From the Center for Research on Healthcare, University of Pittsburgh School of Medicine, Pittsburgh, PA (RJ, MS); Grayken Center for Addiction Training and Technical Assistance, Boston Medical Center, Boston, MA (RJ, SB, SM, ASV, TH, AW, CLB); and Boston Health Care for the Homeless Program, Boston, MA (TJ).
J Addict Med. 2024;18(6):723-726. doi: 10.1097/ADM.0000000000001352. Epub 2024 Jul 23.
As xylazine increasingly adulterates the unregulated opioid supply, people who use drugs (PWUD) are more likely to experience sequalae from xylazine. Given xylazine exposure is consistently associated with development of wounds which can heal with medically directed wound care, we sought to understand the level of preparedness and ability of front-line addiction professionals who interact with PWUD to provide wound care treatment.
We administered a 26-item online survey assessing participant and organizational characteristics, level of wound care training, ability to test for xylazine and treat xylazine-associated wounds, and funding and billing characteristics to a national sample of addiction professionals using a listserv of over 11,000 individuals.
We had a response rate of 12.8% in which 1,280 met eligibility criteria and completed the survey, with the majority (23.7%) being nurses. While nearly all participants had cared for patients who had experienced any xylazine-associated harms, less than half (43.6%) had cared for patients with xylazine wounds and 43.4% had any training or certification in wound care, including 26.9% of physicians. Although 75.9% of participants had access to wound care supplies, just 19.5% provided wound care services onsite.
Most addiction professionals, especially physicians, lack wound care training and do not provide onsite treatment for drug-associated wounds at the organizational level. There is a critical need to bridge this gap in knowledge and build capacity to provide evidence-based wound care services to PWUD in areas impacted by xylazine adulteration.
由于苯环己哌啶（xylazine）越来越多地混入不受监管的阿片类药物供应中，药物使用者（PWUD）更有可能出现苯环己哌啶引起的后遗症。鉴于苯环己哌啶暴露与伤口的形成密切相关，而这些伤口可以通过医学指导的伤口护理来愈合，我们试图了解与 PWUD 互动的一线成瘾专业人员在提供伤口护理治疗方面的准备程度和能力。
我们采用了 26 项的在线调查，评估参与者和组织特征、伤口护理培训水平、检测和治疗苯环己哌啶相关伤口的能力，以及资金和计费特征，调查对象为使用超过 11,000 人的列表服务的全国成瘾专业人员。
我们的回复率为 12.8%，其中 1,280 人符合资格标准并完成了调查，大多数（23.7%）是护士。尽管几乎所有参与者都照顾过经历过任何苯环己哌啶相关伤害的患者，但只有不到一半（43.6%）照顾过有苯环己哌啶伤口的患者，只有 43.4%的人接受过任何伤口护理培训或认证，包括 26.9%的医生。尽管 75.9%的参与者可以获得伤口护理用品，但只有 19.5%的人在现场提供伤口护理服务。
大多数成瘾专业人员，尤其是医生，缺乏伤口护理培训，也没有在组织层面为与药物相关的伤口提供现场治疗。在受苯环己哌啶污染地区，为药物使用者提供基于证据的伤口护理服务，知识和能力的差距亟待弥合。
