ArticleJournal of addiction medicine
Xylazine Exposure and Association With Early Physiological and Withdrawal Symptoms in People With Opioid Use Disorder.
Article in Journal of addiction medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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
1 citing paper in PubMed.
- Unmasking a neurotoxic duo: a comprehensive overview of fentanyl-xylazine crosstalk in kinase pathways.Frontiers in cellular neuroscience · 2026Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectivesThe prevalence of xylazine, an agonist at the alpha-2 adrenergic receptor often used in veterinary medicine, has increased in the illicit opioid drug supply. Case series and survey data suggest that xylazine may increase the nature and severity of opioid withdrawal. We sought to evaluate the association between quantified levels of xylazine exposure and withdrawal symptoms in people undergoing opioid withdrawal.
methodsPeople (n=36; 11 female) with opioid use disorder and physical dependence were enrolled in two harmonized clinical trials. Urine specimens were collected at admission to a residential unit and were analyzed for xylazine, fentanyl, and its inactive metabolite norfentanyl. Opioid withdrawal and physiological effects were collected during stabilization on oral hydromorphone without illicit opioid access.
resultsUrinary xylazine was detected in 69% of samples with concentrations ranging from 5.7 to 15481.1 ng/mL. Among participants with detectable urinary xylazine, higher xylazine concentrations were significantly associated with higher systolic blood pressure ( b =7.68 [2.03, 13.33], P =0.011) and COWS total scores ( b =1.53 [0.17, 2.88], P =0.029). No significant differences in blood pressure or COWS were observed between participants with and without xylazine detected.
conclusionsPotential rebound hypertensive effects following xylazine exposure were observed, consistent with alpha-2 adrenergic mechanisms, which may be accompanied by an exacerbated withdrawal syndrome. Continued preclinical and clinical evaluation of strategies are needed to understand how co-exposure to drug adulterants like xylazine influences withdrawal expression and the utility of existing pharmacological approaches for withdrawal management in clinical settings.
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Registered trials
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