Center for Research on Healthcare, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, 3609 Forbes Ave, 2nd floor, Pittsburgh, PA 15213, USA.
Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA.
Drug Alcohol Depend. 2024 Oct 1;263:112390. doi: 10.1016/j.drugalcdep.2024.112390. Epub 2024 Aug 15.
Exposure to xylazine has been associated with wounds distinct from typical injection-related skin and soft tissue infections. We sought to understand drug use and wound care practices, and treatment experiences of people who use drugs (PWUD) in a high-prevalence area of xylazine adulteration.
In August 2023, we surveyed adult PWUD reporting at least one past-year drug use-related wound across three Massachusetts syringe service programs. Using a representative illustration, participants indicated if they had experienced a xylazine wound in the past 90 days. We compared demographic, drug use factors, wound care, and medical treatment experiences among those with and without xylazine wounds. We also conducted additional content analysis of open-ended responses.
Of the 171 respondents, 87 % (n=148) had a xylazine wound in the past 90 days. There were no statistically significant demographic differences between those with and without xylazine wounds. Among those primarily injecting (n=155), subcutaneous injection was nearly ten times more likely among people with xylazine wounds. For those with xylazine wounds (n=148), many engaged in heterogeneous wound self-treatment practices, and when seeking medical care, 74 % experienced healthcare stigma and 58 % had inadequate pain and withdrawal management.
People with self-identified xylazine wounds were more likely to engage in subcutaneous injection and faced several barriers seeking medical wound treatment. Programs serving people exposed to xylazine should work to support safer injection practices, including alternatives to injecting and improving access to high-quality, effective wound care. Further study is warranted to understand the causes, promoters, and prevention of xylazine-related wounds.
接触苯环己哌啶（一种苯丙胺类药物）与典型的与注射相关的皮肤和软组织感染不同的伤口有关。我们试图了解在苯环己哌啶掺杂物高流行地区药物使用者（PWUD）的药物使用和伤口护理实践以及治疗经验。
在 2023 年 8 月，我们调查了在马萨诸塞州三个注射器服务计划中报告至少有一个过去一年与药物使用相关的伤口的成年 PWUD。参与者使用代表性插图表示他们是否在过去 90 天内经历过苯环己哌啶伤口。我们比较了有和没有苯环己哌啶伤口的人在人口统计学、药物使用因素、伤口护理和医疗治疗方面的经验。我们还对开放式回复进行了额外的内容分析。
在 171 名受访者中，87%（n=148）在过去 90 天内有苯环己哌啶伤口。有和没有苯环己哌啶伤口的人在人口统计学上没有显著差异。在主要注射的人中（n=155），有苯环己哌啶伤口的人进行皮下注射的可能性几乎是没有苯环己哌啶伤口的人的十倍。对于有苯环己哌啶伤口的人（n=148），许多人采用了异质的伤口自我治疗方法，当寻求医疗护理时，74%的人经历了医疗保健耻辱感，58%的人疼痛和戒断管理不足。
自我识别为苯环己哌啶伤口的人更有可能进行皮下注射，并面临着寻求医疗伤口治疗的几个障碍。为接触苯环己哌啶的人提供服务的项目应努力支持更安全的注射实践，包括替代注射和改善获得高质量、有效的伤口护理的机会。需要进一步的研究来了解苯环己哌啶相关伤口的原因、促进因素和预防措施。
