Spotlight : The emergence of Xylazine in Canada

On this page

• Drug Analysis Service
• Summary
• Context
• Aim
• Xylazine overview
• Data limitations
• Analytical methods
• Geographical locations
• Physical Description
• Co-occurring substances
• Conclusion
• References
• Suggested citation

Drug Analysis Service

Health Canada’s Drug Analysis Service (DAS) operates laboratories across Canada that analyze suspected illegal drugs seized by Canadian law enforcement agencies. These statistics are based on samples analyzed and may not be representative of all substances seized in Canada, nor of what drugs are circulating on the market. The data below represent the number of times a substance was identified in submitted samples. A single sample may contain more than one substance. Categorization of substances is based on the Controlled Drugs and Substances Act (CDSA).

Summary

• Since 2019, there has been an increase in the number of Xylazine identifications in samples submitted to the Drug Analysis Service (DAS) by Canadian law enforcement agencies.
• 93% of exhibits containing Xylazine were in powder form.
• In 2022, 75% of samples containing Xylazine were submitted by law enforcement agencies from Ontario.
• 79% of Xylazine samples contained 2 to 4 co-occurring substances. Fentanyl was the most frequent co-occurring psychoactive substance, occurring in 93% of samples.

Context

Xylazine was first identified in Canada in 2001 in exhibits submitted by law enforcement agencies, but it only started emerging in 2019 (Figure 1). Indeed, while there were 5 identifications of Xylazine in 2018, the number of Xylazine identifications increased to 205 in 2019. Between January 2012 and December 2022, Xylazine has been identified in 2,324 exhibits submitted for analysis to the Drug Analysis Service (DAS).

The data presented in this figure is available in Table 1

Aim

The aim of this spotlight report is to characterize trends in Xylazine identifications across Canada since 2012 and draw a more comprehensive picture of Xylazine in Canada based on exhibits seized and submitted to DAS for analysis by law enforcement agencies.

Xylazine overview

• Xylazine is a non-narcotic analgesic drug that is used in veterinary medicine^{Footnote 1}. It is not currently approved for human use in Canada^{Footnote 2}.
• Xylazine causes central nervous system depressant effects such as sedation, muscle relaxation, analgesia and anesthesia^{Footnote 3}.
• Side effects of Xylazine include tiredness or faintness, respiratory depression, bradycardia, hypotension, hyperglycemia and miosis^{Footnote 1Footnote 3}.
• Although Xylazine can potentially be used for its own effects, it is most frequently found, in exhibits submitted for analysis, in combination with other drugs. Indeed, Xylazine is likely used as an adulterant to increase bulk and enhance or mimic the effects of other illicit drugs^{Footnote 1Footnote 3}.
• As of December 2022, Xylazine was not controlled in Canada under the Controlled Drugs and Substances Act.

Data limitations

This report is based on data made available by the Drug Analysis Service (DAS), which regularly analyses suspected illegal drugs seized by Canadian law enforcement agencies and samples submitted by public health partners. Some limitations govern the present data. First, law enforcement agencies submit samples for laboratory analysis based on investigation needs. Thus, analyzed samples may not be representative of substances circulating on the market as a number of factors may influence substances submitted by Canadian law enforcement agencies and reporting, such as increased awareness of substances and law enforcement capacities and priorities. Additionally, the DAS is only required to report substances that are controlled under the Controlled Drugs and Substances Act. As such, it is possible that not all noncontrolled substances (including Xylazine) were reported.

Analytical methods

Results of analyzed samples submitted by Canadian law enforcement agencies are reported in a centralized database called the Laboratory Information Management System (LIMS). The presented data were retrieved from the LIMS and covers the period between January 1, 2012 and December 31, 2022, inclusively. Xylazine identifications are defined as the identification of Xylazine in a unique exhibit.

The analysis of presented data was performed in R4.0.2. Data wrangling and visualization was performed using the tidyverse package ^{Footnote 4}. Time trends were computed on a monthly basis and 3-month rolling averages are plotted in line plots.

Geographical locations

In 2019 to 2020, a majority of the Xylazine identifications originated from samples submitted by law enforcement agencies in British Columbia and Alberta (Table 1). In 2021, a sharp increase of Xylazine identifications from samples submitted by law enforcement agencies in Ontario was observed, with a total of 414 identifications in 2021 and 1,011 in 2022, compared to 9 in 2020. In 2022, both British Columbia and Ontario observed an increase in the number of Xylazine identifications (Figure 1, Table 1).

Physical Description

93% of exhibits containing Xylazine were in powder form (Figure 2).

^* Xylazine has not yet been identified in samples originating from certain provinces or territories.
^ⴕ Due to the low number of Xylazine identifications from some provinces, the available data on form may not be an accurate representation of circulating Xylazine in a given province or territory.

Figure 2 – Text Description

Form (count (n)) of exhibits containing Xylazine per province or territory (2012 to 2022)^{*, ⴕ}

Province/Territory	Form						Total
	Residue	Syringe	Powder	Rock-like solid (crack)	Tablets	Other forms
Alberta	-	4	284	-	9	2	299
British Columbia	14	-	462	1	3	12	492
Manitoba	-	-	4	-	-	-	4
New Brunswick	-	-	4	-	1	-	5
Nova Scotia	-	-	1	-	-	-	1
Ontario	47	12	1,355	8	23	13	1,458
Quebec	4	1	39	-	3	5	52
Saskatchewan	-	-	12	-	-	-	12
Yukon	-	-	1	-	-	-	1
Total	65	17	2,162	9	39	32	2,324
* Xylazine has not yet been identified in samples originating from certain provinces or territories. ⴕ Due to the low number of Xylazine identifications from some provinces, the available data on form may not be an accurate representation of circulating Xylazine in a given province or territory.

Co-occurring substances

79% of exhibits containing Xylazine contained 2 to 4 other substances (Table 2).

While in 2019 to 2020, 81% of Xylazine samples were found with 2 or fewer other substances, in 2021 to 2022, 82% of Xylazine samples contained at least 3 other co-occurring substances (Figure 3).

The data presented in this figure is available in Table 2

Since 2019, Xylazine was most frequently found with opioids and cutting agents. As of 2021, Xylazine was also found in combination with sedative/hypnotics, although this trend appears to have peaked in early 2022 (Figure 4).

^§ Includes cutting agents, precursors/key intermediates/reagents, prescription drugs, over the counter drugs and non-drugs.

Figure 4 – Text Description

Number (count (n)) of Xylazine co-occurrences by pharmacological class across time (2012 to 2022)

Pharmacological Class	Year											Total
	2012	2013	2014	2015	2016	2017	2018	2019	2020	2021	2022
Cannabimimetic	-	-	-	-	-	-	-	3	1	1	6	11
Dissociative	-	-	-	-	-	-	-	-	-	5	4	9
Hallucinogen	-	-	-	-	-	-	-	-	-	1	-	1
Opioid	-	-	-	17	7	4	4	218	238	626	1,523	2,637
Sedative/ Hypnotic	-	-	-	1	-	-	-	-	1	390	918	1,310
Stimulant	-	-	-	1	1	-	2	13	19	68	105	209
Not applicable§	-	-	-	20	3	1	4	209	210	889	2,434	3,770
§Includes cutting agents, precursors/key intermediates/reagents, prescription drugs, over the counter drugs and non-drugs.

Frequently co-occurring substances include Caffeine (cutting agent, 97%), Fentanyl (opioid, 93%), Dimethylsulphone (cutting agent, 38%) and Flualprazolam (sedative/hypnotic, 28%) (Figure 5, Table 3). Previous reports suggest that the combined use of Xylazine and an opioid such as Fentanyl or a benzodiazepine-related drug such as Flualprazolam may increase the risk of overdose fatality^{Footnote 1Footnote 3}.

^§ Includes cutting agents, precursors/key intermediates/reagents, prescription drugs, over the counter drugs and non-drugs.

The data presented in this figure is available in Table 3

Conclusion

In summary, there was an observed increased of the number of identifications of Xylazine since 2019 in Canada in samples submitted by Canadian law enforcement agencies. Xylazine samples were most often submitted by law enforcement agencies from Ontario, Alberta and British Columbia. 93% of exhibits containing Xylazine were in powder form and 97% contained at least 2 co-occurring substances. Psychoactive co-occurring substances with Xylazine included Fentanyl (opioid) which was found in 93% of Xylazine samples and Flualprazolam (sedative/hypnotic), found in 28% of Xylazine samples. Previous studies report that Xylazine can induce central nervous system depression, respiratory depression, bradycardia and hypotension in humans^{Footnote 3}. As such, synergistic effects may occur when Xylazine is consumed concurrently with substances producing similar effects such as opioids and sedative/hypnotics and may increase overdose leading to fatality^{Footnote 1Footnote 3}. Continued monitoring is required to ensure partners are aware of the concomitant presence of Xylazine in the illicit drug supply in Canada.

Drug analysis service - Health Canada:

• Marie-Line Gilbert
• Caroline Maurice-Gélinas
• James Rodrigues
• Janike Pitre
• Benoit Archambault

Public Health Agency of Canada:

• Cindy Leung Soo

References

Suggested citation

Government of Canada. (2023). Health Canada Drug Analysis Service. Spotlight: The Emergence of Xylazine in Canada. Longueuil (QC), 2023. Retrieved from: https://www.canada.ca/en/health-canada/services/publications/healthy-living/emergence-xylazine-canada.html .

For more information, please contact Health Canada's Drug Analysis Service.

^©His Majesty the King in Right of Canada, as represented by the Minister of Health, 2023
Cat.: H139-47/2022E-PDF ׀ ISBN: 978-0-660-46039-0 ׀ Pub.: 220519