ReviewHarm reduction journal2023
Reducing the harms of xylazine: clinical approaches, research deficits, and public health context.
Review in Harm reduction journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 54 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
54 citing papers in PubMed, 1 synthesis or guideline pooled it, 78 citations in OpenAlex.
- Management of xylazine toxicity, overdose, dependence, and withdrawal: A systematic review.The American journal on addictions · 2025Pooled it
- Healthcare provider approaches to managing the health harms of xylazine: A qualitative study.Journal of substance use and addiction treatment · 2026Article
- 'If you've ever experienced it, you'd feel differently': Exploring willingness and skepticism toward using higher dose naloxone products among people who use drugs in Maryland, United States.Addiction (Abingdon, England) · 2026Article
- Responding to medetomidine in Philadelphia: narrative summary of the public health response to a new psychoactive substance.Addiction science & clinical practice · 2026Article
- New trends in the overdose epidemic: postural impact on abusers of fentanyl and xylazine and clinical and forensic implications.Forensic science, medicine, and pathology · 2026Review
- Theorizing causality: A qualitative study of xylazine-related wound diversity and perceived etiology among people who inject drugs.Addiction (Abingdon, England) · 2026Article
- Buprenorphine prescribing is increasingly delivered by primary care nurse practitioners to Medicaid beneficiaries.Journal of the American Association of Nurse Practitioners · 2026Article
- 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
- Surgical Challenges and Harm-reduction Strategies in Xylazine-associated Wounds: A Systematic Review.Plastic and reconstructive surgery. Global open · 2026Article
- Crack/cocaine use to manage xylazine exposure in fentanyl in Connecticut: findings from a convergent mixed methods study.Harm reduction journal · 2026Article
- 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
- "No judgment, no preaching": approaches to harm reduction service provision for people who use drugs in North Carolina.Harm reduction journal · 2026Article
- Evidence that xylazine disrupts skin homeostasis by acting on epithelial cells through the kappa opioid receptor.Disease models & mechanisms · 2026Article
- Xylazine test strip utilization among pregnant and postpartum women with opioid use disorder: A pilot study.Pregnancy (Hoboken, N.J.) · 2026Article
- First Detection of Xylazine in Texas Wastewater and Its Association with Fentanyl Use.ACS ES&T water · 2026Article
- Acute fentanyl and xylazine co-exposure uniquely increase the excitability of dopamine type 2 receptor-expressing striatal medium spiny neurons.Journal of neurophysiology · 2026Article
- Real time, on-site drug checking in low-threshold housing communities.Harm reduction journal · 2026Article
- Emergency department-based testing for xylazine and other novel psychoactive substances in Central Alabama: a feasibility study.Harm reduction journal · 2026Article
- Navigating an Unpredictable Supply: Lived Experiences of Xylazine Exposure Among People Who Use Drugs.Research square · 2026Article
Corrections and comments
- Erratum issued
Authors and funding
10 authors at 6 institutions in 1 country.
Funding
Abstract
objectivesXylazine has emerged as a consistent part of the unregulated drug supply in recent months. We discuss major domains of xylazine's harm, current knowledge deficits, clinical and harm reduction strategies for minimizing harm, and xylazine's public health and policy context. As an interdisciplinary team from across the USA, we have pooled our knowledge to provide an overview of xylazine's current and emerging contexts.
methodsTo inform this essay, the pertinent literature was reviewed, clinical knowledge and protocols were shared by multiple clinicians with direct expertise, and policy and public health context were added by expert authors.
resultsWe describe xylazine's major harm domains-acute poisoning, extended sedation, and wounds, along with anemia and hyperglycemia, which have been reported anecdotally but lack as clear of a connection to xylazine. Current successful practices for xylazine wound care are detailed. Understanding xylazine's epidemiology will also require greater investment in drug checking and surveillance. Finally, approaches to community-based wound care are discussed, along with an orientation to the larger policy and public health context.
conclusionsAddressing the harms of xylazine requires interdisciplinary participation, investment in community-based harm reduction strategies, and improved drug supply surveillance. The relatively unique context of xylazine demands buy-in from public health professionals, harm reduction professionals, clinicians, basic science researchers, policymakers and more.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.