Emerging of Xylazine as a new drug of abuse and its health consequences among drug users in Puerto Rico

During the last decade the veterinary anesthetics have gained popularity as recreational drugs. The aim of this study was to document the use of “anestecia de caballo” (Xylazine) and its consequences among drug users in Puerto Rico. A total of 87 drug users were recruited from communities of the San Juan metropolitan area using a variety of ethnographic and outreach strategies. A short questionnaire developed for the study collected information on sociodemographics, Xylazine use and its consequences. Two focus groups were conducted to discuss the details related to Xylazine use, its consequences and utilization awareness. The majority was male (66.7%) with a mean age of 37.7 years. The mean number of years of drug use was 14.5, with a mean frequency of drug use of 6.1 times daily. More than 65% reported speedball as the principal drug of use. The prevalence of Xylazine use was 73.8%. More than 56% of the sample use Xylazine in a mixture with speedball. The main route of administration of Xylazine was injection but 14% reported the use of Xylazine by inhalation. More than 36% of the sample reported skin lesions and 26% reported at least an overdose episode. Focus groups reveal that drug user tend to recognize that Xylaxine is present in a mixture of speedball based on its effects, taste, the color of the drug (dark brown) and odor. In conclusion, the use of Xylazine among injection drug users in Puerto Rico seems to be an emerging trend with devastating health consequences.