Benzo Dope & Tranq: The Next Wave of the Overdose Crisis

The overdose crisis continues to evolve, with synthetic substances driving record-breaking deaths across North America. One of the most dangerous developments is “benzo dope”​—a combination of fentanyl and benzodiazepines that significantly increases the risk of overdose while limiting the effectiveness of naloxone. These potent mixtures are often produced illicitly, making them unpredictable and far more dangerous than traditional street drugs.

Another growing threat is “tranq”—a mix of fentanyl and xylazine, a veterinary tranquilizer not approved for human use. This combination can severely depress the central nervous system, leading to memory loss, dangerously low vital signs, and devastating physical effects such as non-healing wounds. As explored in Beyond Fentanyl, these emerging drug cocktails highlight a rapidly changing and increasingly lethal drug supply, where users often have no idea what they’re taking—and survival becomes increasingly uncertain.

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“A lot of my trauma and pain could have been prevented if I didn’t make the choices that I made and I just want to share my story and stuff to prevent a lot of other girls from either going through that or girls who have experienced it so they know they’re not alone.”
CARRIE – 16 YEARS OLD

“Early on the opioid crisis was linked to prescription opioid tablets that then evolved into the heroin period. That heroin period then evolved into what was considered the third wave or the fentanyl wave [PDF]. I think it’s very clear now that we’ve entered this poly drug wave, when you have fentanyl being mixed with other stimulants or benzodiazepines or other drugs.”

“Xylazine is a tranquilizer most commonly used on horses but it’s now being used to make the effects of fentanyl last longer. Like benzos, it knocks out users for hours at a time and doesn’t respond to Naloxone, which makes identifying it in the supply all the more important.”

“Fentanyl cut with Xylazine is called tranq or tranq dope. Its impact in Philadelphia is most evident in Kensington. The neighborhood’s commonly called an Open-Air Drug Market because people buy sell and use drugs like tranq right on the street.”

“Five years ago, Sarah Laurel founded Savage Sisters, an organization that runs sober living homes, needle exchanges, and Naloxone training.”

“One reason synthetic drugs are taking up so much space in the drug supply here might surprise you – U.S. foreign policy. From 2014 to 2019, much of North America’s fentanyl supply came from one place. But in 2019, China, under pressure from the Trump Administration, banned fentanyl. Seizures of fentanyl in the U.S. supply dropped that year, only it didn’t last long. Companies in China pivoted from selling fentanyl to marketing substances that mimic its effects, as well as the compounds that make it up. Those compounds were bought by Mexican cartels who are now manufacturing fentanyl and trafficking it back into the U.S.”