Researchers receive grant to study dangers of a drug frequently mixed with fentanyl

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Dr. Nader Moniri and Dr. Clinton Canal from the Mercer College of Pharmacy in a research lab.
Dr. Nader Moniri, left, and Dr. Clinton Canal. Photo by Aaron Williams

The United States faces a growing crisis involving xylazine, a drug often referred to on the streets as “tranq.” It is frequently mixed with fentanyl to extend the powerful opioid’s euphoric effects, but the combination comes at a deadly cost. Two Mercer University College of Pharmacy professors are on a mission to better understand the dangerous side effects of xylazine use.

Dr. Nader Moniri and Dr. Clinton Canal have been awarded a $388,000 grant from the National Institutes of Health to explore how xylazine affects the human body, especially its role in causing dangerous and life-threatening skin lesions.

“Xylazine is primarily used in veterinary medicine as a sedative, but the drug poses serious risks to humans. It depresses vital functions such as breathing, heart rate and blood pressure. However, what’s even more concerning is its association with severe skin lesions that can form all over the body,” said Dr. Moniri, associate dean for research and professor of pharmaceutical sciences.

These lesions, known as eschar, are areas of dead, scaly tissue that can develop anywhere, not just at the injection site.

“What’s alarming is that we don’t yet understand the mechanisms of this phenomenon. The skin tissue is dying, frequently in random parts of the body,” said Dr. Canal, associate professor of pharmaceutical sciences.

Dr. Moniri and Dr. Canal’s investigation aims to shed light on the molecular and biological mechanisms that drive these destructive effects. Their research will focus on how xylazine may interfere with blood flow, causing vessels to contract and stay contracted for extended periods, similar to the effects of frostbite.

“When blood flow is cut off, skin cells are starved of oxygen and nutrients, leading to their death,” Dr. Moniri said.

The implications of this research could lead to life-saving interventions for those affected by xylazine-related complications. Across the country, hospitals and health care providers are seeing an increase in patients with these severe skin lesions, which present unique challenges for treatment.

“Our goal is to understand the molecular causes behind these lesions so that health care professionals can develop more effective treatment strategies,” Dr. Moniri said. “Ultimately, we hope to equip hospitals with the knowledge to better manage, treat these patients and reduce harm.”

This grant is Dr. Canal’s third from the NIH and Dr. Moniri’s fifth, reflecting their deep commitment to advancing scientific knowledge in fields critical to public health. This collaborative research effort marks the first NIH grant they received together, though both researchers have extensive experience in their respective fields. Dr. Moniri, an expert in cellular receptors and molecular pharmacology, and Dr. Canal, whose focus is on neuroscience and addiction, bring complementary expertise to this investigation.

“This is a tremendous opportunity for us to advance our understanding of a growing public health concern,” Dr. Canal said. “We’ve seen fentanyl devastate communities, and the introduction of xylazine into the drug supply adds a new layer of complexity. Our research aims to provide critical insights that can help mitigate the harm caused by this dangerous combination.”

The study will begin later this year and continue through 2026.