From the Aegis Sciences Corporation, Nashville, TN (ACH, DMS, JPS, RH); and University of Texas Southwestern Medical Center, Dallas, TX (KL).
J Addict Med. 2023;17(4):468-470. doi: 10.1097/ADM.0000000000001132. Epub 2023 Jan 6.
Xylazine is a tranquilizer commonly added into the illicit drug supply and a likely contributor to overdoses because it does not respond to naloxone reversal. The objective of this study was to perform a retrospective data analysis on xylazine-positive samples collected from patients in various outpatient healthcare settings to illustrate geographic distribution and common copositive substances, which may also contribute to risk of adverse events.
Samples for which providers ordered testing for xylazine were subjected to enzymatic hydrolysis, extracted, and analyzed using liquid chromatography-tandem mass spectrometry. Retrospective analysis was performed on xylazine-positive samples collected from April 2021 to March 2022, to include geographic location and copositive substances.
Xylazine was identified in 413 of 59,498 samples from adults aged 20-73 years and originated from 25 of the 39 states where xylazine testing was ordered. The most common routine substances detected with xylazine were fentanyl, buprenorphine, naloxone, cocaine, d -methamphetamine, and delta-9-tetrahydrocannabinol. The most common designer drugs detected included fentanyl analogs, isotonitazene, and designer benzodiazepines.
Xylazine is geographically spread throughout the United States, indicative of a wide incorporation into the illicit drug supply. These findings differ from previous studies in that these samples originated from healthcare providers in routine care settings, where other reports typically involve overdose deaths. This analysis illustrates that routine testing for xylazine in outpatient settings can afford providers the opportunity to educate individuals and adjust harm reduction measures to potentially mitigate overdose risk.
苯环己哌啶（Xylazine）是一种常见的镇静剂，常被添加到非法药物供应中，且可能是导致过量用药的原因之一，因为它对纳洛酮逆转无效。本研究的目的是对从各种门诊医疗保健环境中采集的苯环己哌啶阳性样本进行回顾性数据分析，以说明其地理分布和常见的共同阳性物质，这些物质也可能导致不良事件的风险增加。
对提供者为检测苯环己哌啶而订购的样本进行酶水解、提取，并使用液相色谱-串联质谱法进行分析。对 2021 年 4 月至 2022 年 3 月采集的苯环己哌啶阳性样本进行回顾性分析，包括地理位置和共同阳性物质。
在 20-73 岁成年人的 59498 个样本中，有 413 个样本检测出苯环己哌啶，来自 25 个进行苯环己哌啶检测的州。与苯环己哌啶一起检测到的最常见常规物质是芬太尼、丁丙诺啡、纳洛酮、可卡因、d-去甲麻黄碱和Δ9-四氢大麻酚。检测到的最常见的设计药物包括芬太尼类似物、异噁唑酮和设计苯并二氮䓬类药物。
苯环己哌啶在美国各地都有分布，表明其广泛应用于非法药物供应中。这些发现与之前的研究不同，这些样本来自医疗保健提供者在常规护理环境中采集，而其他报告通常涉及过量死亡。本分析表明，在门诊环境中对苯环己哌啶进行常规检测可以让提供者有机会对个体进行教育，并调整减少伤害的措施，以潜在降低过量用药的风险。
