Discover and read the best of Twitter Threads about #xylazine
Most recents (6)
We're seeing more consult questions for this, and it's also garnering national attention, so let's take a brief moment in #tweetorial format to talk about:
XYLAZINE SKIN ULCERS!
#xylazine #MedEd #FOAMEd #dermtwitter #medtwitter
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XYLAZINE SKIN ULCERS!
#xylazine #MedEd #FOAMEd #dermtwitter #medtwitter
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What is Xylazine? It was created in the 70s as a veterinary anesthetic. As an analog of clonidine, it has similar effects as an alpha-2 agonist, leading to sedation, anesthesia, and euphoria in the CNS.
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Recently, Xylazine has entered the drug supply, moreso in certain cities, but increasingly everywhere. It is often mixed with fentanyl as a cutting agent, and can also be used on its own. It may be called Tranq, Zombie Drug, or anestesia de caballo (horse anesthetic).
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介紹一下美國濫藥問題的新趨勢。美國之前幾年主要討論「芬太尼」 #fentanyl ，近幾個月，美國開始討論一種新興藥物物質，名為「甲苯噻嗪」 #xylazine ，外號「鎮靜劑」 #tranq 或「喪屍藥」（zombie drug），因為使用甲笨噻嗪的個案上升，而且更致命，治療時更棘手 /1
shorturl.at/gimP5
shorturl.at/gimP5
... 「喪屍藥」是一種獸醫用的鎮靜劑，主要用來馬匹、牛隻等較大型動物，不可用於人類。吸毒用上「喪屍藥」，最早在2000年代初的波多黎各發現，過去一、兩年美國越來越多發現海洛英等毒品不只混入芬太尼，還混入「喪屍藥」 /2
... 「喪屍藥」最大特點是「食肉」，人類攝入的話，可導致吸毒者皮膚潰爛流濃，如果不盡快醫治，皮膚下的細胞壞死，病人需要截肢。這是芬太尼等其他流行的毒品所沒有的症狀，亦是甲笨噻嗪得名「喪屍藥」的原因之一 /3
Based on our lab data, I reckon #xylazine shows up in the drug supply 5 specific ways:
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1. Veterinary diversion is rare, niche, and localized to interconnected Caribbean communities:
Philly
Puerto Rico
link.springer.com/article/10.118…
Philly
Puerto Rico
link.springer.com/article/10.118…
2. Most commonly... Fentanyl and #xylazine in combo, about 3:1.
We don't see xylazine-related synthesis impurities but do see fentanyl impurities, so our hypothesis is that xyl is being added intentionally in pure form.
Example from Lexington NC: streetsafe.supply/results/p/3003…
We don't see xylazine-related synthesis impurities but do see fentanyl impurities, so our hypothesis is that xyl is being added intentionally in pure form.
Example from Lexington NC: streetsafe.supply/results/p/3003…
What can we learn from buprenorphine precipitated withdrawal in the ED/hospital? A 🧵 @AustinKilaru @JMPerroneMD @kit_delgadoMD @m_lowenstein @especially_APT @JACEPOpen @NIDAnews @PennMedicine #emergencymedicine #toxtwitter
#1 Check those COWS Scores. 4 out of 13 cases of PW, got bupe for COWS scores of less than 8 (see below). Also important to check COWS scores shortly after getting bupe to make sure they are actually getting better. Great place for ordersets to improve care
#2 PW from traditional bupe inductions is real! Definitely a concern in the fentanyl era. We had patients develop PW after greater than 12 hours (sometimes even longer) since last opioid use. people who use fentanyl might be at higher risk
Let's uncover something with #SubstanceSaturdays
1/ #Xylazine is a sedative and analgesic drug that is commonly used in veterinary medicine to sedate and immobilize animals. It is also used as an anesthetic in laboratory animals and as a tranquilizer in horse racing.
1/ #Xylazine is a sedative and analgesic drug that is commonly used in veterinary medicine to sedate and immobilize animals. It is also used as an anesthetic in laboratory animals and as a tranquilizer in horse racing.
2/ Xylazine is a Schedule III controlled substance under the United Nations Convention on Psychotropic Substances, meaning that it has a potential for abuse and dependence, and it should be used under strict medical supervision. One of its nicknames is "#tranq".
3/ Unfortunately, Xylazine is being used to contaminate the drug supply, and it is being sold as a street drug. This is a dangerous practice as Xylazine can cause serious side effects, including respiratory and cardiovascular depression, and even death in high doses.
Our Quarter 3 report is now available on our website. It showcases #drugchecking findings from July 1st - September 30th, 2020, in #yyj. Below are some key findings from the last quarter ⏬
substance.uvic.ca/doc/2020-Q3.pdf
substance.uvic.ca/doc/2020-Q3.pdf
We tested a total of 456 samples. This
shows an increased uptake of testing from the prior quarter, where we only tested 269 samples. This increase was seen across every drug category. Find our first two quarterly reports here:
substance.uvic.ca/#reports
shows an increased uptake of testing from the prior quarter, where we only tested 269 samples. This increase was seen across every drug category. Find our first two quarterly reports here:
substance.uvic.ca/#reports
Adulteration with other notable components was highest for samples expected to be methamphetamine (29%), cocaine HCl or base (21%), opioid - down (17%) or dissociative (16%), demonstrating the volatility of the illicit drug supply which continues to be impacted by prohibition.
