WASHINGTON, Nov. 20, 2024 ~ A recent study published in the journal Clinical Chemistry by researchers at the Washington University School of Medicine in St. Louis has shed light on the body's ability to clear xylazine, a popular emerging drug of abuse in the United States. The study, conducted by a team led by Bridgit Crews, PhD, found that it takes much longer for the human body to process xylazine than previously thought.

Xylazine is traditionally used as a tranquilizer in veterinary practice, but its use as a recreational drug has been on the rise. According to a report from the Centers for Disease Control and Prevention, between 2019 and 2022, there has been a 276% increase in detection of xylazine in fentanyl-associated overdose deaths. This is concerning because unlike opioids, Narcan does not work to revive individuals who have taken xylazine. Furthermore, there is limited research on how xylazine affects humans, making it difficult for healthcare providers to effectively treat patients who have used it.

In an effort to address this gap in knowledge about xylazine, Dr. Crews and her team set out to determine how long the drug remains in the body. They initially identified 493 patients who had used xylazine and also tested positive for fentanyl. After narrowing down their sample size based on specific criteria, they were left with 28 patients whose blood samples could be used to assess xylazine's half-life.

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The half-life of a drug refers to the amount of time it takes for its concentration in the blood to decrease by half. By analyzing these blood samples over time, the researchers found that on average, xylazine has a half-life of 12 hours in humans. This is longer than what has been observed in animal studies and a previous case study involving one human subject which showed a half-life of nearly 5 hours.

This finding suggests that xylazine can remain in the human body for up to 2 days after an individual's last exposure, depending on the amount ingested. Additionally, the team identified metabolites of xylazine that could aid in its detection and improve clinical testing for the drug.

Dr. Crews emphasized the importance of this study in understanding the effects of xylazine on humans, especially in those who may chronically use fentanyl mixed with xylazine. She believes that a better understanding of typical xylazine concentrations and its duration in the body can help improve interpretation of clinical studies, establish appropriate cutoffs for surveillance, and inform treatment and monitoring strategies for patients at risk.

This novel study provides valuable insights into how the human body processes xylazine and highlights the need for further research on this emerging drug of abuse. The full study can be accessed at https://doi.org/10.1093/clinchem/hvae163.

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