GC–MS confirmation of xylazine (Rompun), a veterinary sedative, in exchanged needles

Abstract

In order to assess the extent of Xylazine (Xyz) injection in Puerto Rico, two waves of used-syringe collections were performed. In the first, syringes were gathered, anonymously and without additional information; in the second, a short interview, also anonymous, was administered. We found Xyz in 37.6% of the collected syringes; the majority of the Xyz-containing syringes came from ranching communities. Syringes containing Xyz more frequently also contained "speedball" than those without (90.6% and 66.7%, respectively). Self-reports of Xyz injection deviated markedly from actual detection: only 50% (self-described users) and 22% (self-described non-users) of the collected syringes contained the drug. With a high prevalence of skin ulcers (38.5% vs. 6.8%, p < 0.001), Xyz users were more likely to be in poor health compared to non-users. Surprisingly, though a higher percentage of Xyz users than non-users had college-level educations (23.1% vs. 5.5%), they were more likely to be homeless (64.1% vs. 37%).

The Emerging of Xylazine as a New Drug of Abuse and its Health Consequences among Drug Users in Puerto Rico

“…Xylazine as an adulterant of speedball was also previously identified in Puerto Rico by Rodriguez and collaborators. 20 Skin ulcerations could be considered the primary health concern identified in our study sample. This effect could be caused by the skin's oxygenation response to xylazine intoxication.…”

“…18,20,22 This trend became known to the general public by a series of reports in the popular media that associated the use of this drug to various deaths in a criminal justice hospital in Aguadilla, Puerto Rico…”

“…Some published reports, such as one from the Philadelphia County Medical Examiner's office, showed xylazine to be copresent with fentanyl in seven drug-related deaths, six of which also tested positive for heroin; 23 findings from the Poison Control Center at The Children's Hospital of Philadelphia also confirm xylazine as a heroin adulterant. 16 A study by Rodriguez and others 20 in Puerto Rico used gas chromatography/mass spectroscopy to analyze syringes for the presence of drugs and found that 90.6% of syringes containing xylazine also contained speedball, a mixture of heroin and cocaine; cocaine (without heroin) was present in 7.2%, and heroin (without cocaine) was present in 2.2%.…”

“…The authors suggest the over reporting might have something to do with the xylazine trend and that some study participants might be inadvertently consuming xylazine instead of heroin. 7 In the study previously mentioned by Rodriguez and others, 20 22% of the syringes of participants who reported to be nonusers of xylazine actually contained the drug. Moreover, xylazine users were found to have a high prevalence of skin ulcers (38.5% vs. 6.8%, pG0.01).…”

Quantitation of the anaesthetic xylazine in ovine plasma by LC–MS/MS

“…Low detection limits for drugs are therefore required to demonstrate adequate elimination of drugs and their metabolites from the blood stream. Quantitation of XYL has been reported by a variety of methods including GC-MS using solvent extraction to prepare samples [3,4], or using derivatising agents, such as BSTFA [5,6]. Analysis of aqueous samples such as plasma is better suited to liquid chromatography.…”