# Rapid Research for Xylazine Response

> **NIH NIH R21** · JOHNS HOPKINS UNIVERSITY · 2024 · $122,813

## Abstract

Project Summary
Xylazine is an emerging serious threat to people who inject drugs (PWID). Xylazine and fentanyl drug mixtures
elevate risk overdose and because xylazine is not an opioid, naloxone does not reverse its effects. Despite the
increasing presence of xylazine in overdose deaths across the US, there is limited epidemiologic research
focused on characterizing the prevalence and risk factors of its use in settings where mortality data indicates a
known elevated risk. Although there has been a marked uptick of severe wounds and necrosis among those
using drugs that contain xylazine, the specific drug use practices or other characteristics related to the
development of wounds are not known. The goal of this research is to generate urgently needed evidence to
understand the prevalence, risk factors, knowledge, and harm reduction practices associated with xylazine use
and the development of wounds among PWID, in order to effectively inform practice and raise awareness
among the affected communities, health care and harm reduction service providers and the public regarding
the health risks associated with xylazine. We propose a mixed methods approach using respondent-driven
sampling to identify and survey approximately n=300 PWID in Baltimore and n=40 qualitative interviews with
those who use xylazine, health care and harm reduction providers. We will estimate the prevalence and
correlates of both intentional and suspected xylazine use and examine xylazine-specific overdose knowledge,
beliefs and practices. We will determine the prevalence of wounds associated with xylazine use and the
association between HIV infection, drug use practices and wounds. We will also characterize barriers to
accessing wound care using qualitative methods. This research on a sudden emerging illicit drug will generate
time-sensitive knowledge that will directly contribute to preventing the harmful consequences associated with
xylazine emergence. We will translate our findings and conduct broad dissemination, working with local
stakeholders, partner organizations, and governmental agencies to inform overdose and treatment programs.

## Key facts

- **NIH application ID:** 10929552
- **Project number:** 5R21DA060056-02
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** DANIELLE GERMAN
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $122,813
- **Award type:** 5
- **Project period:** 2023-09-15 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10929552

## Citation

> US National Institutes of Health, RePORTER application 10929552, Rapid Research for Xylazine Response (5R21DA060056-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10929552. Licensed CC0.

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