Erol Öztürk Yeter, Yeter Oya, Aslıyüksek Hızır, Oztuna Ali, Sezigen Sermet, Demirel Göksun
Council of Forensic Medicine, Chemistry Department, Ankara, 06300, Turkey.
Council of Forensic Medicine, Chemistry Department, Istanbul, 34196, Turkey.
Int J Legal Med. 2025 Jul 5. doi: 10.1007/s00414-025-03562-7.
Xylazine, an alpha-2 adrenergic receptor agonist approved for veterinary use, has emerged as a significant adulterant in illicit drugs, particularly synthetic opioids like fentanyl, contributing to a rise in fatal overdoses. Despite its widespread abuse in the United States and other regions, data on xylazine prevalence in Türkiye remain limited. This study aimed to develop and validate a sensitive and rapid liquid chromatography high-resolution mass spectrometry (LC-HRMS) method for detecting xylazine and its metabolites, 2,6-dimethylaniline (DMA) and 4-hydroxyxylazine, in human blood and urine samples. Solid-phase extraction (SPE) was used for sample preparation and the method demonstrated high sensitivity with limits of detection of 0.025-0.06 and 0.068 0.19 ng/mL for xylazine and its metabolites in blood and urine, respectively. Between January and December 2024, 9,123 biological samples from suspected drug users in Ankara were analyzed for xylazine and its metabolites. Xylazine was detected in 28 cases (0.3%). While 4-hydroxyxylazine was detected in 78% of positive cases, DMA was detected in 25% of positive cases. Polysubstance use was common, with pregabalin (50%) and methamphetamine (28%) being the most frequently co-detected substances. This study represents the first report of xylazine abuse in Türkiye, highlighting its emergence in the local drug supply. The findings underscore the need for routine xylazine screening in forensic toxicology to monitor its prevalence and mitigate its impact as an emerging public health threat. The developed LC-HRMS method offers a rapid, sensitive, and reliable tool for detecting xylazine and its metabolites, supporting efforts to address this growing concern.
赛拉嗪是一种已获批准用于兽医领域的α-2肾上腺素能受体激动剂，现已成为非法药物（尤其是芬太尼等合成阿片类药物）中的一种重要掺杂物，导致致命过量用药事件增多。尽管它在美国和其他地区被广泛滥用，但关于土耳其赛拉嗪流行情况的数据仍然有限。本研究旨在开发并验证一种灵敏且快速的液相色谱高分辨率质谱法（LC-HRMS），用于检测人血液和尿液样本中的赛拉嗪及其代谢物2,6-二甲基苯胺（DMA）和4-羟基赛拉嗪。采用固相萃取（SPE）进行样本制备，该方法灵敏度高，血液和尿液中赛拉嗪及其代谢物的检测限分别为0.025 - 0.06 ng/mL和0.068 - 0.19 ng/mL。在2024年1月至12月期间，对安卡拉疑似吸毒者的9123份生物样本进行了赛拉嗪及其代谢物分析。在28例（0.3%）样本中检测到赛拉嗪。在78%的阳性病例中检测到4-羟基赛拉嗪，在25%的阳性病例中检测到DMA。多药滥用情况常见，最常共同检测到的物质是普瑞巴林（50%）和甲基苯丙胺（28%）。本研究是土耳其赛拉嗪滥用的首份报告，凸显了其在当地毒品供应中的出现。研究结果强调了在法医毒理学中进行常规赛拉嗪筛查的必要性，以监测其流行情况并减轻其作为一种新出现的公共卫生威胁所带来的影响。所开发的LC-HRMS方法为检测赛拉嗪及其代谢物提供了一种快速、灵敏且可靠的工具，有助于应对这一日益严重的问题。
