The Emerging of Xylazine as a New Drug of Abuse and its Health Consequences among Drug Users in Puerto Rico (original) (raw)

Abstract

During the last decade, the veterinary anesthetics have gained popularity as recreational drugs. The aim of this study was to document the use of “anestecia de caballo” (xylazine) and its consequences among drug users in Puerto Rico. The study combined a cross-sectional survey with 89 drug users and two focus groups conducted in Mayagüez with frontline drug treatment providers. Drug users were recruited from communities of the San Juan metropolitan area using a variety of ethnographic and outreach strategies. A short questionnaire developed for the study collected information on sociodemographics, xylazine use, and its consequences. The two focus groups were conducted to discuss the details related to xylazine use, its consequences, and utilization awareness. The sample comprised 63 males (70.8%) and 26 females with a mean age of 37.2 years. The mean number of years of drug use was 14.3, with a mean frequency of drug use of 5.9 times daily. More than 65% reported speedball as the principal drug of use. The prevalence of xylazine use was 80.7%. More than 42% of the sample used xylazine in a mixture with speedball. The main route of administration of xylazine was injection but 14% reported the use of xylazine by inhalation. More than 35% of the sample reported skin lesions and 21.1% reported at least one overdose episode. Multiple logistic regression analysis revealed that males (OR = 3.47, CI = 1.10–12.00) and those who reported speedball as their main drug of use (OR = 9.34, CI = 2.51–34.70) were significantly more likely to be xylazine users. Focus groups revealed that drug users claimed to recognize the presence of xylaxine in a mixture of speedball based on its effects, taste, the color of the drug (dark brown), and its odor. In conclusion, the use of xylazine among drug users in Puerto Rico seems to be an emerging trend with potentially serious health consequences.

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References

  1. Abramovic Z, Sentjurc M, Kristl J, Khan N, Hou H, Swartz HM. Influence of different anesthetics on skin oxygenation studied by electron paramagnetic resonance in vivo. Ski Pharmacol Physiol. 2007;20:77-84.
    Article CAS Google Scholar
  2. Barroso M, Gallardo E, Margalho C, Devesa N, Pimentel J, Vieira DN. Solid-phase extraction and gas chromatographic–mass spectrometric determination of the veterinary drug xylazine in human blood. J Anal Toxicol. 2007;31:165-169.
    PubMed CAS Google Scholar
  3. Capraro AJ, Wiley JF, Tucker JR. Severe intoxication from xylazine inhalation. Pediatr Emerg Care. 2001;17(6):447-448.
    Article PubMed CAS Google Scholar
  4. Centers for Disease Control and Prevention. Equine Farm Manager dies from Accidental Overdose of Xilazine—Case Report. http://www..cdc.gov/niosh-survapps/statedocs/DocType.aspx?t=CR. Accessed October 13, 2010.
  5. Chamberlain PL. Xylazyne. Center for Veterinary Medicine, Food Drug and Administration. http://www.inchem.org/documents/jecfa/jecmono/v38je03.htm. Accessed May 1, 2010.
  6. Clatts MC, Welle DL, Goldsamt LA, Lankenau SE. An ethno-epidemiological model for the study of trends in illicit drug use: reflections on the ‘emergence’ of crack injection. Int J Drug Policy. 2002;13(4):285-296.
    Article Google Scholar
  7. Colon HM, Perez CM, Melendez M, Marrero E, Ortiz AP, Suárez E. The validity of drug use responses in a household survey in Puerto Rico: comparison of survey responses with urinalysis. Addict Behav. 2010;35(7):667-672.
    Article PubMed CAS Google Scholar
  8. Fisher D, Needle R, Weatherby N, Brown B, Booth R, Williams M. Reliability of drug users self-report (No. PO-C35-3355). Paper presented at: IX International Conference on AIDS; June 6–11, 1993; Berlin, Germany.
  9. Freedenthal S. Racial disparities in mental health service use by adolescents who thought about or attempted suicide. Suicide Life Threat Behav. Feb 2007;37(1):22-34.
    Google Scholar
  10. Freedenthal S. Challenges in assessing intent to die: can suicide attempters be trusted? Omega (Westport). 2007;55(1):57-70.
  11. Freedenthal S, Vaughn MG, Jenson JM, Howard MO. Inhalant use and suicidality among incarcerated youth. Drug Alcohol Depend. Sep 6 2007;90(1):81-88.
    Google Scholar
  12. Gallanosa AG, Spyker DA, Shype JR, Morris DL. Human xylazine overdose: a comparative review of clonidine, phenothiazines, and tricyclic antidepressants. Clin Toxicol. 1981;18(6):663-678.
    Article PubMed CAS Google Scholar
  13. Hoffmann U, Meister CM, Golle K, Zschiesche M. Severe intoxication with the veterinary tranquilizer xylazine in humans. J Anal Toxicol. 2001;25(4):245-249.
    PubMed CAS Google Scholar
  14. Rivera-Vargas D. Elevada la cifra de muertes por sobredosis de drogas. El Nuevo Día. October 27, 2005;Noticias: 26.
    Google Scholar
  15. Liu CM, Chiu MJ, Fang CC, Chen WJ. Xylazine Abuse: a rare case of syncope. Clin Toxicol. 2007;45(3):309-311.
    Article CAS Google Scholar
  16. Muller AA, Osterhoudt KC, Wingert W. Heroin: what’s in the mix? Ann Emerg Med. 2007;50(3):352-353.
    Article PubMed Google Scholar
  17. Needle R, Weatherby N, Chitwood D, et al. Reliability of self-reported HIV risk behaviors of drug users. Psychol Addict Behav. 1995;9:242-250.
    Article Google Scholar
  18. Torruella RA. Xylazine (veterinary sedative) use in Puerto Rico. Subst Abuse Treat Prev Policy. 2011;6:7.
    Google Scholar
  19. Robles R, Colón H, Sahai H, Matos T, Marrero C, Reyes J. Behavioral risk factors and human immunodeficiency virus (HIV) prevalence among intravenous drug users in Puerto Rico. Am J Epidemiol. 1992;135:531-540.
    PubMed CAS Google Scholar
  20. Rodriguez N, Vargas J, Panelli J, Colon H, Ritchie B, Yamamura Y. GC-MS confirmation of xylazine (Rompun), a veterinary sedative, in exchanged needles. Drug Alcohol Depend. 2008;96(3):290-293.
    Article PubMed CAS Google Scholar
  21. Stillwell ME. A reported case involving impaired driving following self-administration of xylazine. Forensic Sci Int. 2003;134:25-28.
    Article PubMed CAS Google Scholar
  22. Torruella RA. Puerto Rico Does it Better! Some stories on the Intravenous Use of Xylezine (Hose Tranquilizer) on the Island Paradise. Paper presented at: 7th National Harm Reduction Conference; November 13–16, 2008; Miami, FL.
  23. Wong SC, Curtis JA, Wingert WE. Concurrent detection of heroin, fentanyl, and xylazine in seven drug-related deaths reported from the Philadelphia Medical Examiner’s Office. J Forensic Sci. 2008;53(2):495-498.
    Article PubMed Google Scholar

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Authors and Affiliations

  1. Medical Science Campus Universidad de Puerto Rico, San Juan, Puerto Rico
    J. C. Reyes, H. M. Colón, A. M. Padilla & M. Y. Millán
  2. Universidad Central del Caribe, School of Medicine, Bayamón, Puerto Rico
    J. C. Reyes, J. L. Negrón, T. D. Matos & R. R. Robles
  3. Universidad de Puerto Rico, Bayamón Campus, Bayamón, Puerto Rico
    J. L. Negrón

Authors

  1. J. C. Reyes
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  2. J. L. Negrón
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  3. H. M. Colón
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  4. A. M. Padilla
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  5. M. Y. Millán
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  6. T. D. Matos
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  7. R. R. Robles
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Correspondence toJ. C. Reyes.

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Reyes, J.C., Negrón, J.L., Colón, H.M. et al. The Emerging of Xylazine as a New Drug of Abuse and its Health Consequences among Drug Users in Puerto Rico.J Urban Health 89, 519–526 (2012). https://doi.org/10.1007/s11524-011-9662-6

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