The xylazine-fentanyl nexus: A public health emergency

The US opioid crisis has rapidly escalated over the past 4 decades, with a shifting profile of available substances contributing to rising fatalities. Leading this crisis is illicitly manufactured fentanyl, now increasingly adulterated with xylazine, a veterinary sedative not approved for human use....

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Main Authors: Kanwarpreet Singh Sandhu, Siddarth Kumar, Keshav Garg, Kanishk Aggarwal, Mayank Tiwwary, Griffin Perry, Vasu Bansal, Rohit Jain
Format: Article
Language:English
Published: SAGE Publishing 2025-06-01
Series:SAGE Open Medicine
Online Access:https://doi.org/10.1177/20503121251348068
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author Kanwarpreet Singh Sandhu
Siddarth Kumar
Keshav Garg
Kanishk Aggarwal
Mayank Tiwwary
Griffin Perry
Vasu Bansal
Rohit Jain
author_facet Kanwarpreet Singh Sandhu
Siddarth Kumar
Keshav Garg
Kanishk Aggarwal
Mayank Tiwwary
Griffin Perry
Vasu Bansal
Rohit Jain
author_sort Kanwarpreet Singh Sandhu
collection DOAJ
description The US opioid crisis has rapidly escalated over the past 4 decades, with a shifting profile of available substances contributing to rising fatalities. Leading this crisis is illicitly manufactured fentanyl, now increasingly adulterated with xylazine, a veterinary sedative not approved for human use. Despite a greater awareness in recent years regarding the vital role of naloxone in preventing fatal cases of overdose, xylazine has been associated with a sharp increase in overdose-related deaths due to its potent central nervous system effects. Recent data suggest a significant spread of xylazine, underscoring the importance of strategies to counteract fentanyl and implement aggressive supportive care for xylazine-fentanyl toxicity. This combination, often undetectable by standard drug tests, presents challenges in diagnosis and treatment of overdoses. These challenges have become relevant among young adults, a demographic particularly affected, underscoring the need for harm reduction measures and further research into the shifting patterns of fentanyl-related intoxication across the United States.
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spelling doaj-art-7072caa3e1ca46b887be40fa2bbdf7cb2025-08-20T02:09:29ZengSAGE PublishingSAGE Open Medicine2050-31212025-06-011310.1177/20503121251348068The xylazine-fentanyl nexus: A public health emergencyKanwarpreet Singh Sandhu0Siddarth Kumar1Keshav Garg2Kanishk Aggarwal3Mayank Tiwwary4Griffin Perry5Vasu Bansal6Rohit Jain7Government Medical College, Amritsar, IndiaArmed Forces Medical College, Pune, IndiaGovernment Medical College, Chandigarh, IndiaDayanand Medical College and Hospital, Ludhiana, IndiaKasturba Medical College, Manipal, IndiaPenn State College of Medicine Hershey, PA, USADayanand Medical College and Hospital, Ludhiana, IndiaDepartment of Internal Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, USAThe US opioid crisis has rapidly escalated over the past 4 decades, with a shifting profile of available substances contributing to rising fatalities. Leading this crisis is illicitly manufactured fentanyl, now increasingly adulterated with xylazine, a veterinary sedative not approved for human use. Despite a greater awareness in recent years regarding the vital role of naloxone in preventing fatal cases of overdose, xylazine has been associated with a sharp increase in overdose-related deaths due to its potent central nervous system effects. Recent data suggest a significant spread of xylazine, underscoring the importance of strategies to counteract fentanyl and implement aggressive supportive care for xylazine-fentanyl toxicity. This combination, often undetectable by standard drug tests, presents challenges in diagnosis and treatment of overdoses. These challenges have become relevant among young adults, a demographic particularly affected, underscoring the need for harm reduction measures and further research into the shifting patterns of fentanyl-related intoxication across the United States.https://doi.org/10.1177/20503121251348068
spellingShingle Kanwarpreet Singh Sandhu
Siddarth Kumar
Keshav Garg
Kanishk Aggarwal
Mayank Tiwwary
Griffin Perry
Vasu Bansal
Rohit Jain
The xylazine-fentanyl nexus: A public health emergency
SAGE Open Medicine
title The xylazine-fentanyl nexus: A public health emergency
title_full The xylazine-fentanyl nexus: A public health emergency
title_fullStr The xylazine-fentanyl nexus: A public health emergency
title_full_unstemmed The xylazine-fentanyl nexus: A public health emergency
title_short The xylazine-fentanyl nexus: A public health emergency
title_sort xylazine fentanyl nexus a public health emergency
url https://doi.org/10.1177/20503121251348068
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