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1.
Am J Public Health ; 112(8): 1212-1216, 2022 08.
Article in English | MEDLINE | ID: mdl-35830662

ABSTRACT

Xylazine is a nonopioid veterinary anesthetic and sedative that is increasingly detected in the illicit drug supply in the United States. Data indicate a striking prevalence of xylazine among opioid-involved overdose deaths. The emergence of xylazine in the illicit drug supply poses many unknowns and potential risks for people who use drugs. The public health system needs to respond by increasing testing to determine the prevalence of xylazine, identifying its potential toxicity at various exposure levels, and taking mitigating action to prevent harms. Currently, there is little testing capable of identifying xylazine in drug supplies, which limits the possibility of public health intervention, implementation of harm reduction strategies, or development of novel treatment strategies. (Am J Public Health. 2022;112(8):1212-1216. https://doi.org/10.2105/AJPH.2022.306881).


Subject(s)
Drug Overdose , Illicit Drugs , Opiate Overdose , Analgesics, Opioid/toxicity , Drug Overdose/epidemiology , Drug Overdose/prevention & control , Harm Reduction , Humans , Public Health , United States/epidemiology , Xylazine
2.
Med Clin North Am ; 106(1): 43-60, 2022 Jan.
Article in English | MEDLINE | ID: mdl-34823734

ABSTRACT

In the United States, alcohol is the most common substance used and the spectrum of unhealthy alcohol use is highly prevalent. Complications of unhealthy alcohol use affect nearly every organ system. One of the most frequent and potentially life-threatening of these complications is alcohol withdrawal syndrome for which benzodiazepines remain first-line therapy. Pharmacologic treatment of alcohol use disorder, the most severe form of unhealthy alcohol use, is underutilized despite the availability of multiple effective medications. Although behavioral therapies are an important component of treatment, they are overemphasized at the expense of pharmacotherapy.


Subject(s)
Alcoholism/diagnosis , Alcoholism/therapy , Benzodiazepines/therapeutic use , Cognitive Behavioral Therapy/methods , Substance Withdrawal Syndrome/drug therapy , Aged , Alcoholic Korsakoff Syndrome/diagnosis , Alcoholic Korsakoff Syndrome/epidemiology , Alcoholism/complications , Alcoholism/epidemiology , Biomarkers/blood , Blood Alcohol Content , Drug Therapy/economics , Female , Humans , Liver Diseases, Alcoholic/diagnosis , Liver Diseases, Alcoholic/epidemiology , Male , Substance Withdrawal Syndrome/etiology , United States
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