Evaluation of the ARK Diagnostics immunoassay for qualitative detection of xylazine in urine

Journal of Analytical Toxicology, Journal Year: 2024, Volume and Issue: 48(6), P. 468 - 471

Published: May 28, 2024

Abstract Xylazine exposure is common in some US cities, but a commercial assay for routine laboratory testing xylazine not currently available. We evaluated pre-release version of the ARK Diagnostics immunoassay qualitative detection xylazine/4-hydroxyxylazine urine. Studies were conducted using either semi-quantitative application (A. Roche Cobas 503 analyzer) or (B. Beckman Coulter AU480 analyzer). Study specimens consisted deidentified patient urine samples submitted drugs-of-abuse testing. Measurements (X) performed by LC–MS–MS to obtain X-NEGATIVE (X <10 ng/mL) and X-POSITIVE ≥10 ng/mL). The was calibrated with 10 ng/mL cutoff ARK-POSITVE. For (A): among 74 samples, there 1 ARK-NEGATIVE result (false-negative rate = 1.4%); 78 LC–MS–MS, 0% ARK-POSITIVE results (false-positive 0%). (B), 0 0%); sample 1.3%). Common sources interferences investigated without evidence interference. xylazine/4-OH-xylazine found be suitable use screening presence >10 ng/mL.

Language: Английский

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Building Multidisciplinary Consensus on Inpatient Xylazine Management through Clinical Protocols

Substance Use &amp Addiction Journal, Journal Year: 2025, Volume and Issue: unknown

Published: April 15, 2025

The evolving unregulated drug supply in the United States has led to an unprecedented rise xylazine-adulterated synthetic opioid use-related morbidity and mortality, of which Pennsylvania shoulders a disproportionate burden. People experiencing these xylazine harms who seek acute medical care require complex clinical management, multidisciplinary coordination, appropriate linkage outpatient care. We describe our experience leading hospital-wide workgroup from February June 2024 collaboratively develop time-sensitive protocols on inpatient management patients exposed xylazine. Workgroup participants were organized into three subgroups: (1) toxicology screening harm reduction; (2) withdrawal management; (3) wound summarize implementation process protocol recommendations each subgroup highlight important cross-cutting issues related changing supply, standardized patient provider educational tools, next steps.

Language: Английский

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Drug use practices and wound care experiences in the age of xylazine adulteration

Drug and Alcohol Dependence, Journal Year: 2024, Volume and Issue: 263, P. 112390 - 112390

Published: Aug. 15, 2024

Exposure to xylazine has been associated with wounds distinct from typical injection-related skin and soft tissue infections. We sought understand drug use wound care practices, treatment experiences of people who drugs (PWUD) in a high-prevalence area adulteration. In August 2023, we surveyed adult PWUD reporting at least one past-year use-related across three Massachusetts syringe service programs. Using representative illustration, participants indicated if they had experienced the past 90 days. compared demographic, factors, care, medical among those without wounds. also conducted additional content analysis open-ended responses. Of 171 respondents, 87 % (n=148) There were no statistically significant demographic differences between Among primarily injecting (n=155), subcutaneous injection was nearly ten times more likely For (n=148), many engaged heterogeneous self-treatment when seeking 74 healthcare stigma 58 inadequate pain withdrawal management. People self-identified engage faced several barriers treatment. Programs serving exposed should work support safer including alternatives improving access high-quality, effective care. Further study is warranted causes, promoters, prevention xylazine-related

Language: Английский

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Clinical performance of a new lateral flow immunoassay for xylazine detection

Clinical Chemistry and Laboratory Medicine (CCLM), Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 11, 2024

Abstract Objectives Xylazine is a potent sedative used in veterinary medicine. Recently, recreational drugs such as fentanyl have been found to contain xylazine, increasing the risk of respiratory depression and death. Despite similar presentation opioid overdose, patients who ingest xylazine do not respond treatment with Narcan. Therefore, rapid detection could improve patient management prevent adverse outcomes. Methods We evaluated XYL500 one-step drug abuse test for its ability detect 152 urine samples from on chronic therapy pain or substance use disorder. Results were compared LC-MS/MS reference method. Precision, cross-reactivity, interference stability studies performed. Pooled consistently negative positive when tested five times same day over three days testing. The diagnostic sensitivity, specificity accuracy assay 74, 98, 82 % respectively, LC-MS/MS. detected 77 104 identified our initial evaluation, including some that contained low levels (n=8), <10 ng/mL. Minimal cross-reactivity other analgesics commonly encountered was seen only one false result. Interferences by common contaminants negligible. Specimens stable up 160 refrigerated 80 at room temperature. Conclusions allows illustrating utility monitoring ingested containing additive, potential management.

Language: Английский

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Psychosocial Impact of Suspected Xylazine-Associated Skin Wounds Among People Using Fentanyl, Philadelphia, 2022 to 2023

Substance Use &amp Addiction Journal, Journal Year: 2024, Volume and Issue: 46(2), P. 347 - 356

Published: Oct. 27, 2024

Background: The United States opioid crisis has been worsened by the emergence of fentanyl adulterated or associated with veterinary sedative xylazine. Designated White House as an “emerging threat to US” in 2023, xylazine use is severe skin wounds. Methods: This research explored beliefs, concerns, and treatment behaviors for wounds among 93 participants recruited outside a Philadelphia, Pennsylvania harm reduction agency who reported past-6-month history wound via cross-sectional survey administered August-September 2022 (group 1; n = 33). Following December Philadelphia Department Public Health Report that indicated was becoming more prevalent Philadelphian drug supply, additional data collected new from February-March 2023 2; 60) using same survey. Participants were ≥18 years old, past-year use, spoke English. Our 17-item tool measured wound-related behaviors, sources. An open-response item why self-treat Results: averaged 41 old (SD 9), slightly than half men ( 54, 58%), 31% 29) non-White, most 66, 71%) unhoused. Overall, 79% self-treated endorsed worry about limb loss 77; 83%), shame 76; 82%), appearance changes 80; 86%). Sixty (65%) waiting see severity before seeking care. Forty-one (44%) delayed care because withdrawal fears. Conclusions: People probable xylazine-associated have psychosocial concerns these Findings may be harbinger other regions internationally where increasing.

Language: Английский

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Trends and Characteristics during 17 Years of Naloxone Distribution and Administration through a Harm Reduction Program in Pittsburgh, Pennsylvania

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 22, 2024

ABSTRACT Objective Describe time trends during 17.6 years of community-based naloxone distribution. Methods Analysis administrative records from a harm reduction program in Pittsburgh, Pennsylvania, USA, collected encounters for overdose education, dispensing and refills. Monthly were analyzed using segmented regression. Programmatic context aided interpretation quantitative findings. We also evaluated impacts 2014 state legislation loosening prescribing requirements providing Good Samaritan protections. Results From July 2005 to January 2023 there 16,904 service by 7,582 unique participants, resulting 70,234 doses dispensed, with 5,521 response events (OREs), utilizing 8,756 doses. After legislation, new participants increased 10.4 65.9 per month. New tended be older (46 vs. 37 years), female (58% 35%), White race, more likely family/friends as opposed people who use drugs themselves. Consequently, ORE participant fell 1.46 0.47 the year after enactment. On average, 1.63 (95% CI: 1.60, 1.65) administered ORE, which did not change substantially over 17 ( χ 2 =0.28, 3 df, p =0.60) evolution prescription opioids, heroin, illicitly manufactured fentanyl. In 98.0% OREs person experienced “was okay”, i.e., survived. Emergency medical services called 16% overall, but <7% since 2019. There 106 emesis 1,000 4mg nasal spray compared intramuscular injection; 48 reports anger. Titration was associated lower rates adverse events. Conclusions While created environment expansion, reaching previously underserved communities required intentional programmatic development outreach. Long-term consistency <2 high survival rate, robust utilization all lend confidence prioritizing distribution directly their social networks.

Language: Английский

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