{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T06:14:32Z","timestamp":1786947272782,"version":"build-2736575974"},"reference-count":15,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T00:00:00Z","timestamp":1712620800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Xylazine is a non\u2010opioid sedative which has spread rapidly throughout the US illicit drug supply. This study aimed to describe the spread of xylazine throughout the UK illicit drug supply.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Xylazine detections in human biological samples were collated from toxicology laboratories operating in the United Kingdom with the date, location, case type, xylazine concentration and co\u2010detected drugs (with quantifications where performed) detailed, where permitted, by the corresponding coroner. Drug\u2010testing cases positive for xylazine were collated from the Welsh Emerging Drugs and Identification of Novel Substances (WEDINOS) drug\u2010testing postal service with the date, location, purchase intent and co\u2010detected drugs detailed. Drug seizures made by UK law enforcement were communicated by the Office for Health Improvement and Disparities with the date and location detailed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>By the end of August 2023, xylazine was detected in 35 cases from throughout toxicology, drug\u2010testing and drug seizure sources covering England, Scotland and Wales. There were no cases reported from Northern Ireland. Xylazine was detected in biological samples from 16 people. In most cases where full toxicology results were provided, xylazine was detected with heroin and\/or a strong opioid (<jats:italic>n<\/jats:italic>\u2009=\u2009nine of 11), but this polydrug use pattern was not evident in all cases (<jats:italic>n<\/jats:italic>\u2009=\u2009two of 11), suggesting a wider circulation of xylazine in the UK illicit drug market beyond heroin supplies. Evidence from WEDINOS supports this claim, as all 14 drug samples (100%) submitted from across the UK contained xylazine; however, in none of these cases was heroin the purchase intent but rather counterfeit prescription medication tablets (<jats:italic>n<\/jats:italic>\u2009=\u200911 of 14), tetrahydrocannabinol (THC) vapes (<jats:italic>n<\/jats:italic>\u2009=\u2009two of 14) or white powder (<jats:italic>n<\/jats:italic>\u2009=\u2009one of 14). Additional evidence for the spread of illicit xylazine comes from five drug seizures made by law enforcement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Xylazine has penetrated the UK illicit drug market and is not limited to heroin supplies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.16466","type":"journal-article","created":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T23:12:40Z","timestamp":1712704360000},"page":"1301-1309","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Broad evidence of xylazine in the UK illicit drug market beyond heroin supplies: Triangulating from toxicology, drug\u2010testing and law enforcement"],"prefix":"10.1111","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4462-1402","authenticated-orcid":false,"given":"Caroline S.","family":"Copeland","sequence":"first","affiliation":[{"name":"Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science King's College London  London UK"},{"name":"National Programme on Substance Abuse Deaths  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Rice","sequence":"additional","affiliation":[{"name":"Toxicology Unit, Leicester Royal Infirmary  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1434-7585","authenticated-orcid":false,"given":"Kirsten L.","family":"Rock","sequence":"additional","affiliation":[{"name":"Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Hudson","sequence":"additional","affiliation":[{"name":"LGC Limited  Ely UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Streete","sequence":"additional","affiliation":[{"name":"Toxicology Department Hampshire Scientific Services  Hampshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander J.","family":"Lawson","sequence":"additional","affiliation":[{"name":"Department of Toxicology Birmingham Heartlands Hospital  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lewis","family":"Couchman","sequence":"additional","affiliation":[{"name":"Analytical Services International Limited, St George's University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Holland","sequence":"additional","affiliation":[{"name":"School of Psychological Sciences University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Morley","sequence":"additional","affiliation":[{"name":"National Programme on Substance Abuse Deaths  London UK"},{"name":"Toxicology Unit, Leicester Royal Infirmary  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/bkac049"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2022.109380"},{"key":"e_1_2_10_4_1","unstructured":"GuptaR.Biden\u2010Harris administration designates fentanyl combined with xylazine as an emerging threat to the United States [press release]. Washington DC: The White House;2023. Available at:https:\/\/www.whitehouse.gov\/ondcp\/briefing\u2010room\/2023\/04\/12\/biden\u2010harris\u2010administration\u2010designates\u2010fentanyl\u2010combined\u2010with\u2010xylazine\u2010as\u2010an\u2010emerging\u2010threat\u2010to\u2010the\u2010united\u2010states\/#:~:text=By%20declaring%20xylazine%20combined%20with and%20communities%20across%20the%20Nation(accessed August 2023)."},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jflm.2023.102542"},{"key":"e_1_2_10_6_1","unstructured":"European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).The drug situation in Europe up to 2023\u2014an overview and assessment of emerging threats and new developments (European Drug Report 2023). Lisbon Portugal: EMCDDA;2023. Available at:https:\/\/www.emcdda.europa.eu\/publications\/european-drug-report\/2023_en(accessed January 2024)."},{"key":"e_1_2_10_7_1","unstructured":"Food and Drug Administration (FDA).FDA alerts health care professionals of risks to patients exposed to xylazine in illicit drugs. Silver Spring MD: FDA;2022. Available at:https:\/\/www.fda.gov\/drugs\/drug-safety-and-availability\/fda-alerts-health-care-professionals-risks-patients-exposed-xylazine-illicit-drugs(accessed August 2023)."},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2023.2288540"},{"key":"e_1_2_10_9_1","unstructured":"Deaths related to drug poisoning in England and Wales: 2022 registrations [press release]. Newport UK: ONS;2023. Available at:https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/birthsdeathsandmarriages\/deaths\/bulletins\/deathsrelatedtodrugpoisoninginenglandandwales\/2022registrations#:~:text=Just%20under%20half%20of%20all the%2011th%20consecutive%20annual%20rise(accessed January 2024)."},{"key":"e_1_2_10_10_1","unstructured":"National Records of Scotland (NRS).Drug\u2010related deaths in Scotland in 2022. Edinburgh UK: NRS;2023. Available at:https:\/\/www.drugsandalcohol.ie\/39424\/1\/drug-related-deaths-22-report.pdf(accessed January 2024)."},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l570"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002965"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.15734"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01686-0"},{"key":"e_1_2_10_15_1","unstructured":"EPI Laboratory at University College Los Angeles (UCLA).Xylazine info sheet 2023. Los Angeles CA: UCLA. Available at:https:\/\/www.epidemiologylab.com\/resources(accessed August 2023)."},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chempr.2022.11.019"}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.16466","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T03:57:59Z","timestamp":1717646279000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/add.16466"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,9]]},"references-count":15,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1111\/add.16466"],"URL":"https:\/\/doi.org\/10.1111\/add.16466","archive":["Portico"],"relation":{},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"value":"0965-2140","type":"print"},{"value":"1360-0443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,9]]},"assertion":[{"value":"2023-09-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-31","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}