Xylazine as a Drug of Abuse and Its Effects on the Generation of Reactive Species and DNA Damage on Human Umbilical Vein Endothelial Cells

Silva-Torres, Luz; Vélez, Christian; Álvarez, Lyvia; Zayas, Beatriz

doi:10.1155/2014/492609

Cited by 10 publications

(9 citation statements)

References 58 publications

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“…The published literature demonstrates that Xylazine can produce toxicity and fatality in humans in doses ranging from 40 to 2400 mg, with plasma concentrations ranging from 0.03 to 4.6 mg/L in non-fatal cases. In fatalities, blood concentrations of Xylazine range from trace to 16 mg/L [ 52 ]. Due to the significant overlap between non-fatal concentration and postmortem blood concentration, there appears to be no defined safe, toxic, or fatal concentration of Xylazine in humans [ 50 ].…”

Section: Reviewmentioning

confidence: 99%

Xylazine in the Opioid Epidemic: A Systematic Review of Case Reports and Clinical Implications

Ayub¹,

Parnia²,

Poddar³

et al. 2023

Cureus

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Introduction and objectives: The opioid overdose epidemic is exacerbated by the emergence of Xylazine as an illicit drug adulterant. Xylazine, a veterinary sedative, can potentiate opioid effects while also causing toxic and potentially fatal side effects. This systematic review aims to assess the impact of Xylazine use and overdoses within the opioid epidemic context. Method: A systematic search was conducted following PRISMA guidelines to identify relevant case reports, and case series related to Xylazine use. A comprehensive literature search included databases like Web of Science, PubMed, Embase, and Google Scholar, utilizing keywords and Medical Subject Headings (MeSH) terms related to Xylazine. Thirty-four articles met the inclusion criteria for this review. Results: Intravenous (IV) administration was a common route for Xylazine use among various methods, including subcutaneous (SC), intramuscular (IM), and inhalation, with overall doses ranging from 40 mg to 4300 mg. The average dose in fatal cases was 1,200 mg, compared to 525 mg in non-fatal cases. Concurrent administration of other drugs, primarily opioids, occurred in 28 cases (47.5%). Intoxication was identified as a notable concern in 32 out of 34 studies, and treatments varied, with the majority experiencing positive outcomes. Withdrawal symptoms were documented in one case study, but the low number of cases with withdrawal symptoms may be attributed to factors such as a limited number of cases or individual variation. Naloxone was administered in eight cases (13.6%), and all patients recovered, although it should not be misconstrued as an antidote for Xylazine intoxication. Of the 59 cases, 21 (35.6%) resulted in fatal outcomes, with 17 involving Xylazine use in conjunction with other drugs. The IV route was a common factor in six out of the 21 fatal cases (28.6%). Conclusion: This review highlights the clinical challenges associated with Xylazine use and its co-administration with other substances, particularly opioids. Intoxication was identified as a major concern, and treatments varied across the studies, including supportive care, naloxone, and other medications. Further research is needed to explore the epidemiology and clinical implications of Xylazine use. Understanding the motivations and circumstances leading to Xylazine use, as well as its effects on users, is essential for developing effective psychosocial support and treatment interventions to address this public health crisis.

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Section: Reviewmentioning

confidence: 99%

Xylazine in the Opioid Epidemic: A Systematic Review of Case Reports and Clinical Implications

Ayub¹,

Parnia²,

Poddar³

et al. 2023

Cureus

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“…Xylazine, though not as popular as other drugs employed recreationally, has been reported in the literature. Xylazine is either inhaled or snorted (44) and is used in combination with other medications (3) to give the extended effects desired by users, which comes at the risk of multiple concomitant adverse effects (45).…”

Section: Recreational Drugmentioning

confidence: 99%

Abuse of Xylazine by Human and its Emerging Problems: A Review from Forensic Perspective

Teoh¹,

Muslim²,

Chang³

et al. 2022

MJMHS

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Xylazine is a sedative, analgesic and muscle relaxant widely applied in the veterinary field. However, owing to its depressant effect, xylazine has become a substance of abuse by humans. Misuse of xylazine not only triggers unwanted consequences (death), but also linked with various crimes. Google Scholar, PubMed and SciFinder were used to retrieve articles and case reports in relation to the misuses of xylazine and established analytical methods for forensic investigation until November 2021. Literatures reported the accidental and intended poisoning of xylazine, recreational use of xylazine and as an adulterant in recreational drugs. In addition to being a facilitator of crime and sexual assault, it is administered illegally to food producing animals as a sedative and to sports animals as a doping agent. Problems associated with the abuse of xylazine were highlighted in this review, covering the unknown prevalence of xylazine abuse and the need to revise the regulatory status of xylazine. In addition, limited screening and confirmatory methods that can be readily utilised to detect xylazine either alone or simultaneously with other substances of abuse, particularly useful for forensic toxicology and narcotic section were available in the literature. As a conventionally used veterinary drug, xylazine is undoubtedly a potentially hazardous drug, and the investigations on its potential abuse would enhance routine forensic examination to keep pace with the status of illicit drugs.

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“…Xylazine is commonly used as an adulterant in heroin and frequently found in combined heroin and cocaine use 83–85 . The combination of heroin and xylazine (alone or in combination with cocaine) produces a stronger euphoria than heroin alone 83,86 . The most common side effects associated with xylazine administration are bradycardia, respiratory and central nervous system depression, hypotension, and other changes in cardiac output 81–83 …”

Section: Product Adulteration Enrichment and Substitutionmentioning

confidence: 99%

“…Adulterants in the aforementioned substances of abuse can further compromise cardiovascular, respiratory, and immune systems, thereby increasing susceptibility to SARS‐CoV‐2 and risk of COVID‐19 complications. Adulterants of heroin, cocaine, and methamphetamine that can place individuals at higher risk for COVID‐19 are presented in Table 1 34,35,37,40,42,51,55,56–142 …”

Section: Coronavirus Disease 2019 and Substances Of Abusementioning

confidence: 99%

Inherent Dangers of Using Non–US Food and Drug Administration–Approved Substances of Abuse

White

Browne

Nafziger

2021

The Journal of Clinical Pharma

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Use of US Food and Drug Administration–approved substances of abuse has innate risks due to pharmacologic and pharmacokinetic properties of the medications, but the risk when using nonapproved drug products is much greater. Unbeknownst to the user, the dose of active ingredients in substances of abuse can vary substantially between different products because of manufacturing practices or improper storage. Even naturally occurring substances of abuse can have extensive dosage variability because of effects of the growing season and conditions, or differences in harvesting, storage, or manufacture of the finished products. Many illicit substances are adulterated, to make up for intentional underdosing or to enhance the effect of the intended active ingredient. These adulterants can be dangerous and produce direct cardiovascular, neurologic, hematologic, or dermatologic reactions or obscure adverse effects. Finally, an illicit substance can be contaminated or substituted for another one during its manufacture, leading to differences in adverse events, adverse event severity, or the drug interaction profile. Substances can be contaminated with microbes that induce infections or heavy metals that can damage organs or cause cancer. This milieu of undisclosed substances can also induce drug interactions. For reasons that are discussed, individuals who use substances of abuse are at increased risk of morbidity or mortality if they develop coronavirus disease 2019. Health professionals who treat patients with acute, urgent events associated with substances of abuse, or those treating the chronic manifestations of addiction, need to appreciate the complex and variable composition of substances of abuse and their potential health effects.

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Xylazine as a Drug of Abuse and Its Effects on the Generation of Reactive Species and DNA Damage on Human Umbilical Vein Endothelial Cells

Cited by 10 publications

References 58 publications

Xylazine in the Opioid Epidemic: A Systematic Review of Case Reports and Clinical Implications

Xylazine in the Opioid Epidemic: A Systematic Review of Case Reports and Clinical Implications

Abuse of Xylazine by Human and its Emerging Problems: A Review from Forensic Perspective

Inherent Dangers of Using Non–US Food and Drug Administration–Approved Substances of Abuse

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