Xylazine Spreads West According to New Millennium Health Signals Alert™

Urine drug test (UDT) data indicate significant uptick in xylazine use in the West, remains deeply entrenched in the East

According to the Millennium Health Signals Alert released today, xylazine use among those who use fentanyl grew substantially in the West in the year after the Office of National Drug Control Policy (ONDCP) designated fentanyl adulterated with xylazine an emerging threat. At the same time, xylazine use also grew in New England, further tightening its grip on the Eastern U.S. where rates of use are approximately double the national rate of 15.6%.

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Xylazine remains a significant concern in the eastern U.S., and a growing concern out West. Clinicians across the U.S. should be aware of and prepared to address the use of fentanyl adulterated with xylazine in their communities. (Graphic: Business Wire)

“The use of fentanyl adulterated with xylazine is associated with profound, long-lasting sedation that may increase overdose risk and susceptibility to victimization and other harms,” said Chief Clinical Officer Angela Huskey, PharmD, CPE. “Because xylazine exposure remains a significant challenge in the East and is a growing concern in the West, clinicians across the U.S. need to be prepared to recognize and address the consequences of xylazine use among people who use fentanyl.”

Pennsylvania (40.3%), New York (36.5%), and Ohio (34.6%) had the highest xylazine positivity rates over the year and the top 20 states were all situated along or east of the Mississippi River.

“The threat associated with the combination of fentanyl and xylazine is incredibly pernicious and often leads to tragic consequences,” says Scott Walton, CEO. “We are proud of the role that Millennium Health plays in providing timely and actionable data to those on the front lines of helping address this crisis and look forward to continuing to be a resource.”

Methodology

This Signals Alert represents an analysis of over 50,000 fentanyl-positive urine drug test specimens collected between April 12, 2023 and April 11, 2024. Millennium Health researchers analyzed xylazine positivity rates in fentanyl-positive UDT specimens by U.S. Census Division and state. A copy of the full Alert, references, and complete statistical methods can be accessed here.

About Millennium Health

Millennium Health is an accredited specialty laboratory providing medication monitoring via definitive urine and oral fluid drug tests to support improved clinical decision-making as part of treatment for millions of Americans with chronic pain, mental illness, substance use disorders, and other health conditions. Drug testing is used to obtain objective information about patients’ recent use of prescription medications and/or illicit drugs and helps monitor the effectiveness of treatment plans. We also conduct real-time tracking of emerging drug use trends to help researchers, public health officials, and policymakers address the significant increase in drug overdose deaths.

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