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

Abstract

During the last decade, the veterinary anesthetics have gained popularity as recreational drugs. The aim of this study was to document the use of "anestecia de caballo" (xylazine) and its consequences among drug users in Puerto Rico. The study combined a cross-sectional survey with 89 drug users and two focus groups conducted in Mayagüez with frontline drug treatment providers. Drug users were recruited from communities of the San Juan metropolitan area using a variety of ethnographic and outreach strategies. A short questionnaire developed for the study collected information on sociodemographics, xylazine use, and its consequences. The two focus groups were conducted to discuss the details related to xylazine use, its consequences, and utilization awareness. The sample comprised 63 males (70.8%) and 26 females with a mean age of 37.2 years. The mean number of years of drug use was 14.3, with a mean frequency of drug use of 5.9 times daily. More than 65% reported speedball as the principal drug of use. The prevalence of xylazine use was 80.7%. More than 42% of the sample used xylazine in a mixture with speedball. The main route of administration of xylazine was injection but 14% reported the use of xylazine by inhalation. More than 35% of the sample reported skin lesions and 21.1% reported at least one overdose episode. Multiple logistic regression analysis revealed that males (OR=3.47, CI=1.10-12.00) and those who reported speedball as their main drug of use (OR=9.34, CI=2.51-34.70) were significantly more likely to be xylazine users. Focus groups revealed that drug users claimed to recognize the presence of xylaxine in a mixture of speedball based on its effects, taste, the color of the drug (dark brown), and its odor. In conclusion, the use of xylazine among drug users in Puerto Rico seems to be an emerging trend with potentially serious health consequences.

When “the Cure” Is the Risk: Understanding How Substance Use Affects HIV and HCV in a Layered Risk Environment in San Juan, Puerto Rico

“…We often heard PWUD describe La Cura as a priority, an urgent matter— “ me tengo que curar (I have to cure myself).” At $3–5 per hit, they cured themselves an average of seven times per day – a figure reported by most of the syringe exchange clients we encountered in the field and consistent with the literature (Finlinson et al, 2006; Reyes et al, 2012). As consumers of adulterated narcotics, many Puerto Rican PWUD use Xylazine, in addition to or in lieu of heroin (Reyes et al, 2012; Torruella, 2011).…”

“…As consumers of adulterated narcotics, many Puerto Rican PWUD use Xylazine, in addition to or in lieu of heroin (Reyes et al, 2012; Torruella, 2011). The Xylazine “cure” results in physical deterioration when the syringe injecting the drug ruptures the skin to penetrate the veins resulting in bodily lesions and subsequent scars (see Images 1-2).…”

Toxic effects of xylazine on endothelial cells in combination with cocaine and 6-monoacetylmorphine

“…Cases related to xylazine toxicity reported human plasma concentrations in a range among 1.0 µM and 20 µM [4, 52], these cases weren’t consider as drug users. The xylazine concentration on plasma users could be higher than these reported cases, considering that an epidemiologic study reported an increase in the frequency of injection since beginning to use xylazine (4–7/daily) [11, 12]. Which means, that xylazine concentrations used in this study are comparable, to the doses used by addicts.…”

Case report of accidental poisoning with the tranquilizer xylazine and the anesthetic ketamine confirmed by qualitative and quantitative toxicological analysis using GC‐MS and LC‐MSn

“…In case of overdose, confusion, drowsiness, or transient loss of consciousness are documented. [2,3] In some case reports of xylazine poisoning, sedation, respiratory depression, bradycardia, hyperglycemia, and severe hypotension were observed. [2] It was also reported to be misused as a horse doping agent and as a drug of abuse.…”