Kelly Patrick J A, Jessop Amy B, Scialanca Madison, Singley Katie, Luck Caseem C, Hoadley Ariel, Meisner Jessica, Bass Sarah B
Department of Behavioral Social Sciences, Brown University School of Public Health, Providence, RI, USA.
Prevention Point Philadelphia, Philadelphia, PA, USA.
Subst Use Addctn J. 2025 Apr;46(2):347-356. doi: 10.1177/29767342241289797. Epub 2024 Oct 27.
The United States opioid crisis has been worsened by the emergence of fentanyl adulterated or associated with the veterinary sedative xylazine. Designated by the White House as an "emerging threat to the US" in 2023, xylazine use is associated with severe skin wounds.
This research explored beliefs, concerns, and treatment behaviors for skin wounds among 93 participants recruited outside of a Philadelphia, Pennsylvania harm reduction agency who reported past-6-month history of a skin wound via a cross-sectional survey administered August-September 2022 (group 1; = 33). Following a December 2022 Philadelphia Department of Public Health Report that indicated xylazine was becoming more prevalent in the Philadelphian drug supply, additional data was collected with new participants from February-March 2023 (group 2; = 60) using the same survey. Participants were ≥18 years old, reported past-year fentanyl use, and spoke English. Our 17-item tool measured skin wound-related beliefs, concerns, treatment behaviors, and treatment sources. An open-response item explored why participants self-treat skin wounds.
Participants averaged 41 years old (SD = 9), slightly more than half were men ( = 54, 58%), 31% ( = 29) were non-White, and most ( = 66, 71%) were unhoused. Overall, 79% of participants self-treated skin wounds. Participants endorsed worry about limb loss ( = 77; 83%), wound shame ( = 76; 82%), and appearance changes ( = 80; 86%). Sixty participants (65%) reported waiting to see wound severity before seeking care. Forty-one participants (44%) delayed wound care because of withdrawal fears.
People with probable xylazine-associated skin wounds have psychosocial concerns about and self-treat these wounds. Findings may be a harbinger of skin wound harm in other regions of the United States and internationally where xylazine is increasing.
芬太尼掺杂或与兽用镇静剂赛拉嗪相关联的情况出现，加剧了美国的阿片类药物危机。赛拉嗪在2023年被白宫指定为“对美国的新出现威胁”，其使用与严重皮肤伤口有关。
本研究通过2022年8月至9月进行的横断面调查，对宾夕法尼亚州费城一家减少伤害机构外招募的93名参与者进行了探索，这些参与者报告了过去6个月有皮肤伤口史（第1组；n = 33）。2022年12月费城公共卫生部的一份报告表明赛拉嗪在费城的毒品供应中变得更加普遍，之后在2023年2月至3月使用相同调查对新参与者（第2组；n = 60）收集了更多数据。参与者年龄≥18岁，报告过去一年使用过芬太尼，且说英语。我们的17项工具测量了与皮肤伤口相关的信念、担忧、治疗行为和治疗来源。一个开放式回答项目探究了参与者自我治疗皮肤伤口的原因。
参与者平均年龄41岁（标准差 = 9），略多于一半为男性（n = 54，58%），31%（n = 29）为非白人，且大多数（n = 66，71%）无家可归。总体而言，79%的参与者自我治疗皮肤伤口。参与者认可对肢体丧失的担忧（n = 77；83%）、伤口羞耻感（n = 76；82%）和外观变化（n = 80；86%）。60名参与者（65%）报告在等待观察伤口严重程度后再寻求治疗。41名参与者（44%）因害怕戒断而推迟伤口护理。
可能与赛拉嗪相关的皮肤伤口患者对这些伤口存在心理社会方面的担忧并进行自我治疗。研究结果可能预示着在美国其他地区以及赛拉嗪使用增加的国际地区会出现皮肤伤口危害。
