Xylazine withdrawal and how to deal with it

Over the past two years, emergency room physician Kory London, also at Thomas Jefferson University, has treated many patients suffering from painful withdrawal symptoms from xylazine and fentanyl. He recently wrote that patients can vomit so violently and so frequently that it damages their digestive systems, and that just talking can give them persistent panic attacks.

He said patients would take medication so they could go to the hospital without withdrawal symptoms. Doctors would treat her, but the treatments wouldn’t adequately address her symptoms. The patient would then be frustrated and go home with serious untreated conditions such as bone and heart problems, only to end up back in the hospital with worse outcomes.

“If someone tells you 10 times that they’re going, and they understand that they could die and still want to go, and they pull out their IV that you have to keep reinserting, after a while you just say, ‘Okay, please come back when you are ready for treatment.’”

London said after seeing this over and over again, he and his colleagues decided to try something different.

“Before the 21st century … there were no data on patients who had used xylazine recreationally,” he said. “The fentanyl epidemic is also relatively new and the amount of opioids patients are consuming far exceeds anything we have dealt with in…recorded human history.”

Now he’s working with other emergency physicians to treat these patients with short-acting opioids, which doctors already use to treat pain; and a muscle relaxant medication to counteract xylazine withdrawal.

In a recent journal article, he reported that this combination was an effective way to keep patients in the hospital so they could complete their treatment and have a chance of healing their wounds. Canadian doctors are already using short-acting opioids to treat patients suffering from opioid withdrawal.

He said this treatment is still hotly debated even among doctors. But he added that some interested doctors in New York City and Baltimore have been in touch about how they could adapt it for their patients.

“Ten years ago we would certainly have been laughed at at conferences, and now I’m giving talks about it at conferences because I think people are starting to realize that this is a novel disease that requires a different approach to really treat it have to treat… important patient outcomes went well.”

The challenge with this research is that the range of medications is constantly changing and new substances are being added, said Reed.

“We don’t know whether these [new] “Drugs will become entrenched in our drug supply like xylazine, or if they are outliers,” Reed said. “What I want to do moving forward is to continue to do research with drug users to find out what is happening at any given time so that we can respond very quickly and develop interventions that work in that moment.” ”