Xylazine in the Unregulated Drug Market: An Integrative Review of Its Prevalence, Health Impacts, and Detection and Intervention Challenges in the United States.

IF 2.1 Q2 HEALTH POLICY & SERVICES Policy, Politics, and Nursing Practice Pub Date : 2024-11-01 Epub Date: 2024-08-07 DOI:10.1177/15271544241268386
Evans F Kyei, Grace K Kyei, Rockson Ansong, Charles K Boakye, Ernest Asamoah
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Abstract

Xylazine, a veterinary sedative, has emerged as a concerning element in the landscape of substance use in the United States. This integrative review synthesizes evidence from a systematic examination of 14 selected studies conducted between 2008 and 2023. The primary objective is to comprehensively understand the epidemiology and prevalence of xylazine use, particularly its involvement in drug-related deaths, regional variations, national impact, co-occurrence with opioids, and challenges associated with detection and intervention. The results underscore stark regional disparities in xylazine prevalence. West Virginia and Miami-Dade County have experienced alarming surges in xylazine-involved drug-related deaths. Nationally, its influence extends beyond regional boundaries, predominantly affecting white males in the Northeast. The co-occurrence of xylazine with opioids, especially fentanyl and heroin, significantly amplifies the risks of fatal overdoses. Detecting xylazine presents formidable challenges due to its frequent presence alongside other substances, necessitating enhanced surveillance and more effective detection methods. User perspectives emerge as pivotal, emphasizing the importance of user-informed harm reduction strategies. In conclusion, this review has significant policy implications. Tailored, region-specific strategies are imperative to address the diverse prevalence of xylazine use. A nationwide response is indispensable, prioritizing harm reduction initiatives, enhanced detection methods, and active user engagement. The multifaceted nature of the xylazine issue requires comprehensive approaches to mitigate its profound risks effectively. Policymakers are urged to consider regional disparities and the co-occurrence of xylazine with opioids when crafting targeted interventions. Immediate, user-informed harm reduction is vital to address the evolving landscape of xylazine use in the United States.

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未受管制药物市场中的赛拉嗪:对其在美国的流行程度、对健康的影响以及检测和干预挑战的综合评述。
赛拉嗪是一种兽用镇静剂,已成为美国药物使用情况中一个令人担忧的因素。本综合综述对 2008 年至 2023 年期间进行的 14 项精选研究的证据进行了系统分析。主要目的是全面了解异丙嗪使用的流行病学和流行率,特别是其与毒品相关死亡的关系、地区差异、全国影响、与阿片类药物的共存情况以及检测和干预方面的挑战。研究结果表明,木拉西嗪的流行率存在明显的地区差异。西弗吉尼亚州和迈阿密-戴德县与异丙嗪有关的毒品相关死亡人数激增,令人震惊。在全国范围内,它的影响超越了地区界限,主要影响东北部的白人男性。二甲嗪与阿片类药物(尤其是芬太尼和海洛因)同时出现,极大地增加了吸毒过量致死的风险。由于二乙胺嗪经常与其他物质同时出现,因此检测二乙胺嗪面临着巨大的挑战,需要加强监控并采用更有效的检测方法。使用者的观点至关重要,强调了根据使用者情况制定减少危害战略的重要性。总之,本综述具有重要的政策意义。针对不同地区的木拉西嗪使用流行情况,必须采取有针对性的策略。全国范围内的应对措施必不可少,其中应优先考虑减低危害的举措、强化检测方法以及使用者的积极参与。木拉西嗪问题具有多面性,需要采取综合方法来有效降低其深远风险。我们敦促政策制定者在制定有针对性的干预措施时,考虑地区差异以及甲氧苄啶与阿片类药物同时出现的情况。要应对美国不断变化的异丙嗪使用情况,必须立即采取针对使用者的减害措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Policy, Politics, and Nursing Practice
Policy, Politics, and Nursing Practice Nursing-Leadership and Management
CiteScore
3.30
自引率
5.60%
发文量
24
期刊介绍: Policy, Politics & Nursing Practice is a quarterly, peer-reviewed journal that explores the multiple relationships between nursing and health policy. It serves as a major source of data-based study, policy analysis and discussion on timely, relevant policy issues for nurses in a broad variety of roles and settings, and for others outside of nursing who are interested in nursing-related policy issues.
期刊最新文献
Racism and Redlining in the History of Psychiatric Policy and Practice in Atlanta: Implications for Nursing. Xylazine in the Unregulated Drug Market: An Integrative Review of Its Prevalence, Health Impacts, and Detection and Intervention Challenges in the United States. Overcoming Barriers to Healthcare Reform: A Call to Action. Barriers and Enablers of Successful Workplace Integration of Internationally Educated Nurses (IENs) in a Host Country: A Qualitative Evidence Synthesis. Corrigendum to "Advocacy, Research, and Anesthesia Practice Models: Key Studies of Safety and Cost-Effectiveness".
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