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Increasing presence of xylazine in heroin and/or fentanyl deaths, Philadelphia, Pennsylvania, 2010–2019
  1. Jewell Johnson,
  2. Lia Pizzicato,
  3. Caroline Johnson,
  4. Kendra Viner
  1. Philadelphia Department of Public Health, Philadelphia, Pennsylvania, USA
  1. Correspondence to Jewell Johnson, Philadelphia Department of Public Health, Philadelphia, PA 19107, USA; jewell.johnson{at}phila.gov

Abstract

Reports from active drug users state that xylazine, the veterinary tranquilliser, has been increasing in the illicit drug supply in Philadelphia. To describe trends and characteristics of unintentional deaths from heroin and/or fentanyl overdose with xylazine detections occurring in Philadelphia, Pennsylvania, the Philadelphia Department of Public Health analysed data on deaths from unintentional heroin and/or fentanyl overdose from the Philadelphia Medical Examiner’s Office over a 10-year period (2010–2019). Xylazine went from being detected in less than 2% cases of fatal heroin and/or fentanyl overdose between 2010 and 2015 to 262 (31%) of the 858 fatal heroin and/or fentanyl overdose cases in 2019. Currently, information is limited on the presence of xylazine in continental United States. Xylazine’s association with adverse outcomes in other locations indicates that potential health consequences should also be monitored in the USA. Whenever possible, jurisdictions should consistently test for xylazine.

  • drugs
  • poisoning
  • descriptive epidemiology
  • mortality

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Footnotes

  • Contributors JJ, LP, CJ and KV developed the study protocol. JJ and LP were responsible for the literature review. JJ performed the statistical analyses on data from the Philadelphia Medical Examiner’s Office and LP performed the statistical analyses on the data from the Drug Enforcement Administration Philadelphia Division. JJ drafted the first version of the manuscript. LP, CJ and KV contributed to the interpretation of the results and assisted with manuscript revisions. All authors approved the submission of this version of the manuscript.

  • Funding This study was supported by the Centers for Disease Control and Prevention CDC-RFA-CE19-1904 awarded to the Philadelphia Department of Public Health.

  • Disclaimer The funders had no role in the study design, analysis and interpretation of data, and preparation and review of the manuscript.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval This study was determined to be exempt by the institutional review board at the City of Philadelphia Department of Public Health.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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