Reducing the harms of xylazine: clinical approaches, research deficits, and public health context
Abstract Objectives Xylazine has emerged as a consistent part of the unregulated drug supply in recent months. We discuss major domains of xylazine’s harm, current knowledge deficits, clinical and harm reduction strategies for minimizing harm, and xylazine’s public health and policy context. As an i...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-09-01
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| Series: | Harm Reduction Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12954-023-00879-7 |
| _version_ | 1797247439509389312 |
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| author | Claire M. Zagorski Rebecca A. Hosey Christopher Moraff Aaron Ferguson Mary Figgatt Shoshana Aronowitz Natalie E. Stahl Lucas G. Hill Zoe McElligott Nabarun Dasgupta |
| author_facet | Claire M. Zagorski Rebecca A. Hosey Christopher Moraff Aaron Ferguson Mary Figgatt Shoshana Aronowitz Natalie E. Stahl Lucas G. Hill Zoe McElligott Nabarun Dasgupta |
| author_sort | Claire M. Zagorski |
| collection | DOAJ |
| description | Abstract Objectives Xylazine has emerged as a consistent part of the unregulated drug supply in recent months. We discuss major domains of xylazine’s harm, current knowledge deficits, clinical and harm reduction strategies for minimizing harm, and xylazine’s public health and policy context. As an interdisciplinary team from across the USA, we have pooled our knowledge to provide an overview of xylazine’s current and emerging contexts. Methods To inform this essay, the pertinent literature was reviewed, clinical knowledge and protocols were shared by multiple clinicians with direct expertise, and policy and public health context were added by expert authors. Results We describe xylazine’s major harm domains—acute poisoning, extended sedation, and wounds, along with anemia and hyperglycemia, which have been reported anecdotally but lack as clear of a connection to xylazine. Current successful practices for xylazine wound care are detailed. Understanding xylazine’s epidemiology will also require greater investment in drug checking and surveillance. Finally, approaches to community-based wound care are discussed, along with an orientation to the larger policy and public health context. Conclusions Addressing the harms of xylazine requires interdisciplinary participation, investment in community-based harm reduction strategies, and improved drug supply surveillance. The relatively unique context of xylazine demands buy-in from public health professionals, harm reduction professionals, clinicians, basic science researchers, policymakers and more. |
| first_indexed | 2024-03-09T05:51:47Z |
| format | Article |
| id | doaj.art-f26a98db63db4bc0bcd5e37daffac3e6 |
| institution | Directory Open Access Journal |
| issn | 1477-7517 |
| language | English |
| last_indexed | 2024-04-24T19:58:43Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Harm Reduction Journal |
| spelling | doaj.art-f26a98db63db4bc0bcd5e37daffac3e62024-03-24T12:14:33ZengBMCHarm Reduction Journal1477-75172023-09-012011910.1186/s12954-023-00879-7Reducing the harms of xylazine: clinical approaches, research deficits, and public health contextClaire M. Zagorski0Rebecca A. Hosey1Christopher Moraff2Aaron Ferguson3Mary Figgatt4Shoshana Aronowitz5Natalie E. Stahl6Lucas G. Hill7Zoe McElligott8Nabarun Dasgupta9College of Pharmacy, The University of Texas at AustinHIV Prevention Research Division, Department of Psychiatry, School of Medicine, University of PennsylvaniaNarcomedia, Inc.National Survivors UnionDepartment of Epidemiology, University of North Carolina Gillings School of Global Public HealthUniversity of Pennsylvania School of NursingGreater Lawrence Family Health CenterCollege of Pharmacy, The University of Texas at AustinDepartment of Pharmacology, Bowles Center for Alcohol Studies, University of North CarolinaUniversity of North CarolinaAbstract Objectives Xylazine has emerged as a consistent part of the unregulated drug supply in recent months. We discuss major domains of xylazine’s harm, current knowledge deficits, clinical and harm reduction strategies for minimizing harm, and xylazine’s public health and policy context. As an interdisciplinary team from across the USA, we have pooled our knowledge to provide an overview of xylazine’s current and emerging contexts. Methods To inform this essay, the pertinent literature was reviewed, clinical knowledge and protocols were shared by multiple clinicians with direct expertise, and policy and public health context were added by expert authors. Results We describe xylazine’s major harm domains—acute poisoning, extended sedation, and wounds, along with anemia and hyperglycemia, which have been reported anecdotally but lack as clear of a connection to xylazine. Current successful practices for xylazine wound care are detailed. Understanding xylazine’s epidemiology will also require greater investment in drug checking and surveillance. Finally, approaches to community-based wound care are discussed, along with an orientation to the larger policy and public health context. Conclusions Addressing the harms of xylazine requires interdisciplinary participation, investment in community-based harm reduction strategies, and improved drug supply surveillance. The relatively unique context of xylazine demands buy-in from public health professionals, harm reduction professionals, clinicians, basic science researchers, policymakers and more.https://doi.org/10.1186/s12954-023-00879-7XylazineHarm reductionWoundsDrug injection |
| spellingShingle | Claire M. Zagorski Rebecca A. Hosey Christopher Moraff Aaron Ferguson Mary Figgatt Shoshana Aronowitz Natalie E. Stahl Lucas G. Hill Zoe McElligott Nabarun Dasgupta Reducing the harms of xylazine: clinical approaches, research deficits, and public health context Harm Reduction Journal Xylazine Harm reduction Wounds Drug injection |
| title | Reducing the harms of xylazine: clinical approaches, research deficits, and public health context |
| title_full | Reducing the harms of xylazine: clinical approaches, research deficits, and public health context |
| title_fullStr | Reducing the harms of xylazine: clinical approaches, research deficits, and public health context |
| title_full_unstemmed | Reducing the harms of xylazine: clinical approaches, research deficits, and public health context |
| title_short | Reducing the harms of xylazine: clinical approaches, research deficits, and public health context |
| title_sort | reducing the harms of xylazine clinical approaches research deficits and public health context |
| topic | Xylazine Harm reduction Wounds Drug injection |
| url | https://doi.org/10.1186/s12954-023-00879-7 |
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