Reducing the harms of xylazine: clinical approaches, research deficits, and public health context

Harm Reduction Journal

Perspective

Lucas G. Hill¹  Claire M. Zagorski¹  Mary Figgatt²  Zoe McElligott³  Natalie E. Stahl⁴  Rebecca A. Hosey⁵  Christopher Moraff⁶  Aaron Ferguson⁷  Nabarun Dasgupta⁸  Shoshana Aronowitz⁹ 

[1] College of Pharmacy, The University of Texas at Austin, 2409 University Avenue, A1910, PHR 3.208J, 78712, Austin, TX, USA;Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, 135 Dauer Drive, 27599, Chapel Hill, NC, USA;Department of Pharmacology, Bowles Center for Alcohol Studies, University of North Carolina, CB#7178, 104 Manning Road, 2759, Chapel Hill, NC, USA;Greater Lawrence Family Health Center, 34 Haverhill Street, 01841, Lawrence, MA, USA;HIV Prevention Research Division, Department of Psychiatry, School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 4000, 19104, Philadelphia, PA, USA;Narcomedia, Inc., Philadelphia, PA, USA;National Survivors Union, 1116 Grove St, 27403, Greensboro, NC, USA;University of North Carolina, 725 MLK Jr. Blvd., CB 7505, 27599, Chapel Hill, NC, USA;University of Pennsylvania School of Nursing, Fagin Hall, 418 Curie Blvd, 19104, Philadelphia, PA, USA;

关键词: Xylazine;    Harm reduction;    Wounds;    Drug injection;   

DOI  :  10.1186/s12954-023-00879-7

 received in 2023-05-16, accepted in 2023-09-27,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectivesXylazine 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.MethodsTo 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.ResultsWe 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.ConclusionsAddressing 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.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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