Journal of Addiction Medicine最新文献

{"title":"Categorizing Stigma as a Barrier to Support Following Nonfatal Overdose: A Qualitative Study.","authors":"Kaylee Larsen, Sydney Silverstein, Timothy Crawford, Shahidul Hassan, Nathaniel Mack, Tasha Perdue, Bradley Ray","doi":"10.1097/ADM.0000000000001436","DOIUrl":"10.1097/ADM.0000000000001436","url":null,"abstract":"<p><strong>Objectives: </strong>Stigma is known to be a major barrier to treatment for people who use drugs (PWUD). This study uses the Stigma and Health Discrimination Framework to analyze how different forms of stigma shape experiences in the wake of an overdose incident, and perceptions of the efficacy and utility of postoverdose interventions among a sample of PWUD in Dayton, Ohio-a location with a high overdose rate.</p><p><strong>Methods: </strong>Interviews were conducted with 23 individuals who self-reported past-month illicit opioid, crack/cocaine, or methamphetamine use who had experienced or witnessed a drug overdose in the past 6 months. Interviews were recorded, transcribed, and thematically analyzed using Taguette software.</p><p><strong>Results: </strong>Discrete forms of stigma were identified as barriers to postoverdose interventions intended to link PWUD with support and services to help them access treatment. Individuals identified experiences of enacted stigma through medical mistreatment, exploitation, and judgment. They identified anticipated stigma through mistrust and unsustainable treatment. Internalized stigma was identified through the effect of loss on mental health, feeling \"stuck,\" and the role of race on support-seeking behaviors. Experiences of structural stigma included desensitization of addiction as a disease and lack of feasible, long-term treatment options.</p><p><strong>Conclusions: </strong>The results suggest that enacted, anticipated, internalized, and structural forms of stigma act as barriers to the efficacy of postoverdose outreach programs, and the initiation and sustainability of treatment. Understanding how each form of stigma adversely impacts PWUD can improve public health and clinical interventions to reduce stigma and overdose death.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"412-417"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Online Drug Markets and Implications for Addiction Medicine: A Narrative Literature Review.","authors":"Nicolas Garel, Priyanka Goonetilleke, Artem Kuriksha, Steven Tate","doi":"10.1097/ADM.0000000000001490","DOIUrl":"10.1097/ADM.0000000000001490","url":null,"abstract":"<p><p>This narrative review examines the evolving landscape of online drug markets, focusing on darknet markets for illegal drugs and their implications for addiction medicine. We provide an overview of the development and current state of these markets, highlighting key features of their operation and the demographics of users. Finally, we address the implications for addiction medicine clinicians, including the need for adapted prevention efforts, new approaches to intervention and relapse prevention, and the potential for leveraging digital platforms in treatment. This review aims to equip addiction medicine professionals with the knowledge needed to navigate the challenges posed by online drug markets and to enhance their ability to provide effective care in this changing environment.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"365-370"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interest in Injectable and Oral PrEP for HIV Prevention Among Women and Men Who Inject Drugs.","authors":"Elenore P Bhatraju, Judith I Tsui, Moonseong Heo, Laksika B Sivaraj, Snehal S Lopes, Shruti Mehta, Paula Lum, Lynn E Taylor, Judith Feinberg, Arthur Kim, Brianna Norton, Irene Pericot-Valverde, Kimberly A Page, Alain H Litwin","doi":"10.1097/ADM.0000000000001440","DOIUrl":"10.1097/ADM.0000000000001440","url":null,"abstract":"<p><strong>Background: </strong>People who inject drugs (PWID) are at increased risk for human immunodeficiency virus (HIV). Women who inject are a particularly vulnerable group. Preexposure prophylaxis (PrEP) is effective, but access and uptake has been limited. This study evaluated interest and concerns around oral and injectable PrEP among PWID based on gender.</p><p><strong>Methods: </strong>This cross-sectional analysis of survey data from 8 sites in the United States (n = 284) assessed attitudes and interest in PrEP. Demographics, HIV risk behaviors, and attitudes toward PrEP were described overall and by self-identified gender (female vs male).</p><p><strong>Results: </strong>Participants completed the PrEP survey between 2019 and 2021. The mean (standard deviation) age was 44.6 (11.4) years, 29% female, and 66% White. Mean self-perceived HIV risk score (0-10) was 2.3 (standard deviation 2.0). Interest in injectable PrEP (49.5%) was significantly higher than interest in daily oral PrEP (20.1%) ( P  ≤ 0.001). The most cited concerns were medication side effects (53%) and medication interactions (39.2%). Perceived HIV risk and PrEP concerns were not significantly different between genders.</p><p><strong>Conclusions: </strong>There was high interest in injectable PrEP, particularly among females. The top concerns were medication side effects and medication interactions. These results suggest high acceptability of injectable PrEP among PWID. Future research could explore the advantages identified by female participants as well as implementation strategies for access and uptake among this vulnerable population.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"479-483"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and Ethnic Inequities in the Receipt of Medications to Treat Opioid Use Disorder Among Pregnant People: A Meta-analysis.","authors":"Grace Gerdts, Katherine Sale, Phyllis Raynor, Davida M Schiff, Mishka Terplan, Elsie Bush, Nichole Nidey","doi":"10.1097/ADM.0000000000001465","DOIUrl":"10.1097/ADM.0000000000001465","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this meta-analysis is to examine inequities in the receipt of medications for opioid use disorder (MOUD) by race and ethnicity among pregnant people.</p><p><strong>Methods: </strong>PubMed and Embase were searched for studies examining the relationship between race and ethnicity and the receipt of MOUD during pregnancy. Studies were included if they were observational in nature and reported sufficient data to ascertain effect measures. Random-effects meta-analyses were conducted to estimate the pooled odds ratios (OR) with 95% CIs.</p><p><strong>Results: </strong>Fourteen studies were included with data on 157,208 individuals. Receipt of MOUD among Black (pooled OR: 0.35, 95% CI: 0.23, 0.55) and Hispanic (pooled OR: 0.60, 95% CI: 0.40, 0.89) pregnant people was significantly lower compared to their White counterparts. Among all other racial and ethnic categories, receipt of MOUD was nonsignificantly lower compared to White pregnant people (pooled OR: 0.79, 95% CI: 0.56, 1.12). Ten studies utilized self-reported race and ethnicity, and 3 studies reported data on well-defined racial and ethnic categories outside of White, Black, and Hispanic.</p><p><strong>Conclusions: </strong>There is strong evidence of racial and ethnic inequities in the receipt of MOUD during pregnancy. We hypothesize these inequities to be caused by structural and interpersonal racism impacting the quality of care for pregnant people with opioid use disorder. Increased use of self-identified race and ethnicity alongside improved reporting of racial and ethnic categories beyond Black, White, and Hispanic is needed in future research to better understand and measure constructs related to racism.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"437-445"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Practices to Reduce of Sudden Unexpected Infant Death Among Caregivers of Opioid Exposed Newborns.","authors":"Margaret G Parker, Fiona Rice, Chanel Peguero, Ariana Evans, Davida M Schiff, Bryanne Colvin, Hayley Friedman, Katherine Harer, Stephen M Kerr, Michael J Corwin, Timothy C Heeren, Eve R Colson, Elisha M Wachman","doi":"10.1097/ADM.0000000000001442","DOIUrl":"10.1097/ADM.0000000000001442","url":null,"abstract":"<p><strong>Objectives: </strong>Sudden unexpected infant death (SUID) occurs disproportionately among opioid exposed newborns (OENs) compared to those unexposed. The extent that primary caregivers of OENs adhere to SUID-reducing infant care practices is unknown. We examined rates of SUID-reducing practices (smoking cessation, breastfeeding, and safe sleep [supine sleep, room-sharing not bed-sharing, nonuse of soft bedding or objects]) in a pilot sample of caregivers of OENs.</p><p><strong>Methods: </strong>We surveyed 50 English-speaking mothers and other primary caregivers of OENs 1-6 months old between 02/2022 and 10/2023. We examined prenatal and postnatal cigarette smoking exposure, breastfeeding initiation and duration, and sleep position (side, back, or stomach), sleep location (bed-sharing, room-sharing not bed-sharing, or separate room), and soft bedding or objects in the infant sleep space.</p><p><strong>Results: </strong>Thirty-six (72%) of 50 respondents were birth mothers and 14/50 (28%) were other caregivers. Sixty-one percent of infants were exposed to cigarette smoking prenatally (mothers only) and 34% postnatally (41% mothers vs 14% other caregivers). Sixty percent of infants received breast milk ≤4 weeks. Among respondents, 32% placed infants in nonsupine sleep position (36% mothers vs 21% other caregivers), 38% shared a bed with their infant for sleep (47% mothers vs 14% other caregivers), and 30% used soft bedding in the infant sleep space (33% among mothers vs 21% among other caregivers).</p><p><strong>Conclusions: </strong>Infant care practices associated with SUID were highly prevalent in our pilot sample of OENs and differed among mothers versus other caregivers. Further investigation and tailored approaches to this population are needed.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"418-422"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Split-dosing of Methadone During Pregnancy and Postpartum Period: A Systematic Review of Outcomes.","authors":"Nighat Z Khan, Dennis J Hand, Elaine Qian, Jamie L Conklin, Elisabeth Johnson, John J McCarthy, Melinda Ramage, Vania Rudolf, Charles Schauberger, Kenneth B Stoller, Mishka Terplan, Hendrée E Jones","doi":"10.1097/ADM.0000000000001470","DOIUrl":"10.1097/ADM.0000000000001470","url":null,"abstract":"<p><strong>Objectives: </strong>The primary objective of this study is to conduct a systematic review of the scientific literature on the practice of methadone split-dosing, where the total daily dose is divided into 2 or more doses taken 10-12 hours apart rather than administered as a single daily dose. The review aims to evaluate the perinatal effects of this dosing regimen on maternal, fetal, and neonatal outcomes.</p><p><strong>Methods: </strong>A systematic review was conducted by searching 6 databases, including APA PsycInfo, the Cochrane Library, CINAHL, Embase, PubMed, and Scopus, through the last search date of June 13, 2023. We included studies that reported maternal, fetal, or neonatal outcomes. Multiple researchers screened references. Data were extracted using a standardized spreadsheet, including study details and outcomes, and included studies were assessed for bias independently by 2 researchers using JBI Critical Appraisal Tools.</p><p><strong>Results: </strong>The systematic search yielded 612 unique references, of which 8 studies met the criteria. These studies focused on investigating the pharmacokinetics of methadone during pregnancy, fetal responses to maternal methadone administration, variables related to maternal substance use disorder treatment, and outcomes related to birth or neonatal health. The findings demonstrated significant alterations in methadone metabolism during pregnancy due to increased methadone metabolism as a result of enhanced hepatic enzyme activity (CYP3A4 and CYP2B6), resulting in lower plasma methadone levels and requiring dose adjustments. Neonatal outcomes were favorable, including higher birth weights, reduced preterm birth risk, improved intrauterine growth, and reduced neonatal abstinence syndrome (NAS).</p><p><strong>Conclusion: </strong>The evidence suggests that pregnancy significantly alters methadone metabolism, subsequently impacting both maternal and neonatal outcomes. These findings demonstrate that split-dosing of methadone is associated with more favorable outcomes compared with once-daily dosing.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"358-364"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Pattern Recognition to Augment Traditional Monitoring in the Prevention of Opioid Overdose Harm.","authors":"Rakesh Patel, Anne Marie Hopkins, Basil Matta, William C Wilson, Hoomai Sayed, Linus Park, Gabriel E Dilanji","doi":"10.1097/ADM.0000000000001444","DOIUrl":"10.1097/ADM.0000000000001444","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of the study was to investigate the correlation of a pattern recognition algorithm to the opioid overdose intervention activities of trained medical staff at a safe consumption site (SCS).</p><p><strong>Methods: </strong>Continuous physiological data were collected using the Masimo Radius PPG pulse oximeter from volunteer users of nonprescribed, unregulated opioids at a SCS. The algorithm retrospectively calculated opioid-induced respiratory depression (OIRD) severity scores (Opioid Halo scores) were compared to interventions recorded by SCS staff.</p><p><strong>Results: </strong>The study included data prospectively collected from 167 individuals, who underwent 370 sessions of intravenous injection of nonprescribed, unregulated opioids ( Fentanyl ). Interventions were documented for 150 sessions (~41%) by the SCS staff. The remaining 220 sessions had no interventions documented. The algorithm demonstrated a strong correlation with the intervention activities (Spearman ρ = 0.80, P  < 0.001). The area under the receiver operating curve for the correlation with intervention activities (ie, supplemental oxygen or naloxone administration) was 0.94. The OIRD severity scores were significantly higher ( P  < 0.001) in sessions requiring interventions compared to nonintervention sessions.</p><p><strong>Conclusions: </strong>In this study, the algorithm generated OIRD severity scores had a strong correlation with the intervention activities provided by SCS staff who were blinded to the study pulse oximeter and algorithm scores. This suggests that the algorithm may be useful in detecting severe opioid-induced respiratory depression for which intervention is needed.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"430-436"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous Fentanyl for Symptom Management in Hospitalized Patients With Refractory Opioid Withdrawal: A Retrospective Cohort Study.","authors":"Julia Zazoulina, Seonaid Nolan, Nadia Fairbairn, Andrea Ryan, Brittany B Dennis, Paxton Bach","doi":"10.1097/ADM.0000000000001498","DOIUrl":"10.1097/ADM.0000000000001498","url":null,"abstract":"<p><strong>Objectives: </strong>Potent synthetic opioids in the drug supply have resulted in patients with increasingly refractory opioid withdrawal syndromes. This study describes patient characteristics and short-term treatment outcomes for a cohort of hospitalized individuals with opioid use disorder (OUD) treated with intravenous fentanyl for opioid withdrawal.</p><p><strong>Methods: </strong>A retrospective cohort study of inpatients with fentanyl use disorder and refractory opioid withdrawal, treated with intravenous fentanyl at St. Paul's Hospital (Vancouver, Canada) between November 2019 and December 2021. Descriptive variables included sociodemographic factors, substance use history, and fentanyl dosing. Treatment outcomes included retention in the hospital and initiation of medication for opioid use disorder (MOUD). Safety outcomes included opioid toxicity (excessive drowsiness, myoclonus, administration of naloxone, etc) and transfer to a higher level of care.</p><p><strong>Results: </strong>Fifty-nine encounters were identified, consisting of 43 individuals (56% men), with 56% (n = 24) hospitalized with infection. Intravenous fentanyl bolus doses ranged from 250-5000 mcg. In 71% of encounters (n = 42), patients were prescribed 1000 mcg intravenously every 1-2 hours as needed. The average maximum dose received within 24 hours was a median of 6000 mcg (IQR: 3500-10150 mcg). Patients received a median of 9 days of treatment (IQR: 5-16 d). At discharge, 80% of encounters (n = 47) received an MOUD prescription. Opioid toxicity occurred in 19% of encounters (n = 11), including 8% (n = 5) overdoses. All overdose events involved the use of unregulated fentanyl.</p><p><strong>Conclusions: </strong>Prescribed intravenous fentanyl may support the management of refractory opioid withdrawal for hospitalized patients with severe OUD. Further evaluation of approaches to manage patients with tolerance to fentanyl and other high-potency opioids is a research priority.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"449-455"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"False-Positive Phosphatidylethanol Results Due to Blood Transfusion and Implications in the Process of Liver Transplantation Selection.","authors":"Jessica A S Wang, Giovani V Cruz Cruz, Akshay Shetty, Darlene Esquivel, Sammy Saab, Steven Shoptaw, Julio Meza","doi":"10.1097/ADM.0000000000001424","DOIUrl":"10.1097/ADM.0000000000001424","url":null,"abstract":"<p><p>Phosphatidylethanol (PEth) testing is becoming increasingly common as a tool to assess for alcohol consumption in the practice of addiction medicine. Its potential to be an objective measure of ethanol exposure is appealing; however, the field has yet to develop a complete understanding of the factors that can influence a PEth level. Here we describe 3 patient cases in which blood transfusion within the preceding 28 days was the reason that PEth studies were positive in patients undergoing liver transplant evaluation. These patients all had in-depth evaluations by physicians on an addiction medicine consult service and were believed abstinent from alcohol. In the field of liver transplant, even a mildly elevated PEth level can result in listing delay or even liver transplant candidacy denial. Further study is needed to understand how PEth is impacted by medical procedures and events such as blood transfusion if we are to maintain a just and ethical practice in the setting of addiction and transplant medicine.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"487-489"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a High-sensitivity Rapid Xylazine Dipstick for Clinical Urine Testing.","authors":"Ping Wang, William Butler, Niluksha Walalawela Abeykoon, Bridgit O Crews, Xiaofeng Xia","doi":"10.1097/ADM.0000000000001513","DOIUrl":"10.1097/ADM.0000000000001513","url":null,"abstract":"<p><strong>Objectives: </strong>Xylazine has been increasingly identified in human overdose deaths. Detection of xylazine in clinical urine samples has clinical utility when treating overdoses. No screening method for xylazine has been approved by the US Food and Drug Administration (FDA). We aim to develop and validate a rapid and high sensitivity xylazine test for clinical urine testing.</p><p><strong>Methods: </strong>Monoclonal antibodies with high sensitivity and specificity against xylazine were developed. The leading clone was used to develop a competitive lateral flow immunoassay. The analytical cutoff, specificity, and clinical performance of this test was characterized using standards in drug-free urine and clinical urine samples.</p><p><strong>Results: </strong>The rapid xylazine dipstick test has a test time of 5 minutes and a cutoff of 10 ng/mL xylazine in drug-free urine. No cross reactivity with other commonly used drugs or endogenous metabolites were observed, except for 3% cross reactivity with clonidine. In 190 mass spectrometry confirmed clinical urine samples with xylazine concentrations ≥10 ng/mL and 168 urine samples with xylazine concentrations <10 ng/mL, the dipstick demonstrated a clinical sensitivity of 100% and a clinical specificity of 98%. All 4 false positives had combined xylazine and 4-hydroxy-xylazine concentrations in the 5-10 ng/mL range, with additional xylazine metabolites detected by mass spectrometry.</p><p><strong>Conclusions: </strong>When used with 10 ng/mL cutoff, the rapid xylazine dipstick demonstrates high clinical sensitivity and clinical specificity in urine samples, compared with gold standard mass spectrometry methods. This novel test has the potential to enable informed clinical decisions in cases with suspected xylazine exposure.</p>","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":"456-462"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}