National Institute on Drug Abuse Clinical Trials Network Meeting Report: Managing Patients Exposed to Xylazine-Adulterated Opioids in Emergency, Hospital and Addiction Care Settings

Annals of Emergency Medicine, Journal Year: 2024, Volume and Issue: 84(1), P. 20 - 28

Published: March 16, 2024

Language: Английский

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Pilot findings on the real-world performance of xylazine test strips for drug residue testing and the importance of secondary testing methods

Drug and Alcohol Dependence Reports, Journal Year: 2024, Volume and Issue: 11, P. 100241 - 100241

Published: May 7, 2024

Xylazine is a sedative found increasingly in the illicit fentanyl supply that can cause hypotension, bradycardia, necrosis and death. This pilot examined real-world performance of BTNX xylazine test strips (XTS) drug residue samples. study was nested within checking service Rhode Island. We tested unmeasured dissolved 5 mL distilled water using XTS Liquid Chromatography Quadrupole Time-of-Flight Mass Spectrometry (LC-QTOF-MS). Analyses compared LC-QTOF-MS results to calculate detection residue. Among 41 samples, detected 11% by 44 % laboratory. The 18 samples: 4 major, 9 minor, trace volume relative whole sample. disagreed with indicating negative result 77.8 (N=14) samples but never indicated positive when reported xylazine's absence. correctly 22 time, however, this increased 100 time if major active component. In study, often result, likely due dilution levels used sample composition. may not be accurate detecting residual amounts xylazine, especially dominant component Given novelty BTNX's products, we recommend only conjunction other advanced modalities for testing.

Language: Английский

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Evaluation of the relationship of xylazine and fentanyl blood concentrations among fentanyl-associated fatalities

Clinical Toxicology, Journal Year: 2024, Volume and Issue: 62(1), P. 26 - 31

Published: Jan. 2, 2024

Introduction Illicit fentanyl and fentanyl-analogs have produced a devastating increase in opioid fatalities the United States. Increasingly, xylazine has been found illicit supply. The role of intoxication remains unclear. We reviewed coroner records to evaluate trends effects associated with fentanyl-related fatalities.

Language: Английский

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Xylazine and Adulterants in the Evolving Drug Supply: Urgent Call for Responsive Education Models

Substance Use &amp Addiction Journal, Journal Year: 2024, Volume and Issue: 45(2), P. 168 - 175

Published: Feb. 20, 2024

Novel adulterants and synthetic substances are rapidly infiltrating the US drug supply causing new clinical harms. There is an urgent need for responsive education training to address these evolving harms mitigate risks. Since 2020, xylazine, a veterinary tranquilizer, has become increasingly common in illicit opioid supply, especially alongside fentanyl. Training technical assistance (TTA) programs employing adaptive model can quickly disseminate emerging information provide tools respond effectively. We describe our TTA program’s experience developing delivering virtual instructor-led xylazine diverse group of addiction care professionals. The objectives included following: (1) introducing epidemiologic trends, pharmacology, existing literature related xylazine; (2) reviewing xylazine-associated management; (3) discussing harm reduction strategies use. conducted 14 sessions between October 2022 July 2023, which were attended by over 2000 individuals across 49 states. review innovative content managing flexible logistics highlight lessons learned, including targeting multidisciplinary professionals, leveraging online synchronous delivery methods, sustainable funding programs.

Language: Английский

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Reported xylazine exposure highly associated with overdose outcomes in a rapid community assessment among people who inject drugs in Baltimore

Harm Reduction Journal, Journal Year: 2024, Volume and Issue: 21(1)

Published: Jan. 22, 2024

Abstract Background Addressing xylazine harms are now a critical harm reduction priority, but relatively little epidemiological information exists to determine prevalence, magnitude, and correlates of use or related outcomes. Methods We conducted rapid behavioral survey among people who inject drugs ( n = 96) in Baltimore November–December 2022. Using novel indicator self-reported presumed effects, we examined prevalence sociodemographic past year effects association with overdose wound-related Chi-square descriptive statistics were used examine bivariate associations overall separately for those reported by name fentanyl frequency. Results Almost two-thirds (61.5%) experiencing effects. There no differences socio-demographics, more commonly injecting alone (66% vs 38%%, p < 0.007) daily (47% 24% 0.003). Those reporting exposure was three times as likely report (32% 11%, 0.03) twice have naloxone (78% 46%, They also knowing someone died an (92% 76%, 0.09) abscess requiring medical attention (36% 19%, 0.80). These higher respondents specifically named frequently, frequency did not fully explain the heightened Conclusions This study provides insight into scope associated health concerns community-based PWID suggests measures that may be instrumental urgently needed research.

Language: Английский

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Xylazine Use among People Who Inject Drugs, Philadelphia 2022

Journal of Addiction Medicine, Journal Year: 2024, Volume and Issue: 18(2), P. 194 - 200

Published: Jan. 30, 2024

Objectives Xylazine is commonly mixed with illicit opioids in Philadelphia, and potential associations wound issues, infectious diseases, overdoses are of public health concern. We used data from the National HIV Behavioral Surveillance Survey among persons who inject drugs (PWIDs) Philadelphia to better identify individuals at risk inform patients clinicians about xylazine factors. Methods compared characteristics participants reported using those not past 12 months. Among use, we between people prefer did use xylazine. Results In this sample PWIDs, most xylazine, yet common. Compared PWIDs were more likely have recent homelessness, polysubstance overdose history, hepatitis C virus infection ( P < 0.05 for all comparisons). concordant discordant was associated lower preference fentanyl, heroin as primary injection drug, syringe service programs Conclusions Public entities should prioritize studying effects their jurisdictions consider supporting point-of-care drug-checking surveillance addition raising awareness drug supply.

Language: Английский

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Enhancing translation: A need to leverage complex preclinical models of addictive drugs to accelerate substance use treatment options

Pharmacology Biochemistry and Behavior, Journal Year: 2024, Volume and Issue: 243, P. 173836 - 173836

Published: July 26, 2024

Preclinical models of addictive drugs have been developed for decades to model aspects the clinical experience in substance use disorders (SUDs). These include passive exposure as well volitional intake across and utilized also measure withdrawal symptomatology potential neurobehavioral mechanisms underlying relapse drug seeking or taking. There are a number Food Drug Administration (FDA)-approved medications SUDs, however, many demonstrate low efficacy sex differences, we note gaps continuum care certain experiences individuals who drugs. In this review, provide comprehensive update on both frequently novel behavioral addiction with focus translational value highlight need preclinical research follow epidemiological trends patterns stay abreast treatment needs. We then areas which could be improved enhance development pipeline through efforts translation models. Next, describe neuroscience that can leveraged identify biological focusing specifically advances brain transcriptomics approaches screening identification targets. Together, confluence review demonstrates careful selection methodological parameters better approximate combined cutting edge techniques advance SUDs.

Language: Английский

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The effects of xylazine on locomotion and motor behaviour in a planarian model

Behavioural Pharmacology, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 23, 2025

In recent years, the recreational use of xylazine has increased dramatically in USA. Although been used as an anesthetic veterinary medicine for decades, little is known about its behavioral effects. We took advantage planarian’s innate negative phototaxis, reliable movement from light side to dark a Petri dish, explore organism’s suitability animal model investigating preclinical pharmacology xylazine. two experiments, we tested effects several doses on locomotion by recording latency transition into opaque area. Xylazine disrupted dose-dependent fashion. Larger first produced period hyperkinesia without forward motion. This was followed sedation. Physical stimulation sedation and evoked resumption locomotion. Data outside anesthesia are limited; therefore, current study adds relatively small literature

Language: Английский

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Xylazine potentiates the interoceptive effects of fentanyl in male and female rats

bioRxiv (Cold Spring Harbor Laboratory), Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 8, 2025

Abstract Rationale Xylazine, a sedative typically used in veterinary medicine, has been increasingly detected as an adulterant the unregulated opioid supply and present overdose deaths. Therefore, xylazine-adulterated fentanyl is growing public health concern. People who use drugs have reported that xylazine changes prolongs effects of Objectives We standard operant drug discrimination procedures to better understand how impacts discriminative stimulus/interoceptive fentanyl. Methods Male female Long-Evans rats (n=23) were trained discriminate (0.032 mg/kg intraperitoneal) such one lever was reinforced with sucrose on days when administered, other vehicle administered. Once met testing criteria, we tested dose range confirm stimulus control, then if alone produced fentanyl-like addition impacted interoceptive effects. Results Stimulus control confirmed, showed increased percent responses fentanyl-appropriate well decreased response rates for increasing doses Xylazine did not substitute but similar rate reductions alone. co-administered potentiated lower both males females reductions. Conclusions These results indicate enhances fentanyl, which may inform clinical research about

Language: Английский

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Rising illicit drug Adulterants: Xylazine and levamisole

Clinical Biochemistry, Journal Year: 2025, Volume and Issue: unknown, P. 110912 - 110912

Published: March 1, 2025

The increasing prevalence of xylazine and levamisole as adulterants in illicit drugs presents significant challenges for medical professionals. This review aims to provide an overview the mechanisms action, adulteration, detection methods levamisole. Clinical implications associated with levamisole-contaminated are also discussed. It provides a comprehensive examination methodologies analyzing these emerging contaminants, shedding light on faced by toxicology laboratories accurately identifying quantifying substances. Various analytical techniques, including but not limited GC-MS, HPLC-MS, HPLC-MS/MS, explored detail, focus their strengths limitations. serves valuable resource clinicians seeking navigate complexities drug samples. contributes existing knowledge adulteration levamisole, providing insights that can inform public health interventions, law enforcement efforts, treatment strategies aimed at mitigating risks contaminated

Language: Английский

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