Exploring Xylazine Awareness, Health Impacts, and Harm Reduction Strategies: Findings From a Multimethods Study in Lowell, Massachusetts.

Shikhar Shrestha, Kevin Cyr, Grace Hajinazarian, Jaime Dillon, Takkyung Oh, Jennifer Pustz, Thomas J Stopka
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Abstract

Background: Xylazine, an adulterant in local drug supplies, has been detected in approximately 30% of opioid samples submitted for testing in Massachusetts. A better understanding of local risks, harms, and use preferences is needed to combat xylazine-related impacts on local communities.

Methods: Through the STOP-OD Lowell study, we aimed to assess local xylazine awareness through in-depth interviews with local community stakeholders (n = 15) and local people who use drugs (PWUD; n = 15) and surveys with local PWUD (n = 94). The qualitative interviews focused on the current drug landscape and knowledge of adulterants in Lowell, and the results informed subsequent survey design. Through our survey, we examined whether PWUD were aware of xylazine and their willingness to use xylazine test strips.

Results: Most community stakeholders and PWUD had limited awareness about the presence and impact of xylazine as an adulterant. Forty-seven (50%) survey respondents were aware of xylazine. When provided with more information about xylazine, 65% of all respondents expressed a willingness to use xylazine test strips. PWUD who had received naloxone training, reported using with others, and using tester shots were more willing to use xylazine test strips.

Conclusion: Our findings are congruent with existing literature that indicates that there is limited awareness of xylazine among PWUD, and they consider xylazine an unwanted adulterant. We also found that PWUD who use other harm reduction measures are more willing to use xylazine test strips. The increase in xylazine warrants additional community-level interventions such as wound management and local testing infrastructure. Further research is needed to understand better the impacts associated with xylazine use, effective harm reduction techniques, and perceptions of xylazine test strips.

探索对羟嗪的认识、对健康的影响以及减低危害的策略:马萨诸塞州洛厄尔市多种方法研究的结果。
背景:在马萨诸塞州送检的阿片类药物样本中,约有 30% 检测出当地药物供应中的掺杂物--异丙嗪。需要更好地了解当地的风险、危害和使用偏好,以消除与恶嗪有关的对当地社区的影响:通过 STOP-OD Lowell 研究,我们旨在通过对当地社区利益相关者(n = 15)和当地吸毒者(PWUD;n = 15)的深入访谈以及对当地吸毒者(PWUD)(n = 94)的调查,评估当地对异丙嗪的认识。定性访谈的重点是洛厄尔当前的毒品状况和对掺杂物的了解,访谈结果为随后的调查设计提供了参考。通过调查,我们了解了残疾人是否了解异丙嗪以及他们是否愿意使用异丙嗪试纸:结果:大多数社区利益相关者和残疾人对作为掺杂物的异丙嗪的存在和影响认识有限。47(50%)名调查对象知道有异丙嗪。当获得更多有关二甲嗪的信息时,65%的受访者表示愿意使用二甲嗪试纸。接受过纳洛酮培训、报告与他人一起使用过纳洛酮以及使用过测试针的残疾人更愿意使用异丙嗪试纸:我们的研究结果与现有文献一致,这些文献表明,吸毒者对异丙嗪的认识有限,他们认为异丙嗪是一种不受欢迎的掺杂物。我们还发现,使用其他减低危害措施的吸毒者更愿意使用异丙嗪试纸。因此,有必要在社区层面采取更多干预措施,如伤口管理和当地检测基础设施。需要进一步开展研究,以便更好地了解与使用异丙嗪相关的影响、有效的减低危害技术以及对异丙嗪试纸的看法。
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