The first drug-related death associated with xylazine use in the UK and Europe

Rock, Kirsten L; Lawson, Alexander J.; Duffy, Joanne; Mellor, Alice; Treble, Ric; Copeland, Caroline S.

doi:10.1016/j.jflm.2023.102542

Cited by 18 publications

(14 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In recognition, the federal government designated "fentanyl adulterated or associated with xylazine" as an emerging drug threat in April 2023 (6,7). However, xylazine and fentanyl co-exposure is not an exclusively American phenomenon: the earliest documented xylazine-fentanyl coingestion was accidental in a farmworker in New Zealand in 1984 (11), and a xylazine-fentanylheroin overdose death was reported in the United Kingdom in 2023 (12). Clinical management of human xylazine exposure is made difficult by disfiguring and lingering skin ulcers, a distinctive agitated withdrawal syndrome, and lack of approved antidote or withdrawal support medications (13,14).…”

Section: Introductionmentioning

confidence: 99%

Xylazine is an agonist at kappa opioid receptors and exhibits sex-specific responses to naloxone administration

Bedard,

Murray,

Huang

et al. 2023

Preprint

View full text Add to dashboard Cite

Xylazine has been found in the unregulated drug supply at increasing rates, usually in combination with fentanyl. It has become critical to understand its basic pharmacology, how it impacts behavior, and how it interacts with fentanyl in rodent models of opioid administration. Despite commentary from scientists, politicians, and public health officials, it is not known if xylazine impacts the efficacy of naloxone, the opioid receptor antagonist used to reverse opioid induced respiratory depression. Furthermore, few studies have examined the effects of xylazine alone, without co-administration of ketamine. Here, we examine the impact of xylazine alone and in combination with fentanyl on several key behaviors in male and female mice. We demonstrate differential locomotor responses by dose and sex to xylazine. Surprisingly, our results further indicate that naloxone precipitates withdrawal from xylazine and a fentanyl/xylazine combination, in both sexes, with enhanced sensitivity in females. Further, we show that xylazine is a full agonist at the kappa opioid receptor, a potential mechanism for its naloxone sensitivity.One-Sentence SummaryWe present surprising new insights into xylazine and fentanyl pharmacology with immediate implications for clinical practice and frontline public health.

show abstract

Section: Introductionmentioning

confidence: 99%

Xylazine is an agonist at kappa opioid receptors and exhibits sex-specific responses to naloxone administration

Bedard,

Murray,

Huang

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…The veterinary tranquilliser xylazine has been linked to a death in the UK, said a report in the Journal of Forensic and Legal Medicine 4. Postmortem toxicology detected a number of drugs in a 43 year old who was found dead in May 2022, including xylazine, heroin, fentanyl, and cocaine.…”

Section: Substance Misusementioning

confidence: 99%

Seven days in medicine: 24-30 May 2023

2023

BMJ

View full text Add to dashboard Cite

“…The increase in xylazine participation in rural states indicated the widespread and emerging public legal issues concerning the misuse and abuse of xylazine in the United States [ 9 ]. Recently, a xylazine-related death was first reported in Europe [ 10 ]. Indeed, xylazine poisoning is emerging in clinical and forensic practice; whereas most of them are case reports and they are often combined with other toxins or drugs, the pathological changes in xylazine poisoning cases have seldom been reported [ 10 , 11 , 12 , 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…Recently, a xylazine-related death was first reported in Europe [ 10 ]. Indeed, xylazine poisoning is emerging in clinical and forensic practice; whereas most of them are case reports and they are often combined with other toxins or drugs, the pathological changes in xylazine poisoning cases have seldom been reported [ 10 , 11 , 12 , 13 , 14 , 15 ]. Therefore, the lethal concentration of xylazine in blood and other organs is far from identified and the underlying mechanism in the cause of death in xylazine-related deaths needs further study to be demonstrated.…”

Section: Introductionmentioning

confidence: 99%

Xylazine Poisoning in Clinical and Forensic Practice: Analysis Method, Characteristics, Mechanism and Future Challenges

Mai,

Zhang,

Zhao

2023

Toxics

View full text Add to dashboard Cite

Xylazine abuse is emerging globally, while the identification of xylazine lethal cases poses a great challenge in clinical and forensic practice. The non-specific symptoms delay the diagnosis and treatment of xylazine poisoning, the pathological changes and lethal concentration of xylazine in body fluid and organs of fatal xylazine poisoning cases are seldom reported and the other toxins detected in such cases complicate the role of xylazine in the cause of death. Therefore, we carefully reviewed related updated information on xylazine, summarized the knowledge from clinical and forensic perspectives and can thus provide a reference in such cases and throw light on further study in the field of xylazine poisoning.

show abstract

The first drug-related death associated with xylazine use in the UK and Europe

Cited by 18 publications

References 9 publications

Xylazine is an agonist at kappa opioid receptors and exhibits sex-specific responses to naloxone administration

Xylazine is an agonist at kappa opioid receptors and exhibits sex-specific responses to naloxone administration

Seven days in medicine: 24-30 May 2023

Xylazine Poisoning in Clinical and Forensic Practice: Analysis Method, Characteristics, Mechanism and Future Challenges

Contact Info

Product

Resources

About