A composite vignette: xylazine, infectious complications and the importance of community-based drug checking services

Authors

• Liam John, MaineHealth Maine Medical Center, Portland, ME, USA.
• Nathaniel Flint, Colby College, Department of Chemistry, Waterville, ME, USA.
• Francesca Piccolo, MaineHealth Institute for Research, Portland, ME, USA.
• Katherine Hill, Yale School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, CT, USA.
• Michael Fletcher, Maine Access Points, Brunswick, ME, USA.
• Kristen Silvia, MaineHealth Maine Medical Center, Portland, ME, USA.
• Kinna Thakarar, MaineHealth

Document Type

Article

Publication Date

1-2025

Institution/Department

Center for Interdisciplinary Population & Health Research; MaineHealth Medical Group Academic Pathway

Journal Title

Therapeutic advances in infectious disease

Abstract

Here we describe a composite vignette of a patient who developed necrotic wounds and systemic infection after reported exposure to xylazine, a veterinary anesthetic found as an adulterant in the unregulated drug supply. While exposure to xylazine-containing compounds via the use of fentanyl is not a new phenomenon, xylazine's prevalence in overdose deaths has escalated, and its geographic distribution has expanded to include rural areas such as Maine. We use this composite vignette to highlight: (1) the growing number of overdoses in Maine where xylazine was found in combination with fentanyl, (2) the potential severe, infection-related complications of xylazine exposure, and (3) describe novel harm reduction strategies that utilize community- and laboratory-based drug checking technology.

ISSN

2049-9361

First Page

20499361251365090

Recommended Citation

John, Liam; Flint, Nathaniel; Piccolo, Francesca; Hill, Katherine; Fletcher, Michael; Silvia, Kristen; and Thakarar, Kinna, "A composite vignette: xylazine, infectious complications and the importance of community-based drug checking services" (2025). MaineHealth Maine Medical Center. 4573.
https://knowledgeconnection.mainehealth.org/mmc/4573