ArticleDrug and alcohol dependence2025
Assessing an ICD-10 code approach for estimating xylazine-involved overdose deaths in the United States.
Article in Drug and alcohol dependence, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Charting the decline of the fourth wave: US overdose deaths by race, ethnicity and substance involvement.Addiction (Abingdon, England) · 2026Article
- Charting the Decline of the Fourth Wave: US Overdose Deaths by Race, Ethnicity, and Substance Involvement.medRxiv : the preprint server for health sciences · 2026Article
- Polydrug overdose mortality caused by synthetic opioids and stimulants: current sex- and age-specific trajectories in United States national data for 2018-2024.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Article
- US Overdose Mortality Saw First Drop Below the Jalal-Burke Exponential Growth Curve in 2024.medRxiv : the preprint server for health sciences · 2026Article
- Assessing the real-world performance of xylazine test strips for community-based drug checking in Los Angeles.Harm reduction journal · 2026Article
- What does 'polysubstance' really mean? Comparing drug-involved deaths in CDC records vs. detailed medical examiner data from Los Angeles.The International journal on drug policy · 2026Article
- High variation in purity of consumer-level illicit fentanyl samples in Los Angeles, September 2023-April 2025.The International journal on drug policy · 2025Article
- Xylazine prevalence and concentration in the Los Angeles fentanyl market, 2023-2025.Drug and alcohol dependence reports · 2025Article
- What Does 'Polysubstance' Really Mean? Comparing Drug-Involved Deaths in Los Angeles in CDC Records vs. Detailed Medical Examiner Data.medRxiv : the preprint server for health sciences · 2025Article
Corrections and comments
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Authors and funding
1 author.
Funding
Abstract
introductionThe prevalence of the veterinary sedative xylazine in US overdose deaths rose between 2018 and 2021. More updated estimates are limited, partially due to the lack of a dedicated ICD-10 code-a primary mechanism used to specify drugs implicated in overdose deaths in the US, including in the CDC WONDER system, which provides public data for download with a 6-month lag. For other emerging substances lacking dedicated codes, over time umbrella codes have come to de facto represent them, yet it has not been demonstrated if this has occurred for xylazine.
methodsOverdose deaths in CDC WONDER involving T42.7 ("Antiepileptic and sedative-hypnotic drugs, unspecified") or T46.5 ("Other antihypertensive drugs, not elsewhere classified") were compared to two more specific, albeit delayed, sources: NVSS describing national trends in 2018-2021 and SUDORS describing state-level trends in 2020-2022. This CDC WONDER approach was also used to estimate trends in xylazine-involved deaths through 2024 Q1 by geography, race/ethnicity, substance co-involvement, and demographic categories.
resultsAt the national level, concordance between CDC WONDER records and previous NVSS estimates improved after 2019 and became highly similar in 2021 (3480 vs 3468 deaths). Concordance was also high for estimates stratified by race, age, and region. At the state-level, across 49 state-year pairs, correlation between CDC WONDER and SUDORS was 0.97. Estimated xylazine-involved deaths doubled between 2021 and 2024 Q1, and estimated racial inequalities widened. DISCUSSION: T42.7 or T46.5, together, may have become the de facto coding scheme representing xylazine-involved deaths. This approach provides more up-to-date estimates, showing increasing prevalence and worsening racial inequalities in xylazine-involved deaths into 2024.
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