Evidence map›Paper›PMID 42251817›Full record

ArticleDrug and alcohol dependence2026

Pharmacokinetics of xylazine and fentanyl in patients presenting to the emergency department after non-fatal opioid overdose.

Alex J Krotulski, Michael H Baumann, Brittany P Chapman, Patricia Mae E Martinez, John P Broach, John Nguyen, Deborah Olabisi, Jyothi Polackal, Sara E Walton, Brianna N Stang and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Drug and alcohol dependence, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Alex J KrotulskiCenter for Forensic Science Research and Education, Fredric Rieders Family Foundation, 206 Welsh Road, Horsham, PA 19044, USA; College of Life Sciences, Thomas Jefferson University, 1020 Locust St, Philadelphia, PA 19107, USA. Electronic address: alex.krotulski@cfsre.org.
Michael H BaumannDesigner Drug Research Unit, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, 333 Cassell Drive, Suite 4400, Baltimore, MD 21224, USA.
Brittany P ChapmanDepartment of Emergency Medicine, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
Patricia Mae E MartinezDepartment of Emergency Medicine, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, New York, NY 10029, USA.
John P BroachDepartment of Emergency Medicine, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
John NguyenDesigner Drug Research Unit, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, 333 Cassell Drive, Suite 4400, Baltimore, MD 21224, USA.
Deborah OlabisiDepartment of Emergency Medicine, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
Jyothi PolackalDepartment of Emergency Medicine, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
Sara E WaltonCenter for Forensic Science Research and Education, Fredric Rieders Family Foundation, 206 Welsh Road, Horsham, PA 19044, USA.
Brianna N StangCenter for Forensic Science Research and Education, Fredric Rieders Family Foundation, 206 Welsh Road, Horsham, PA 19044, USA.
Alyssa G ReyesCenter for Forensic Science Research and Education, Fredric Rieders Family Foundation, 206 Welsh Road, Horsham, PA 19044, USA.
Barry K LoganCenter for Forensic Science Research and Education, Fredric Rieders Family Foundation, 206 Welsh Road, Horsham, PA 19044, USA; NMS Labs, 200 Welsh Road, Horsham, PA 19044, USA.
Aidan J HampsonNational Institute on Drug Abuse, National Institutes of Health, 6001 Executive Blvd, North Bethesda, MD 20852, USA.
Roland C MerchantDepartment of Emergency Medicine, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, New York, NY 10029, USA; Morsani College of Medicine, University of South Florida, 560 Channelside Dr, Tampa, FL 33602, USA.
Kavita M BabuDepartment of Emergency Medicine, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.

Funding

Sentanyl II: A Multi-State Analysis of Fentanyl/Analogs, Naloxone, and Clinical Features of Non-Fatal Opioid OverdoseUG3DA056892 · NIDA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI BABU, KAVITA M, MERCHANT, ROLAND C · 2022 to 2023
$1.5M
NIDA NIH HHS UG3 DA056892
6 · The paper itself

Abstract

backgroundXylazine is an alpha-2 agonist found as an adulterant in illicitly-manufactured fentanyl. Little information is available about its pharmacokinetics in humans. We conducted a naturalistic study with thirteen adult patients presenting to two urban, tertiary care emergency departments for suspected opioid overdose and concomitant xylazine exposure.

methodsThis study was conducted at two US emergency departments in Worcester, MA. Serial blood specimens were collected over 4h at 30-60min intervals for pharmacokinetic analyses. We developed a quantitative analytical method to measure the blood concentration of xylazine and its metabolites, fentanyl and its metabolite, and medetomidine and its metabolite.

resultsAll thirteen participants had detectable concentrations of xylazine and fentanyl in their blood; five participants also had medetomidine present. Initial blood concentrations (mean±SD, ng/mL) were 47 ± 53 for xylazine, 14 ± 15 for fentanyl, 23 ± 19 for norfentanyl, and 25 ± 24 for medetomidine. Data from a subset of eight participants were used to calculate drug half-lives (t

conclusionThe elimination t

Indexed as

Adrenergic alpha-2 Receptor AgonistsAnalgesics, OpioidDrug OverdoseFentanylOpiate OverdoseXylazineAdultEmergency Service, HospitalFemaleHalf-LifeHumansMaleMedetomidineMiddle AgedYoung AdultAdrenergic alpha-2 Receptor AgonistsAnalgesics, OpioidFentanylMedetomidinenorfentanylXylazineClinicalFentanylHalf-lifeOverdosePharmacokineticsPharmacologyToxicologyXylazine

Identifiers

PMID42251817
PMCPMC13310520

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.