Xylazine Detected in Over 60% of Pacific Northwest Fentanyl Samples, DEA Reports

The DEA's Pacific Northwest field division reported this week that xylazine — a veterinary sedative not approved for human use — is now present in 62% of fentanyl samples seized in Oregon, Washington, and Idaho during the first quarter of 2026. That is up from 41% in the same period last year.

If you or someone you know uses opioids that may come from the illicit supply, this changes the calculus on overdose response in specific ways.

What Xylazine Does

Xylazine is a sedative used in veterinary medicine. In humans, at the doses now appearing in adulterated fentanyl, it causes:

• Deep sedation that can last much longer than a typical opioid overdose.
• Respiratory depression that compounds the effect of fentanyl.
• Severe skin wounds with repeated exposure — often appearing far from injection sites because of vascular damage.
• Cardiovascular effects including dangerously low blood pressure.

It is not an opioid. That is the key clinical point and the one most often misunderstood.

Naloxone Still Works — But Not for Everything

Naloxone (Narcan) reverses the opioid component of an overdose. Because most xylazine-involved overdoses also involve fentanyl, naloxone is still the right first response and can save lives.

What changes:

• The person may not wake up fully even after naloxone reverses the opioid. They may continue to breathe inadequately because of xylazine sedation.
• Rescue breathing matters more. Continue rescue breaths and call 911 even if the person is breathing somewhat after naloxone.
• Do not assume the person is "fine" because they responded to naloxone. Xylazine sedation can re-emerge as the naloxone wears off.

There is no approved xylazine reversal agent. Supportive care — airway management, oxygen, IV fluids — is the medical response, and it requires emergency services.

What To Do If You Use

Harm-reduction guidance from the CDC and from harm-reduction organizations across the region:

1. Never use alone. If using alone is unavoidable, call the Never Use Alone hotline at 1-800-484-3731. They stay on the line during use and call 911 if you go unresponsive.
2. Test your supply. Fentanyl test strips do not detect xylazine, but xylazine test strips are now distributed by most syringe service programs in Oregon, Washington, and Idaho.
3. Carry naloxone — and carry more than one dose. Multi-dose response is increasingly necessary.
4. Know that recovery is possible from where you are. Medication-assisted treatment (buprenorphine, methadone) reduces overdose death risk by more than half.

Skin Wound Risk

The skin lesions associated with chronic xylazine exposure can develop into serious infections that require hospitalization, IV antibiotics, and sometimes amputation. They appear as dry, blackened areas of dead skin and often do not heal without medical care.

If you see these wounds on yourself or someone you know, they require medical attention even if they do not hurt. Harm-reduction organizations in Portland, Seattle, and Boise offer wound-care clinics that do not require insurance and do not report patients to law enforcement.

Where to Find Help

• SAMHSA National Helpline: 1-800-662-4357 (free, confidential, 24/7)
• 988 Suicide & Crisis Lifeline: Call or text 988
• Never Use Alone: 1-800-484-3731

If you are seeking treatment and need help understanding your options, our directory lists accredited facilities by location and accepted insurance.

What's Next

The DEA and state public health departments are coordinating expanded distribution of xylazine test strips through 2026, with funding from opioid settlement allocations. State medical examiners in all three states are tracking xylazine-involved deaths separately from opioid-only deaths beginning July 1, 2026 — the first time this data will be reported in standardized form across the region.

We will update this article when new clinical guidance is released. For now: the message is that naloxone saves lives, rescue breathing matters, and getting to a hospital after an overdose response is more important than it used to be.