ArticleClinical toxicology (Philadelphia, Pa.)2023
Opioid overdoses involving xylazine in emergency department patients: a multicenter study.
Article in Clinical toxicology (Philadelphia, Pa.), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
41 citing papers in PubMed.
- Trial
- Fentanyl purity and overdose decline: A reexamination of geographic trends.Science advances · 2026Article
- Toxicological evidence of xylazine in fatal and non-fatal human intoxication: a systematic review.Forensic science, medicine, and pathology · 2026Review
- Characterizing pediatric xylazine exposures reported to United States poison centers, 2010-2024.Clinical toxicology (Philadelphia, Pa.) · 2026Article
- Navigating an unpredictable supply: lived experiences of xylazine exposure among people who use drugs.Harm reduction journal · 2026Article
- Fentanyl Purity and Overdose Decline: A Reexamination of Geographic Trends.medRxiv : the preprint server for health sciences · 2026Article
- Crack/cocaine use to manage xylazine exposure in fentanyl in Connecticut: findings from a convergent mixed methods study.Harm reduction journal · 2026Article
- Clinical factors linked to xylazine exposure in emergency department patients with illicit opioid overdose.Addiction (Abingdon, England) · 2026Observational
- Zeroing in on xylazine - a mixed methods study to explore correlates of reported xylazine use and educational gaps among people who use drugs.Harm reduction journal · 2026Article
- Naloxone Administration in Relation to Fentanyl, Xylazine, CNS Depressants, and Stimulants Exposure After Suspected Opioid Overdose: A Pilot Study.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Observational
- Emergency department-based testing for xylazine and other novel psychoactive substances in Central Alabama: a feasibility study.Harm reduction journal · 2026Article
- Comprehensive method to detect nitazene analogues and xylazine in wastewater.Environmental science and pollution research international · 2025Article
- Early evidence of the effects of xylazine-adulterated fentanyl in Ohio.The International journal on drug policy · 2025Article
- The first report from Ankara on the presence of xylazine abuse in blood and urine samples using a validated LC-HRMS method.International journal of legal medicine · 2025Article
- Recent advances in the identification and quantification of xylazine and medetomidine in biological specimens.Bioanalysis · 2025Review
- Interactions between cardiorespiratory effects of fentanyl and xylazine and their reversal in male and female Sprague-Dawley rats.The Journal of pharmacology and experimental therapeutics · 2025Article
- Trends of all opioid-, heroin-, and fentanyl-involved nonfatal overdoses in the United States, October 2020 - April 2025.Drug and alcohol dependence · 2025Article
- Tranq burn: Exploring the etiology of xylazine-related soft tissue injuries.The International journal on drug policy · 2025Article
- "Anything can happen": experiences of people using opioids in a xylazine market.Harm reduction journal · 2025Article
- Decline in US Drug Overdose Deaths by Region, Substance, and Demographics.JAMA network open · 2025Article
Corrections and comments
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Authors and funding
20 authors.
Funding
Abstract
introductionIllicit opioids, consisting largely of fentanyl, novel synthetic opioids, and adulterants, are the primary cause of drug overdose fatality in the United States. Xylazine, an alpha-2 adrenergic agonist and veterinary tranquilizer, is being increasingly detected among decedents following illicit opioid overdose. Clinical outcomes in non-fatal overdose involving xylazine are unexplored. Therefore, among emergency department patients with illicit opioid overdose, we evaluated clinical outcome differences for patients with and without xylazine exposures.
methodsThis multicenter, prospective cohort study enrolled adult patients with opioid overdose who presented to one of nine United States emergency departments between 21 September 2020, and 17 August 2021. Patients with opioid overdose were screened and included if they tested positive for an illicit opioid (heroin, fentanyl, fentanyl analog, or novel synthetic opioid) or xylazine. Patient serum was analyzed
resultsThree hundred and twenty-one patients met inclusion criteria: 90 tested positive for xylazine and 231 were negative. The primary outcome occurred in 37 patients, and the secondary outcome occurred in 111 patients. Using multivariable regression analysis, patients positive for xylazine had significantly lower adjusted odds of cardiac arrest (adjusted OR 0.30, 95% CI 0.10-0.92) and coma (adjusted OR 0.52, 95% CI 0.29-0.94).
conclusionsIn this large multicenter cohort, cardiac arrest and coma in emergency department patients with illicit opioid overdose were significantly less severe in those testing positive for xylazine.
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