Xylazine: a public health crisis amidst an overdose epidemic
OA Version
Citation
Abstract
Interactions between opioids and xylazine are increasing overdose risks and perpetuating problematic health outcomes. The appearance and proliferation of xylazine have contributed to the lethality of the illicit drug supply, which is becoming increasingly contaminated with potent, pharmacologically active substances. In the wake of an overdose crisis marked by deaths involving illicitly manufactured fentanyl, the synergistic mechanisms between opioids and xylazine require further understanding. Similarities in the clinical presentations of xylazine and opioid toxicity have complicated the clinical identification and management of xylazine-opioid overdoses. Xylazine use increases one’s risks for adverse cardiovascular effects, prolonged sedation, and purulent skin and soft tissue infections. Furthermore, an efficacious anecdote for overdoses involving xylazine is currently nonexistent. While xylazine’s pathological influences are investigated, an endeavor that requires substantial time and resources, there is an immediate need for public health policies addressing the state of the overdose epidemic. Considerations for amending state and national drug policies for drug legalization and decriminalization may have a significant impact on not only preventing xylazine-related overdoses but also illicit drug supply lethality. Low-barrier harm reduction programs would increase drug supply surveillance and decrease rates of overdose and infectious disease. The purpose of this thesis is to report on the current state of the xylazine crisis in the context of the opioid overdose epidemic and discuss immediate actions that can be taken to improve public health outcomes among people who use drugs.
Description
2024