Yes, xylazine use can lead to long-term health issues, particularly when used in combination with opioids like fentanyl. One of the most significant risks is severe skin ulcers and infections, which can persist long after drug use stops and may require extensive medical treatment. Additionally, long-term xylazine use can cause tissue damage, respiratory issues, and delayed wound healing. In some cases, repeated use can also lead to cardiovascular problems and other complications that affect overall health. Because of these risks, ongoing medical care is often needed even after withdrawal, to manage the damage caused by long-term xylazine use.