Butte Glenn Medical Society

Xylazine

Since early 2023, xylazine has become an emerging topic and challenge in the field of substance use. There has been laboratory confirmed and self reported cases of xylazine inside of Butte County as of September 2023. As providers and community members, we can take steps to stay educated with up to date and accurate information and spread awareness and resources. Butte Glenn Opioid Safety Coalition applauses and is grateful for our partners that have taken initiative to help our community.

Get xylazine test strips at these sites:
  • Aegis Treatment Center
590 Rio Lindo Ave, Chico - (530)876-2547
  • North Valley Harm Reduction Coalition
171 E 18th St, Chico - (530)332-8065

*Attention*: On a larger scale xylazine is often found in mixture with opioids specifically fentanyl, best results from test strips come from suspected opioids, some samples of stimulants (methamphetamine, MDMA, and cocaine) have been found to show false positives1.

What to know
  • What is xylazine?
Xylazine (zai-luh-zeen) is an animal tranquilizer classified as a sedative, analgesic, and muscle relaxant that is used in veterinary practices 2. Xylazine depresses the central nervous system similar to opioid, alcohol, or benzodiazepines, increasing the danger of overdoses when in combination 3. First cases in the US were initially identified inside Puerto Rico in the early 2000’s, then found along the east coast, and now across the US 2,3,4.
  • How do people use xylazine?
Xylazine is predominantly found in combination with fentanyl, however, in some cases it can be detected in other common substances and rarely (less than 0.5%) detected without other substances 1,2,3,4. Xylazine is most commonly injected, however, every route of administration has been documented 3,4.
  • Why do people get large wounds from xylazine?
The exact reasoning behind xylazine and the related wounds are currently unknown 5,6,7. The wounds that have been observed in association with xylazine use are considered skin ulcers and necrotizing wounds that typical appear as smaller wounds that progress into a larger wound 3,4,6,7. The wounds may appear near sites of injection, however, xylazine related wounds may appear without injection (i.e., smoking or ingestion) or in sites that a person does not inject 3,4,6,7.
  • How to care for xylazine related wounds?
Xylazine related wounds respond to wound care if supported fast enough 6,7. Avoid the usage of rubbing alcohol or hydrogen peroxide for cleaning the wound, instead soap and water have shown to provide best results 6,7,8. Ideally wounds would be dressed and changed daily with nonadherent bandages 6,7,8. Monitor closely for changes in size, coloring, and overall condition for any signs or symptoms of infection or disease progression 6,7,8.
  • Is there any way to reverse a xylazine overdose?
In any case of an overdose, administration of naloxone is recommended, increased by the presence of fentanyl in xylazine related overdoses 5,6,7. Some early studies have shown that xylazine may have some naloxone sensitivity, but there are still signs of sedation after administration 5,6,7,9. After naloxone administration, rescue breathing is important to support central nervous system depressions 5,6,7,9.
  • How do xylazine test strips work?
Xylazine test strips work very similar to fentanyl test strips: a small amount of a substance is diluted into water, put on a test strip, within a few minutes results show if any xylazine was detected 1, 10. It is important to follow the instructions on the packet and use only the required small amount, due to higher concentrations of substance resulting in false positives in some cases 1,10.

1: https://www.cfsre.org/images/content/reports/drug_checking/CFSRE_Xylazine_Report-Rev-1-18-23.pdf
2: https://www.dea.gov/sites/default/files/2022-12/The%20Growing%20Threat%20of%20Xylazine%20and%20its%20Mixture%20with%20Illicit%20Drugs.pdf
3: https://www.sciencedirect.com/science/article/abs/pii/S037687162200117X?via%3Dihub
4: https://link.springer.com/article/10.1007/s11524-011-9662-6
5: https://preventoverdoseri.org/xylazine/
6: https://www.health.pa.gov/topics/Documents/Opioids/Xylazine%20Provider%20Info.pdf
7: https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-023-00879-7
8: https://www.cdph.ca.gov/Programs/CCDPHP/sapb/CDPH%20Document%20Library/xylazine-wound-care-factsheet.pdf
9: https://www.biorxiv.org/content/10.1101/2023.09.08.556914v1
10: https://dancesafe.org/you-may-be-using-fentanyl-testing-strips-incorrectly/
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