The Curbsiders Internal Medicine Podcast #392 Live! Opioid and Xylazine Withdrawal in the Hospital
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Apr 26, 2023 AI Snips
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Xylazine Is An Alpha-2 Sedative, Not An Opioid
- Xylazine is an alpha-2 agonist sedative used in animals that causes heavy sedation in humans and is not opioid-reversible.
- It produces naloxone-resistant overdoses because it does not act at the mu receptor.
Market Forces Drive Xylazine Adulteration
- Xylazine's rise likely reflects market forces: it's cheap and readily available to adulterate the opioid supply.
- Many users actually try to avoid xylazine because it doesn't provide opioid effects and causes early withdrawal.
Distinct Injection Wounds From Xylazine
- Severe chronic necrotic skin wounds are a hallmark of injected xylazine exposure and often localize to injection sites.
- Mechanism is unclear but likely cytotoxic plus behavioral factors like picking and repeated local injection.