentanil

• What is it? A strong unregulated opioid, stronger than fentanyl.
• Effects
• Deep sleepiness (on the nod, heavily sedated).
• Passing out. People may be hard to wake up.
• Slow breathing, heart rate, and blood pressure.
• Very low or no pulse.

Nitazenes

• What is it? A very strong unregulated opioid. Test your drugs with Nitazene test strips. A positive result could mean Nitazenes are in your drugs.
• Effects:
• Deep sleepiness (on the nod, heavily sedated).
• Passing out. People may be hard to wake up.
• Slow breathing, heart rate, and blood pressure.
• Very low or no pulse.

What to do:  

• Stay with anyone on the nod and watch for signs of an overdose.
• Follow the 5 steps to respond to an opioid overdose:

1. Shout their name and shake their shoulders. 
2. Call 911 if they won’t wake up or if breathing is very slow or not at all.
3. Give naloxone.
   1. Nitazens are opioids. Naloxone will work on nitazenes.
   2. Nefopam, Medetomidine, Benzodiazepines, and Xylazine are not opioids. Naloxone cannot stop the effects of nefopam, medetomidine, benzodiazepines and xylazine. Give naloxone because it will work on opioids that may be mixed in the drugs. 

4. Check that the person is breathing regularly. They may not wake up right away. Perform rescue breathing or give oxygen if you can.
5. Additional doses of naloxone may be needed. Give another dose every 2-3 minutes until breathing is back to normal.

• If they are very sedated (sleepy) but still breathing, encourage them to keep breathing.  
• Stay with them until help arrives.