College of Pharmacy, The University of Texas at Austin, 2409 University Avenue, A1910, PHR 3.208J, Austin, TX, 78712, USA.
HIV Prevention Research Division, Department of Psychiatry, School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 4000, Philadelphia, PA, 19104, USA.
Harm Reduct J. 2023 Sep 30;20(1):141. doi: 10.1186/s12954-023-00879-7.
Xylazine 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.
To 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.
We 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.
Addressing 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.
最近几个月，唑吡坦已成为不受监管的毒品供应中常见的一部分。我们讨论了唑吡坦危害的主要领域、当前的知识空白、临床和减少危害的策略，以尽量减少危害，以及唑吡坦的公共卫生和政策背景。作为一个来自美国各地的跨学科团队，我们汇集了我们的知识，提供了唑吡坦当前和新兴背景的概述。
为了撰写这篇文章，我们查阅了相关文献，多位具有直接专业知识的临床医生分享了临床知识和方案，专家作者则补充了政策和公共卫生背景。
我们描述了唑吡坦的主要危害领域——急性中毒、长时间镇静以及由此导致的伤口，还有贫血和高血糖，这些虽然有过一些报道，但与唑吡坦的联系并不明确。我们详细介绍了目前用于唑吡坦伤口护理的成功实践。要了解唑吡坦的流行病学，还需要在药物检测和监测方面投入更多资金。最后，我们讨论了基于社区的伤口护理方法，并介绍了更大的政策和公共卫生背景。
解决唑吡坦的危害需要跨学科参与、对基于社区的减少危害策略的投资，以及改善药物供应监测。唑吡坦相对独特的背景要求公共卫生专业人员、减少危害专业人员、临床医生、基础科学研究人员、政策制定者等多方参与。
