To describe spatiotemporal trends in the prevalence of xylazine in combination with fentanyl and the concentration of xylazine in urine drug testing (UDT) samples from March 2023 to September 2025.
Approach:
Study Design: Retrospective cross-sectional study analyzing UDT results from patient specimens collected by Millennium Health between March 2023 and September 2025.
Key Findings:
Xylazine was detected in 38% of fentanyl powder samples and over 12% of pills seized by the DEA by the end of 2024, up from 23% and 7% in 2022, respectively.
Xylazine-involved overdose mortality increased by 5- to 10-fold between 2020 and 2021.
Xylazine is associated with complex soft tissue wounds that can lead to amputations.
Interpretation:
The study highlights the increasing prevalence of xylazine in the drug supply and its association with severe health consequences, emphasizing the need for further research on its epidemiology and health effects.
Limitations:
Limited geographic data on xylazine exposure due to lack of systematic tracking.
The study only includes data from a single laboratory, which may not represent broader trends.
Conclusion:
Understanding the prevalence and concentration of xylazine in combination with fentanyl is important for addressing public health challenges related to the opioid crisis.
The judgment stemmed from controlled-substance prescriptions issued after William C. Gardner, DDS, no longer held the state licensure required for federal prescribing authority.
