Burke, Robin
(2024)
Xylazine in the Illicit Opioid Supply: Injury, Overdose, and Trends in the United States.
Master Essay, University of Pittsburgh.
Abstract
Introduction: An estimated 9.4 million people in the United States use illicit opioids or misued prescription opioids in 2020, of which 2.7 million people in the United States had an Opioid Use Disorder. In 2021, there were 80,411 fatal opioid overdoses involving any opioids, nearly 88% of which involved synthetic opioids other than methadone, such as fentanyl. Fentanyl, its analogues, and other adulterants have greatly contributed to the overdose epidemic in the U.S. Since 2020, xylazine has begun to be reported as an adulterant in illicit opioid supplies. What remains less understood is its associated injuries and role in contributing to nonfatal and fatal opioid overdoses.
Methods: A literature search of PubMed in September 2023 revealed nineteen articles relating to xylazine exposure and injury or overdose: eleven surveillance reports of xylazine in drug and biological samples or included on death certificates, three case reports, one mixed-methods study, one cohort study, two interviews and surveys, and one cross-sectional, case-control-matched spatial analysis.
Results: Chronic xylazine use is associated with injuries including wounds that can require hospitalization and intensive care. All studies that commented on temporal trends in xylazine detection agreed that xylazine detections have increased over the past decade, especially since 2019. The vast majority of xylazine detections in the American illicit opioid supply were in combination with fentanyl. Xylazine detections in opioid overdoses were most common in men, non-Hispanic white persons, and those aged 25-44. Xylazine detection in fatal overdoses was highest in the Northeast U.S. from 2020-2022.
Conclusion: Xylazine presents a significant public health threat to people who use illicit opioids. Major policy changes and more expansive, standardized surveillance efforts are needed to avoid short-term and long-term health consequences of xylazine use as well as contribution to mortality from opioid overdose.
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Details
| Item Type: |
Other Thesis, Dissertation, or Long Paper
(Master Essay)
|
| Status: |
Unpublished |
| Creators/Authors: |
|
| Contributors: |
| Contribution | Contributors Name | Email | Pitt Username | ORCID  |
|---|
| Thesis advisor | Songer, Thomas | tjs@pitt.edu | tjs | UNSPECIFIED | | Committee Member | Jawa, Raagini | raagini.jawa@pitt.edu | raagini.jawa | UNSPECIFIED | | Committee Member | Buchanich, Jeanine | jeanine@pitt.edu | jeanine | UNSPECIFIED | | Committee Member | Arnold, Aaron | UNSPECIFIED | UNSPECIFIED | UNSPECIFIED |
|
| Date: |
3 January 2024 |
| Date Type: |
Completion |
| Submission Date: |
14 December 2023 |
| Access Restriction: |
2 year -- Restrict access to University of Pittsburgh for a period of 2 years. |
| Number of Pages: |
50 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Epidemiology |
| Degree: |
MPH - Master of Public Health |
| Thesis Type: |
Master Essay |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
opioid, xylazine, overdose |
| Date Deposited: |
03 Jan 2024 16:10 |
| Last Modified: |
03 Jan 2024 16:10 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/45702 |
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