{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T22:29:03Z","timestamp":1793744943843,"version":"4.6.1"},"reference-count":35,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2024,8,3]],"date-time":"2024-08-03T00:00:00Z","timestamp":1722643200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100020097","name":"Foundation for Opioid Response Efforts","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020097","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Use &amp; Addiction Journal"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Xylazine, an adulterant in local drug supplies, has been detected in approximately 30% of opioid samples submitted for testing in Massachusetts. A better understanding of local risks, harms, and use preferences is needed to combat xylazine-related impacts on local communities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Through the STOP-OD Lowell study, we aimed to assess local xylazine awareness through in-depth interviews with local community stakeholders (n\u2009=\u200915) and local people who use drugs (PWUD; n\u2009=\u200915) and surveys with local PWUD (n\u2009=\u200994). The qualitative interviews focused on the current drug landscape and knowledge of adulterants in Lowell, and the results informed subsequent survey design. Through our survey, we examined whether PWUD were aware of xylazine and their willingness to use xylazine test strips.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Most community stakeholders and PWUD had limited awareness about the presence and impact of xylazine as an adulterant. Forty-seven (50%) survey respondents were aware of xylazine. When provided with more information about xylazine, 65% of all respondents expressed a willingness to use xylazine test strips. PWUD who had received naloxone training, reported using with others, and using tester shots were more willing to use xylazine test strips.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our findings are congruent with existing literature that indicates that there is limited awareness of xylazine among PWUD, and they consider xylazine an unwanted adulterant. We also found that PWUD who use other harm reduction measures are more willing to use xylazine test strips. The increase in xylazine warrants additional community-level interventions such as wound management and local testing infrastructure. Further research is needed to understand better the impacts associated with xylazine use, effective harm reduction techniques, and perceptions of xylazine test strips.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/29767342241265181","type":"journal-article","created":{"date-parts":[[2025,3,15]],"date-time":"2025-03-15T02:58:56Z","timestamp":1742007536000},"page":"291-301","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":20,"title":["Exploring Xylazine Awareness, Health Impacts, and Harm Reduction Strategies: Findings From a Multimethods Study in Lowell, Massachusetts"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4349-8326","authenticated-orcid":false,"given":"Shikhar","family":"Shrestha","sequence":"first","affiliation":[{"name":"Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Cyr","sequence":"additional","affiliation":[{"name":"Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Hajinazarian","sequence":"additional","affiliation":[{"name":"Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Dillon","sequence":"additional","affiliation":[{"name":"Life Connection Center, Lowell, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5457-7591","authenticated-orcid":false,"given":"Takkyung","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Pustz","sequence":"additional","affiliation":[{"name":"Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J.","family":"Stopka","sequence":"additional","affiliation":[{"name":"Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,8,3]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"crossref","unstructured":"Spencer M Mini\u00f1o AM. Warner M. Drug overdose deaths in the United States 2001\u20132021. 2022. Accessed August 8 2023. www.cdc.gov\/nchs\/data\/databriefs\/db457.pdf","DOI":"10.15620\/cdc:122556"},{"key":"e_1_3_3_3_2","unstructured":"Centers for Disease Control and Prevention. Understanding the opioid overdose epidemic.Accessed June 30 2024. https:\/\/www.cdc.gov\/overdose-prevention\/about\/understanding-the-opioid-overdose-epidemic.html"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7037a4"},{"key":"e_1_3_3_5_2","unstructured":"Centers for Disease Control and Prevention. Wide-ranging online data for epidemiologic research (WONDER). National Center for Health Statistics; 2021. Accessed August 30 2023. Available at: http:\/\/wonder.cdc.gov"},{"key":"e_1_3_3_6_2","unstructured":"Centers for Disease Control and Prevention. Provisional data shows U.S. drug overdose deaths top 100 000 in 2022. 2023. 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