Share this page!

Enter URL or ID to Unroll

You can paste full URL like: https://x.com/threadreaderapp/status/1644127596119195649
or just the ID like: 1644127596119195649

How to get URL link on X (Twitter) App

  1. On the Twitter thread, click on or icon on the bottom
  2. Click again on or Share Via icon
  3. Click on Copy Link to Tweet
  4. Paste it above and click "Unroll Thread"!
  5. More info at Twitter Help
Dr. Nabarun Dasgupta Profile picture
@nabarund
Apr 12, 2023 • 14 tweets • 10 min read • Read on X
Based on our lab data, I reckon #xylazine shows up in the drug supply 5 specific ways:
🧵👇
1. Veterinary diversion is rare, niche, and localized to interconnected Caribbean communities:

Philly


Puerto Rico
link.springer.com/article/10.118…
2. Most commonly... Fentanyl and #xylazine in combo, about 3:1.

We don't see xylazine-related synthesis impurities but do see fentanyl impurities, so our hypothesis is that xyl is being added intentionally in pure form.
Example from Lexington NC: streetsafe.supply/results/p/3003…
3. #xylazine as a ridealong.

Xylazine one part of *premixed cut* you can buy online from China. Esp in metro NYC, we see specific constellations of 5-8 substances (quinine, lidocaine, gabapentin, procaine, levamisole, etc) that match.

streetsafe.supply/results/p/3003… Image
4. #Xylazine as cross-contamination.

Sometimes xylazine is in trace abundance, mixed with actives: gabapentin, cocaine, methamphetamine plus opioids. Likely product VERY stepped on.

From TN:
streetsafe.supply/results/p/4001…
From NC:
streetsafe.supply/results/p/nc01…
5. #Xylazine without fentanyl, but with other alpha-2 agonists, caffeine, and/or designer benzos.

This is rare but emerging.
OH: streetsafe.supply/results/p/4001…
NC: streetsafe.supply/results/p/3004…
NY: streetsafe.supply/results/p/3009…
NC: streetsafe.supply/results/p/4006…
Here's @mary_figgatt and my deep dive from 2021 into #xylazine history and science

And shout out to Don Jackson of @nc_usu who was the first person in public health to detect #xylazine in North Carolina Image
Sadly, missed opportunity. Local law enforcement knew about this 4 years ago and chose not to work with anyone in public health on education and prevention.

latimes.com/california/sto…
Props to our amazing chemist @LunaJBear who has been analyzing #xylazine samples in the lab!!
Here's our live report with data on where #xyalzine has been detected in North Carolina

ncxylazine.streamlit.app
Why are we concerned about #xylazine? @hcharmreduxxx @WeezieBeale @nc_usu lay it out in this short video

This webinar is the most current and useful resource for info on #xylazine from @NASTAD. Covers antidotes, skin wounds, naloxone, etc.

Our friends in Pittsburgh @Raaginizzle have great info on how to treat #xylazine wounds.

Download free at:
addiction-training.org/resources/?cat…

Wound-specific training session April 27 register NOW: addictiontraining.org/training/regis… ImageImage

• • •

Missing some Tweet in this thread? You can try to force a refresh
　

Keep Current with Dr. Nabarun Dasgupta

Dr. Nabarun Dasgupta Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @nabarund

Dr. Nabarun Dasgupta Profile picture
Sep 9, 2023
1 🚨Attention please: Turns out #xylazine is a kappa opioid. This validates experience from frontline folks and PWUD. Fresh science from collaborators @nanopharmNC @MadiganLBedard @zenbrainest
Pre-print:
Public health 🧵 below
#TwitteRx #harmreductionbiorxiv.org/content/10.110…
Check out @nanopharmNC's explainer on the lab science. I'll breakdown the #publichealth implications.
@nanopharmNC Basic pharmacology. Mu is the opioid receptor in the brain we usually talk about when we say “opioid” – but there are others. Kappa is less popular, but still very much an opioid receptor. HOWEVER, it’s NOT canonically linked to opioid euphoria.

sites.tufts.edu/opioidpeptides…
Image
Read 18 tweets
Dr. Nabarun Dasgupta Profile picture
May 22, 2023
Let's talk #nalmefene for OD reversal, an old generic drug in new expensive clothes. FDA approved Rx-only nasal spray today. Will this help prevent overdose deaths in the fentanyl-xylazine-strongbenzo era?

🧵👇

fda.gov/news-events/pr…
Nalmefene was developed in the 1980s by erstwhile Key Pharma in Miami, with help from scientists at @UVA
europepmc.org/article/med/39…
It was marketed as an injectable by Baxter Pharma as Revex for alcohol dependence, initially approved in April 1995 and "discontinued on May 21, 2008, for business reasons."

federalregister.gov/documents/2017…
Read 21 tweets
Dr. Nabarun Dasgupta Profile picture
Feb 15, 2023
Y'all ready for this? 🍿👊
#NarcanAdCom about to pop off
Use this # to follow today's updates

CONCEPT
The culmination of 2 decades of advocacy to make naloxone OTC

REALITY
2 decades of advocacy erased by overdose crisis profiteers $EBS

Right out the gate, FDA frames this as a solution for saving kids from overdose. Guess that’s why there are so many pediatric anesthesiologists on the AdCom
In the review of the history FDA forgets to credit the people (like Dan Bigg) who invented the intervention
Read 53 tweets
Dr. Nabarun Dasgupta Profile picture
Sep 23, 2022
🚨 Something huge happened today. 🚨

@US_FDA @DrCaliff_FDA listened to harm reduction programs and made it infinitely easier to purchase #naloxone in bulk. With 100,000+ overdose deaths each year, we need BIG solutions.

w/@RemedyAlliance @ejwheeler9 @coreysdavis
🧵 1/26
@US_FDA @DrCaliff_FDA @RemedyAlliance @ejwheeler9 @coreysdavis The FDA Guidance provides clear federal support for bulk purchase and distribution of naloxone to meet one of the biggest public health challenges of our times.

Full text via link below, but let's break it down.


2/26
@US_FDA @DrCaliff_FDA @RemedyAlliance @ejwheeler9 @coreysdavis This is a watershed moment. Along with low-cost naloxone available through @RemedyAlliance and state standing orders, this Guidance establishes a trifecta of innovations that will help rapidly scale up naloxone distribution.
3/26
Read 33 tweets
Dr. Nabarun Dasgupta Profile picture
Sep 21, 2022
“There are a lot of abandoned people who were on pain medications, who cannot get access to adequate pain management anymore, and are therefore, increasingly, turning to the street. We hear those stories every day.”

time.com/6214811/overdo…
Thanks to @ibdgirl76 @LelenaPeacock and others who have shared with me many stories about abandoned CPP. This article from @TaraLaw27 is a solid starting point to recentering folks in pain who can’t get the help they deserve.
To be clear, overdose deaths now mostly involve unregulated street drugs. Those who are dying are heterogenous: people who were on Rx opioids for years, people who never got a single script, suicides from lack of pain ctrl, and occasional users w/o tolerance.
Read 4 tweets
Dr. Nabarun Dasgupta Profile picture
Oct 1, 2021
To initiate over-the-counter status for prescription drugs, FDA prioritized *anti-flatulent drugs* and *ingrown toenails* over life-saving antidote naloxone. I daresay preventing 93,000 overdose deaths should have been first. 🧵 with Maya & @ejwheeler9
accessdata.fda.gov/scripts/cder/o…
@ejwheeler9 We have an incredible opportunity. A generic pharma is willing to make a harm reduction-only naloxone. They have filed for the new NDC. If we have an injectable naloxone that can only be accessed by syringe exchange programs, why do we need the antiquated Rx requirement?
@ejwheeler9 Would you pay $2 to save a life? With political will, we could have $2 OTC naloxone by Thanksgiving. There is a 45 day public comment period. This would be restricted to harm reduction programs, the ones that form the backbone of overdose prevention.

fda.gov/drugs/over-cou…
Read 15 tweets

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us!

Send Email!

:(