Xylazine spreads across the US: A growing component of the increasingly synthetic and polysubstance overdose crisis.
Xylazine spreads across the US: A growing component of the increasingly synthetic and polysubstance overdose crisis.
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DOI：
10.1016/j.drugalcdep.2022.109380
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发表时间：
2022-04-01
影响因子：
4.2
通讯作者：
Shover, Chelsea
中科院分区：
文献类型：
--
作者：
Friedman, Joseph;Montero, Fernando;Bourgois, Phillippe;Wahbi, Rafik;Dye, Daniel;Goodman-Meza, David;Shover, Chelsea
美国药物过量危机的急剧恶化与合成化合物的多物质使用有关。赛拉嗪是一种兽医镇静剂，长期以来在波多黎各的街头阿片类药物供应中被注意到，最近在费城。然而，其国家趋势、地理分布和健康风险的特征却很差。在这项连续的混合方法研究中，费城的人种学家越来越多地在毒品销售者和注射毒品者（PWID）中观察到甲苯噻嗪。随后，我们系统性地检索了描述美国境内赛拉嗪过量死亡率的记录，并评估了时间趋势和与其他药物的重叠。在10个司法管辖区-代表所有四个美国人口普查区-赛拉嗪越来越多地出现在过量死亡中，从2020年0.15亿死亡的0.36%上升到6.7%。在费城观察到最高的甲苯噻嗪流行率数据（占死亡的25.8%），其次是马里兰州（19.3%）和康涅狄格州（10.2%）。在98.4%的甲苯噻嗪过量死亡中存在非法制造的芬太尼，这表明了强烈的生态联系，以及可卡因（45.4%），苯二氮卓类药物（28.4%），海洛因（23.3%）和酒精（19.7%）。费城的PWID将甲苯噻嗪描述为一种受欢迎的掺假物，它延长了芬太尼注射的短暂时间。他们还将其与软组织感染和纳洛酮耐药过量的风险增加联系起来。甲苯噻嗪越来越多地出现在过量死亡中，与非法制造的芬太尼的扩散有关。人种学报告将其与PWID的严重风险联系在一起。尽管如此，许多司法管辖区并没有对甲苯噻嗪进行常规检测，也没有在全国范围内进行全面跟踪。需要进一步努力为PWID提供服务，以帮助最大限度地减少与药物供应变化相关的额外风险。
Sharp exacerbations of the US overdose crisis are linked to polysubstance use of synthetic compounds. Xylazine is a veterinary tranquilizer, long noted in the street opioid supply of Puerto Rico, and more recently Philadelphia. Yet its national trends, geographic distribution, and health risks are poorly characterized. In this sequential mixed-methods study, xylazine was increasingly observed by ethnographers in Philadelphia among drug-sellers and people who inject drugs (PWID). Subsequently, we systematically searched for records describing xylazine-present overdose mortality across the US and assessed time trends and overlap with other drugs. In 10 jurisdictions – representing all four US Census Regions – xylazine was increasingly present in overdose deaths, rising from 0.36% of deaths in 015m 6.7% in 2020. The highest xylazine prevalence data was observed in Philadelphia, (25.8% of deaths), followed by Maryland (19.3%) and Connecticut (10.2%). Illicitly-manufactured-fentanyls were present in 98.4% of xylazine-present-overdose-deaths – suggesting a strong ecological link – as well as cocaine (45.4%), benzodiazepines (28.4%), heroin (23.3%), and alcohol (19.7%). PWID in Philadelphia described xylazine as a sought-after adulterant that lengthens the short duration of fentanyl injections. They also linked it to increased risk of soft tissue infection and naloxone-resistant overdose. Xylazine is increasingly present in overdose deaths, linked to the proliferation of illicitly-manufactured-fentanyls. Ethnographic accounts associate it with profound risks for PWID. Nevertheless, many jurisdictions do not routinely test for xylazine, and it is not comprehensively tracked nationally. Further efforts are needed to provide PWID with services that can help minimize additional risks associated with a shifting drug supply.
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DOI：
10.1109/tvcg.2014.2346248
发表时间：
2014-12
影响因子：
5.2
作者：
Lex A;Gehlenborg N;Strobelt H;Vuillemot R;Pfister H
通讯作者：
Pfister H
影响因子：
6
作者：
Fleiz, Clara;Arredondo, Jaime;de laFuente, Juan R.
通讯作者：
de laFuente, Juan R.
影响因子：
12.7
作者：
Friedman, Joseph;Akre, Samir
通讯作者：
Akre, Samir
影响因子：
1.5
作者：
Forrester, Mathias B.
通讯作者：
Forrester, Mathias B.
DOI：
10.1126/science.aau1184
发表时间：
2018-09-21
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Jalal H;Buchanich JM;Roberts MS;Balmert LC;Zhang K;Burke DS
通讯作者：
Burke DS