SynthesisThe American journal on addictions2025
Management of xylazine toxicity, overdose, dependence, and withdrawal: A systematic review.
Synthesis in The American journal on addictions, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 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
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Management of xylazine toxicity, overdose, dependence, and withdrawal: A systematic review.The American journal on addictions · 2025Pooled it
- Perioperative Pain in the Era of Emerging and Unregulated Substances: Recognition, Risk Assessment, and Management.Current pain and headache reports · 2026Review
- Xylazine-Fentanyl Positivity and Concentration in Urine Drug Tests.JAMA network open · 2026Article
- The Effect of Ketamine, Xylazine, and Ketamine/Xylazine Administration on SCN5A (Nav1.5) Gene Expression in Pigeons.Veterinary medicine and science · 2026Article
- Emergency department-based testing for xylazine and other novel psychoactive substances in Central Alabama: a feasibility study.Harm reduction journal · 2026Article
- Perceptions and Experiences of Xylazine, Disparities in Xylazine Awareness, and Correlates of Xylazine-Attributed Wounds Among People Who Use Opioids.International journal of environmental research and public health · 2026Article
- Post-marketing Surveillance of Intranasal Nalmefene: Prevalence and Clinical Relevance of Precipitated Withdrawal.Cureus · 2025Article
- Recent advances in the identification and quantification of xylazine and medetomidine in biological specimens.Bioanalysis · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
BACKGROUND AND
objectivesXylazine, an alpha-2-adrenergic agonist, has been increasingly implicated in substance use and overdose crises. However, little is known about its effects on humans. With the growing public health crisis surrounding xylazine, it has become important to recognize and promptly manage symptoms of xylazine toxicity, withdrawal, and overdose. We conducted a systematic review to consolidate the existing literature on the topics, aiming to identify gaps and propose evidence-based actions for managing patients.
methodsPublished literature from 1957 to 2024 was searched to identify studies focusing on the management of xylazine intoxication, withdrawal, overdose, and dependence in humans. PRISMA guidelines and JBI critical appraisal tools were used to ensure the methodological quality of the included studies and reduce bias in study selection. Thirty-four studies were included in this review.
resultsXylazine misuse was common among men aged 19-45 years and was more likely to be used with other substances than alone. The doses ranged from 40 to 4300 mg, with no established toxic dosing. Supportive care included treatment with naloxone, alpha-2 agonists, and GABAergic medications. There is no antidote or evidence-based treatment recommendations. DISCUSSION AND
conclusionsThis systematic review consolidated the outcomes and proposed guidelines from xylazine management trials. It can serve as a reference for providers to promptly manage xylazine toxicity, withdrawal, and overdose symptoms to improve patient outcomes. SCIENTIFIC SIGNIFICANCE: Although there is currently no standardized treatment or antidote, this review will aid ongoing research to address these gaps in xylazine management.
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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.