Psychosocial consequences of xylazine and implications for harm reduction services
Introduction: Xylazine, a veterinary tranquilizer not approved for human use, has increasingly contaminated the unregulated drug supply in the United States and is a key driver of an increasingly synthetic, polysubstance overdose crisis. While research has focused on xylazine’s toxicologic and physi...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-09-01
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| Series: | Drug and Alcohol Dependence Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S277272462500040X |
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| author | Marina Plesons William H. Eger Erika L. Crable Maia H. Hauschild Corbin C. McElrath Cyrus Owens David W. Forrest Angela R. Bazzi Naida De Los Santos Hansel E. Tookes Tyler S. Bartholomew |
| author_facet | Marina Plesons William H. Eger Erika L. Crable Maia H. Hauschild Corbin C. McElrath Cyrus Owens David W. Forrest Angela R. Bazzi Naida De Los Santos Hansel E. Tookes Tyler S. Bartholomew |
| author_sort | Marina Plesons |
| collection | DOAJ |
| description | Introduction: Xylazine, a veterinary tranquilizer not approved for human use, has increasingly contaminated the unregulated drug supply in the United States and is a key driver of an increasingly synthetic, polysubstance overdose crisis. While research has focused on xylazine’s toxicologic and physiologic effects, less is known about its psychosocial consequences for people who use drugs (PWUD) and their implications for harm reduction services. Methods: We conducted semi-structured qualitative interviews with 17 PWUD and 8 staff at a syringe services program in Miami, FL from June–July 2023. Emergent codes in the transcripts were identified using inductive memos. Final themes were established through team-based thematic analysis and validated through member-checking. Results: Participants reported that xylazine intensified five key psychosocial harms that exacerbated existing challenges for PWUD, including 1) keeping oneself and others alive; 2) protecting oneself and one’s possessions; (3) curbing withdrawal; (4) entering and remaining in addiction recovery; and (5) fitting into society. Discussion: Xylazine’s emergence has compounded existing harms for PWUD and introduced new challenges for harm reduction services. This study underscores the need for novel and expanded harm reduction services that go beyond traditional opioid-focused approaches to encompass the complexity of polysubstance use and the unique features of xylazine dependence. This includes additional drug-checking services for xylazine detection, updated clinical protocols for xylazine-related wound care and substance use disorder treatment complicated by xylazine dependence and polysubstance use, and expanded social and psychological support—for PWUD and the frontline harm reduction staff who care for them. |
| format | Article |
| id | doaj-art-d096d84fdf88456d8907a41617d56e6a |
| institution | Kabale University |
| issn | 2772-7246 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Drug and Alcohol Dependence Reports |
| spelling | doaj-art-d096d84fdf88456d8907a41617d56e6a2025-08-20T03:50:21ZengElsevierDrug and Alcohol Dependence Reports2772-72462025-09-011610035710.1016/j.dadr.2025.100357Psychosocial consequences of xylazine and implications for harm reduction servicesMarina Plesons0William H. Eger1Erika L. Crable2Maia H. Hauschild3Corbin C. McElrath4Cyrus Owens5David W. Forrest6Angela R. Bazzi7Naida De Los Santos8Hansel E. Tookes9Tyler S. Bartholomew10Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States; Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, United States; Correspondence to: 1668 NW 7th Ave, Miami, FL 33136, United States.School of Medicine, University of California, San Diego, La Jolla, CA, United States; School of Social Work, San Diego State University, San Diego, CA, United StatesSchool of Medicine, University of California, San Diego, La Jolla, CA, United States; Herbert Wertheim School of Public Health, University of California, San Diego, La Jolla, CA, United StatesDepartment of Medicine, University of Miami Miller School of Medicine, Miami, FL, United StatesDepartment of Medicine, University of Miami Miller School of Medicine, Miami, FL, United StatesDepartment of Medicine, University of Miami Miller School of Medicine, Miami, FL, United StatesDepartment of Medicine, University of Miami Miller School of Medicine, Miami, FL, United StatesHerbert Wertheim School of Public Health, University of California, San Diego, La Jolla, CA, United States; Boston University School of Public Health, Boston, MA, United StatesDepartment of Medicine, University of Miami Miller School of Medicine, Miami, FL, United StatesDepartment of Medicine, University of Miami Miller School of Medicine, Miami, FL, United StatesDepartment of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United StatesIntroduction: Xylazine, a veterinary tranquilizer not approved for human use, has increasingly contaminated the unregulated drug supply in the United States and is a key driver of an increasingly synthetic, polysubstance overdose crisis. While research has focused on xylazine’s toxicologic and physiologic effects, less is known about its psychosocial consequences for people who use drugs (PWUD) and their implications for harm reduction services. Methods: We conducted semi-structured qualitative interviews with 17 PWUD and 8 staff at a syringe services program in Miami, FL from June–July 2023. Emergent codes in the transcripts were identified using inductive memos. Final themes were established through team-based thematic analysis and validated through member-checking. Results: Participants reported that xylazine intensified five key psychosocial harms that exacerbated existing challenges for PWUD, including 1) keeping oneself and others alive; 2) protecting oneself and one’s possessions; (3) curbing withdrawal; (4) entering and remaining in addiction recovery; and (5) fitting into society. Discussion: Xylazine’s emergence has compounded existing harms for PWUD and introduced new challenges for harm reduction services. This study underscores the need for novel and expanded harm reduction services that go beyond traditional opioid-focused approaches to encompass the complexity of polysubstance use and the unique features of xylazine dependence. This includes additional drug-checking services for xylazine detection, updated clinical protocols for xylazine-related wound care and substance use disorder treatment complicated by xylazine dependence and polysubstance use, and expanded social and psychological support—for PWUD and the frontline harm reduction staff who care for them.http://www.sciencedirect.com/science/article/pii/S277272462500040XXylazineOpioidsOverdosePeople who use drugsPsychosocial impacts |
| spellingShingle | Marina Plesons William H. Eger Erika L. Crable Maia H. Hauschild Corbin C. McElrath Cyrus Owens David W. Forrest Angela R. Bazzi Naida De Los Santos Hansel E. Tookes Tyler S. Bartholomew Psychosocial consequences of xylazine and implications for harm reduction services Drug and Alcohol Dependence Reports Xylazine Opioids Overdose People who use drugs Psychosocial impacts |
| title | Psychosocial consequences of xylazine and implications for harm reduction services |
| title_full | Psychosocial consequences of xylazine and implications for harm reduction services |
| title_fullStr | Psychosocial consequences of xylazine and implications for harm reduction services |
| title_full_unstemmed | Psychosocial consequences of xylazine and implications for harm reduction services |
| title_short | Psychosocial consequences of xylazine and implications for harm reduction services |
| title_sort | psychosocial consequences of xylazine and implications for harm reduction services |
| topic | Xylazine Opioids Overdose People who use drugs Psychosocial impacts |
| url | http://www.sciencedirect.com/science/article/pii/S277272462500040X |
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