Xylazine, an alpha-adrenergic agent, is a common adulterant in the non-prescribed opioid supply. It has multiplicative sedative effects when used with opioids and these effects can negatively impact pregnancy. Given that the opioid epidemic in Canada is not abating and continues to evolve, cases of xylazine exposure during pregnancy are beginning to present in obstetrical units and emergency departments. Rapid dissemination regarding the obstetrical and medical complications that may be seen in patients presenting with unstable opioid use disorders is needed.
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Xylazine: An emerging threat in obstetrics.
J Obstet Gynaecol Can
January 2025
Department of Family and Community Medicine, Western Michigan University.
Xylazine, an alpha-adrenergic agent, is a common adulterant in the non-prescribed opioid supply. It has multiplicative sedative effects when used with opioids and these effects can negatively impact pregnancy. Given that the opioid epidemic in Canada is not abating and continues to evolve, cases of xylazine exposure during pregnancy are beginning to present in obstetrical units and emergency departments.
View Article and Find Full Text PDFA Case of Xylazine-Induced Necrotic Skin Ulcerations in an IV-Drug User in Florida.
HCA Healthc J Med
December 2024
HCA Florida Orange Park Hospital, Orange Park, FL.
Introduction: As illicit drug manufacturers find new ways to market their products and increase their profit margins, multiple contaminants have found their way into the illicit drug supply. The newest addition, xylazine, also known as "tranq," has spread through the city of Philadelphia and has recently been gaining ground across the United States, including in the state of Florida.
Case Presentation: This case describes a 37-year-old male with a significant past psychiatric history of severe polysubstance intravenous (IV) use, including fentanyl and methamphetamine.
Street Pharmacology: Toxico-Dermatology of Injection Drug Use.
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Division of Dermatology, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.
Street medicine is a point-of-care, mobile approach that services the needs of unhoused individuals who are otherwise unable to access medical care in traditional settings. The prevalence of injection drug use combines with the pipeline of illicit substances, to produce a constellation of severe, potentially life-threatening dermatological disorders unique to this population. This review applies principles of clinical pharmacology to clarify the mechanisms underlying the dermatological toxicity of xylazine, desomorphine, and 3,4-methylenedioxymethamphetamine (MDMA).
View Article and Find Full Text PDFTwo-Layer Retrieval-Augmented Generation Framework for Low-Resource Medical Question Answering Using Reddit Data: Proof-of-Concept Study.
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Department of Biomedical Informatics, School of Medicine, Emory University, Atlanta, GA, United States.
Background: The increasing use of social media to share lived and living experiences of substance use presents a unique opportunity to obtain information on side effects, use patterns, and opinions on novel psychoactive substances. However, due to the large volume of data, obtaining useful insights through natural language processing technologies such as large language models is challenging.
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Xylazine-Associated Necrotic Upper-Extremity Wounds: A Single Hospital System's Experience with 82 Patients and 125 Wounds.
J Bone Joint Surg Am
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Philadelphia Hand to Shoulder Center, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Background: The rise in xylazine-adulterated heroin and fentanyl poses novel challenges to hand surgeons and a rising epidemic of necrotic upper-extremity wounds. While prior case studies have focused on particularly severe and complex xylazine-associated necrotic (XAN) wounds, the aim of this consecutive case series was to characterize the variability of presentations (ranging from mild to severe) at a single institution at the epicenter of the xylazine epidemic.
Methods: Patients presenting to a tertiary referral center for XAN upper-extremity wounds were retrospectively identified from emergency department visits and hospital admissions between January 2021 and December 2023.
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