Friend of the podcast and toxicologist extraordinaire, Dr. Jerry Snow, MD, joins the podcast crew to discuss a scary and potentially deadly twist in the opiate crisis … xylazine. Dr. Snow will school us all on xylazine pharmacology, treatment tips and why EMS high-dose naloxone may not be ideal.
Together, they discuss:
- The difference in patient presentation in fentanyl alone overdoses versus fentanyl/xylazine overdoses
- How the naloxone and resuscitation approach differs if xylazine is involved in OD
- Will we likely ever know if we see a xylazine OD?
- Is there any risk for the medics encountering xylazine?
About our guest
Dr. Jerry Snow, MD, is assistant director of the Medical Toxicology Fellowship and director of the Toxicology rotation at Banner – University Medical Center in Phoenix.
Read more: White House warning: What you need to know about xylazine
References
1. ACEP. McAward A. Xylazine, an Emerging Adulterant
2. Reader G, Moreno C, Washington J. KXAN. 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. Maryland Poison Control. Xylazine
9. Drug Enforcement Administration. Xylazine
