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Integrating public health and translational basic science to address challenges of xylazine adulteration of fentanyl

Neuropsychopharmacology volume 49, pages 319–320 (2024)Cite this article

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Changes in the drug supply landscape directly influence morbidity and mortality with the reduced efficacy of naloxone to reverse fentanyl overdose (versus heroin) emphasizing this impact [1]. The rapid spread of the veterinary anesthetic xylazine in the opioid drug supply (also known as “tranq”) poses a similar public health challenge resulting in a 1127% increase in xylazine-positive overdose mortalities in the American south from 2020 to 2021 [2]. Past experience with novel drug adulterants provides a roadmap for translating research into effective risk prevention and mitigation that can be applied to the emergence of xylazine.

Effective intervention relies on the real-time surveillance of novel drug trends. Programs such as the National Drug Early Warning System (NDEWS) can provide early signals of emerging adulterants like xylazine and offer appropriate lead-in time to curtail more widespread occurrence. Surveillance can also occur at the level of the person through harm reduction tools like drug checking equipment. The development of rapid xylazine testing strips may offer similar gains as with fentanyl testing strips by informing the individual of possible invisible contaminants and allowing for engagement in risk reduction strategies.

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References

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Funding

The authors are supported by DA046526, DA055879, DA058933, and DA049130 (to CDG), and DA055634 (to JCS).

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Authors and Affiliations

  1. Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, USA

    Cassandra D. Gipson

  2. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Justin C. Strickland

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  1. Cassandra D. Gipson
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  2. Justin C. Strickland
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Contributions

CDG wrote the initial draft of the Hot Topic piece, and JCS contributed additional text. Both CDG and JCS edited the manuscript and approved the final version.

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Correspondence to Cassandra D. Gipson or Justin C. Strickland.

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Gipson, C.D., Strickland, J.C. Integrating public health and translational basic science to address challenges of xylazine adulteration of fentanyl. Neuropsychopharmacol. 49, 319–320 (2024). https://doi.org/10.1038/s41386-023-01680-7

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