Along with harmful drugs like fentanyl, xylazine — also known as “tranq” — has been linked to a recent rise in overdoses across the United States.

The powerful animal tranquilizer has become a dangerous street drug, with xylazine found in the drug supply of 48 in 50 states. That means fentanyl, an already extremely deadly drug, has been made “even deadlier” when laced with tranq.

In the City of San Diego, “accidental overdose” was the leading cause of death, according to 2022 data and is especially a risk factor for people experiencing homelessness. Accidental overdoses have increased 438% between 2018 and 2022 among the city’s homeless population, a majority of which involved fentanyl.

Narcan is an overdose reversal medication, but it unfortunately does not reverse the effects of xylazine. Photo courtesy of Father Joe's Villages of San Diego

Fentanyl overdoses can be reversed with the use of medications like naloxone (popularly known as the brand name Narcan), but overdose reversal medications do not reverse the effects of xylazine. 

Even more, xylazine does not have a taste or smell, making it even more dangerous when mixed with other substances, like cocaine, or methamphetamines. 

San Diego Mayor Todd Gloria has sponsored a bill that would add xylazine to a list of Schedule III substances to help law enforcement prosecute drug trafficking and related deaths.

But preventing those deaths is another task entirely.

That’s why homeless support nonprofit Father Joe’s Villages has introduced xylazine test strips to its 24/7 Harm Reduction vending machines. 

Test strips and wound care have been added to vending machines to help those who may encounter or use xylazine. Photo courtesy of Father Joe's Villages of San Diego

“Preventing people from accidentally ingesting the substance is key” in reducing accidental overdose deaths, a press release from the nonprofit explains.

Xylazine test strips are small strips of paper that can be placed within a sample of drugs to detect the presence of xylazine, allowing people to make more informed choices about using a given substance.

A year ago, Father Joe’s Villages installed a naloxone vending machine for homeless people who are at risk of an overdose. Now, a second vending machine includes testing strips for both fentanyl and xylazine, as well as sharps boxes and wound care kits.

Xylazine test strips. Photo courtesy of National Library of Medicine (CC BY-NC-ND 4.0)

“The location and ease of 24/7 access means that these machines are frequented by individuals who are housed and unhoused alike,” said Megan Partch, PhD, chief health officer for Father Joe’s Villages.

“We are a community and we’re meant to care for one another. Having these types of resources readily at hand means we can support anyone in a time of need, whether they are a family member, friend, neighbor or member of the community.”

Recent reductions in fentanyl-related deaths have been partly attributed to the widespread expansion and availability of naloxone nationwide. The hope is that easy access to xylazine test strips will yield similar progress.

“People have life-saving resources available to intervene directly instead of waiting for emergency medical services,” Partch added. 

“Last week, when our Street Health team encountered someone who was in a state of overdose, we learned that community members had already administered doses of naloxone, which helped stabilize this person until help arrived.”

Father Joe’s Villages also has a Street Health team that provides substance use education, connects people to resources, and provides clinical drug and alcohol counseling to unhoused community members.

Any member of the public can access the vending machines. Photo courtesy of Father Joe's Villages of San Diego

Alongside these efforts to increase awareness and safety, the vending machines are a key strategy in the organization’s harm reduction practices.

Harm reduction refers to practices that help people minimize the negative health, social and legal impacts caused by substance use, even when they are not completely ready to stop drug use. 

This helps them move further along on the path to recovery and build trust with providers, like those at Father Joe’s Villages.

“The presence of the vending machines, alone, continues to be a catalyst for ongoing conversation around the overall topic of harm reduction,” Jennifer Wilkens, the manager of street health for Father Joe’s Villages, told Good Good Good.

“These conversations are opportunities to provide education, build awareness, help people gain insight and challenge their thinking around the topic, encourage compassion and understanding, and help people to recognize that they are not alone in this fight. Clearly promoted access to these supplies reminds people that they are seen and their lives and the lives of their loved ones are valued.”

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Header image courtesy of Father Joe's Villages of San Diego

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