Theme: Epidemiology & Public Health Research Year: 2024
Background: The United States (U.S.) is facing an ongoing public health crisis with growing morbidity and mortality from an evolving adulterated illicit drug supply. People who use drugs (PWUD) exposed to xylazine-contaminated drugs are experiencing ulcerating wounds that can heal with longitudinal medically-directed wound care. However, if left untreated, these can progress to debilitating wounds at risk of infection, hospitalization, limb loss, or death. We sought to understand the capacity of professionals interfacing with PWUD to provide wound care and identify gaps in knowledge related to xylazine-related wounds and care.
Methods: A cross-sectional, 26-item anonymous web-based survey was designed and distributed to a national listserv of U.S. addiction professionals with diverse roles and practice environments (n=11,207). The survey assessed demographics, prior wound training, experience caring for xylazine-related wounds, and capacity to provide xylazine testing and wound care. Inclusion criteria included individuals 18 years or older who interact with PWUD in a clinical and/or harm reduction setting. Data were collected for a 4-week period (August -September 2023), aggregated, and descriptively analyzed.
Results: The survey response rate was 12.8%, and of the 1280 eligible participants, 82% were female, 73% white, 24% nurses, 18% physicians or advanced practice providers, and 28% peer support/harm reduction providers. Nearly all (99%) had cared for patients with any xylazine-associated harms, while less (44%) had cared for xylazine wounds. Only 43% had received prior wound care training. 20% provided onsite wound care services, while 56% relied on external referrals. Just 23% had access to xylazine testing.
Conclusion: We found that while many addiction professionals have encountered and cared for PWUD experiencing xylazine wounds, less than half received any formal training and most relied on off-site referrals. Our findings demonstrate an urgent need to expand wound care training to professionals and services to PWUD impacted by xylazine wounds.
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