Episode 132 - Xylazine Update

Friend of the podcast emergency physician, addiction specialist, and toxicologist extraordinaire, Dr. Jerry Snow joins the podcast crew to discuss a scary and potentially deadly twist in the opiate crisis…xylazine. Dr. Snow will school us all about xylazine pharmacology and treatment tips and why EMS high-dose naloxone may not be ideal. REFERENCES 1. https://www.acep.org/tacticalem/newsroom/oct-2021/xylazine-an-emerging-adulterant/ 2. https://www.kxan.com/news/drug-responsible-for-recent-overdoses-in-austin-travis-county-identified-by-officials/ 3. Reyes, J. C., et al. "The emerging of xylazine as a new drug of abuse and its health consequences among drug users in Puerto Rico." Journal of Urban Health 89.3 (2012): 519-526. 4. Ruiz-Colón, Kazandra, et al. "Xylazine intoxication in humans and its importance as an emerging adulterant in abused drugs: a comprehensive review of the literature." Forensic Science International 240 (2014): 1-8. 5. Nunez, Jacqueline, Maura E. DeJoseph, and James R. Gill. "Xylazine, a veterinary tranquilizer, detected in 42 accidental fentanyl intoxication deaths." The American Journal of Forensic Medicine and Pathology 42.1 (2021): 9-11. 6. Johnson, Jewell, et al. "Increasing presence of xylazine in heroin and/or fentanyl deaths, Philadelphia, Pennsylvania, 2010–2019." Injury prevention 27.4 (2021): 395-398. 7. Friedman, Joseph, et al. "Xylazine spreads across the US: A growing component of the increasingly synthetic and polysubstance overdose crisis." Drug and Alcohol Dependence (2022): 109380. 8.https://www.mdpoison.com/media/SOP/mdpoisoncom/ToxTidbits/2019/Jan%202019%20ToxTidbits.pdf 9. https://www.deadiversion.usdoj.gov/drug_chem_info/Xylazine.pdf