Xylazine

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psx:substance/xylazine/src/doi:10.1016/j.annemergmed.2024.01.041

src2026-10-02recordconsumed

derived from · upstream

none recorded

feeds · downstream

usedRevision 1psx:substance/xylazine/version/1
usedClaim in summary — inconclusivepsx:substance/xylazine/claim/7d1ce1c7-4083-4cd7-acf9-2c1d27389a5a
usedClaim in safety — inconclusivepsx:substance/xylazine/claim/0c7f7339-9e52-4d32-9612-51418c1cda97
usedClaim in safety — inconclusivepsx:substance/xylazine/claim/d1ffc097-41a4-48fe-8b4d-316b2d67146d
usedClaim in safety — inconclusivepsx:substance/xylazine/claim/4948fda4-6a42-4f78-b29f-59436d2c3289
usedClaim in clinical-evidence — inconclusivepsx:substance/xylazine/claim/8abc5e3f-5cba-47f0-ba2f-39e87b929094
usedClaim in safety — inconclusivepsx:substance/xylazine/claim/aaa4343f-2044-4b53-8865-41744ca093cb
usedClaim in summary — inconclusivepsx:substance/xylazine/claim/c51103b4-2867-4ae0-b679-ceac050c333c
usedClaim in safety — inconclusivepsx:substance/xylazine/claim/206e3126-5569-4fd9-bb12-28f888141e1c
usedClaim in safety — inconclusivepsx:substance/xylazine/claim/6415cbfb-ab6e-44a2-adf3-538171b61329
usedClaim in clinical-evidence — inconclusivepsx:substance/xylazine/claim/d86b2d21-0207-406b-a267-ee5318c25c88

psx:substance/xylazine/src/doi:10.1016/j.annemergmed.2024.01.041
  ├─ used  src/url:bb3252139fde5103  Xylazine Toxicity - StatPearls
  ├─ used  src/doi:10.1186/1747-597X-6-7
  ├─ used  src/doi:10.1136/injuryprev-2020-043968  Increasing presence of xylazine in heroin and/or fentanyl deaths, Philadelphia, Pennsylvania, 2010-2019
  ├─ used  src/doi:10.1016/j.drugalcdep.2022.109380  Xylazine spreads across the US: A growing component of the increasingly synthetic and polysubstance overdose crisis
  ├─ used  src/doi:10.1016/j.addicn.2024.100155  Xylazine is an agonist at kappa opioid receptors and exhibits sex-specific responses to opioid antagonism
  ├─ used  src/doi:10.64898/2026.03.04.709652  Xylazine's kappa opioid agonist activity is not shared with other FDA-approved alpha2-adrenergic agonists
  ├─ used  src/doi:10.1242/dmm.052600  Evidence that xylazine disrupts skin homeostasis by acting on epithelial cells through the kappa opioid receptor
  ├─ used  src/doi:10.7759/cureus.36864  Xylazine in the Opioid Epidemic: A Systematic Review of Case Reports and Clinical Implications
  ├─ used  src/doi:10.15585/mmwr.mm7226a4  Illicitly Manufactured Fentanyl-Involved Overdose Deaths with Detected Xylazine - United States, January 2019-June 2022
  ├─ used  src/doi:10.1016/j.socscimed.2025.118521  Temporal and spatial patterns of xylazine and medetomidine detected in the DEA NFLIS reports
  ├─ used  src/doi:10.1186/s12954-021-00546-9  Xylazine detected in unregulated opioids and drug administration equipment in Toronto, Canada
  ├─ used  src/doi:10.1016/j.drugpo.2026.105184  Emergence of xylazine in accidental overdose deaths, impaired drivers, sexual assaults, and public intoxications within San Francisco
  ├─ used  src/url:fffcaeb4f34aedee  State and Federal Actions to Respond to Xylazine - National Governors Association
  ├─ used  src/url:a40ebed4f313bda7  UK ACMD Amendment Report: Use and Harms of Xylazine, Medetomidine and Detomidine
  ├─ used  src/doi:10.1007/s11916-024-01211-z  Xylazine: A Drug Adulterant of Clinical Concern
  ├─ used  src/doi:10.1016/j.jpet.2025.103397  Antagonism of the antinociceptive effects of fentanyl and the veterinary anesthetic xylazine in mice
  ├─ used  src/doi:10.1016/j.jpet.2025.103711  Interactions between cardiorespiratory effects of fentanyl and xylazine and their reversal
  ├─ used  src/doi:10.1038/s41386-023-01782-2  Combined treatment with naloxone and atipamezole reversed brain hypoxia induced by a fentanyl-xylazine mixture in a rat model
  ├─ used  src/doi:10.1016/j.brainres.2013.02.030  Xylazine induced central antinociception mediated by endogenous opioids and mu-opioid receptor, but not delta- or kappa-opioid receptors
  ├─ used  src/doi:10.1016/j.neulet.2013.02.022  Alpha2-Adrenergic agonists including xylazine and dexmedetomidine inhibit norepinephrine transporter function in SK-N-SH cells
  ├─ used  src/doi:10.1016/j.ejphar.2009.04.031  alpha(2)-Adrenoceptor agonist xylazine induces peripheral antinociceptive effect by activation of the L-arginine/nitric oxide/cyclic GMP pathway in rat
  ├─ used  src/pmid:2986946  Inhibition of glucose-induced insulin release by xylazine
  ├─ used  src/pmid:6266810  Xylazine-induced hyperglycemia in cattle: a possible involvement of alpha 2-adrenergic receptors regulating insulin release
  ├─ used  src/doi:10.1186/s12954-023-00879-7  Reducing the harms of xylazine: clinical approaches, research deficits, and public health context
  ├─ used  src/doi:10.1093/clinchem/hvae163  Xylazine Pharmacokinetics in Patients Testing Positive for Fentanyl and Xylazine
  ├─ used  src/doi:10.1007/s00414-025-03562-7  The first report from Ankara on the presence of xylazine abuse in blood and urine samples using a validated LC-HRMS method
  ├─ used  src/pmid:16740450  Systemic toxicity after an ocular exposure to xylazine hydrochloride
  ├─ used  src/doi:10.1111/ajad.70015  Case Series: Magnitude and duration of fentanyl and xylazine detection in the urine of persons with opioid use disorder
  ├─ used  src/doi:10.1016/j.cll.2025.01.011  Detecting Xylazine: Prevalence, Pharmacokinetics, and Analytical Considerations
  ├─ used  src/doi:10.1097/ADM.0000000000001633
  ├─ used  src/doi:10.1213/ANE.0000000000007589
  ├─ used  src/doi:10.2174/0113892002446297260217075246  In Vitro Drug-Drug Interactions between Oxycodone and Commonly Co-Consumed Drugs in Rat and Human Liver Microsomes
  ├─ used  src/doi:10.1111/dar.70037  Point-Of-Care Drug-Checking: Assessing the Rhode Island Drug Supply Using FTIR Spectroscopy to Detect Fentanyl, Xylazine and Other Substances
  ├─ used  src/doi:10.1016/S2215-0366(24)00068-3
  ├─ used  src/doi:10.1037/pha0000670  Xylazine suppresses fentanyl consumption during self-administration and induces a unique sex-specific withdrawal syndrome not altered by naloxone in rats
  ├─ used  src/doi:10.1097/ADM.0000000000001500
  ├─ used  src/pmid:10688982  Cross-tolerance between analgesia produced by xylazine and selective opioid receptor subtype treatments
  ├─ used  src/doi:10.1016/j.bbr.2023.114726  Enhancing fentanyl antinociception and preventing tolerance with alpha-2 adrenoceptor agonists in rats
  ├─ used  src/doi:10.1097/adm.0000000000001216  Self-reported Xylazine Experiences: A Mixed-methods Study of Reddit Subscribers
  ├─ used  src/pmid:11753193  Severe intoxication from xylazine inhalation
  ├─ used  src/doi:10.1097/ASW.0000000000000436
  ├─ used  src/doi:10.7759/cureus.66609  Xylazine-Induced Necrotic Skin Ulcers in a Fentanyl-Injecting Individual in South Florida
  ├─ used  src/doi:10.7759/cureus.28160  Xylazine-Induced Skin Ulcers in a Person Who Injects Drugs in Philadelphia, Pennsylvania
  ├─ used  src/doi:10.5435/JAAOS-D-24-00125
  ├─ used  src/doi:10.1097/adm.0000000000001245  Xylazine-associated Wounds: Clinical Experience From a Low-barrier Wound Care Clinic in Philadelphia
  ├─ used  src/doi:10.1097/ADM.0000000000001641
  ├─ used  src/doi:10.1097/ADM.0000000000001659
  ├─ used  src/doi:10.1111/1556-4029.15375  Prevalence of xylazine in overdose cases: An analysis of Miami-Dade County medical examiner case data
  ├─ used  src/doi:10.1371/journal.pone.0292674  Postmortem toxicology findings from the Camden Opioid Research Initiative
  ├─ derived_from  gen/f88867b4-3c7d-4451-8bdd-6273af4eed4a  Generation — pipeline-v5
  └─ generated_by  pub/ca1fac57-4716-44ee-a4cc-47146cf602c5  Publication — backfill
├─ used  version/1  Revision 1
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  ├─ derived_from  issue/notice@75296dca2515  Issued notice
  ├─ derived_from  issue/info_card@28136b1670ce  Issued info_card
  ├─ derived_from  issue/emergency@777b5863d801  Issued emergency
  ├─ derived_from  issue/info_card@5b1088216a36  Issued info_card
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    ├─ used  claim/f520516e-a514-472e-ac76-3b5634546ffc  Claim in safety — inconclusive  working
    ├─ used  claim/5d0d19cb-01f6-446c-993c-7fa04ad41ae0  Claim in safety — inconclusive  working
    ├─ used  claim/a4a33e0d-36dc-451c-af1a-50ddab17885c  Claim in pharmacology — inconclusive  working
    ├─ used  claim/5fc20f91-bf64-427e-ad7a-d5dd604df0ea  Claim in safety — inconclusive  working
    ├─ used  claim/154de943-e088-47dc-a735-ae0e4d314152  Claim in safety — inconclusive  working
    ├─ used  claim/e9a012d2-38b9-4be5-b48d-bdbe2b5a652b  Claim in safety — inconclusive  working
    ├─ used  claim/20a67b1b-94b7-485e-b1fe-b85f3e7b1b29  Claim in safety — inconclusive  working
    ├─ used  claim/d2bc97f7-2be1-4b1d-b5aa-c30843f2dcb4  Claim in safety — inconclusive  working
    ├─ used  claim/330c670b-bdcb-4d12-a8a2-8c597629d537  Claim in pharmacology — inconclusive  working
    ├─ used  claim/4120db24-b93d-4a6a-a0d5-b5d6b535131e  Claim in safety — inconclusive  working
    ├─ used  claim/d98bee19-e591-4080-9330-f49cdd9fece0  Claim in pharmacology — inconclusive  working
    ├─ used  claim/7dc7bfea-d00b-4036-a54b-ba98640ce2f7  Claim in safety — inconclusive  working
    ├─ used  claim/aeee8f62-5523-4ecf-b223-a60932a64938  Claim in safety — inconclusive  working
    ├─ used  claim/6ccdffa7-6a47-4e28-b7d8-54f26049b24f  Claim in safety — inconclusive  working
    ├─ used  claim/fc8c7769-20ea-4994-97dd-092425e438c5  Claim in pharmacology — inconclusive  working
    ├─ used  claim/4cb2384b-0da5-45b2-a332-ba496dc12a1e  Claim in safety — inconclusive  working
    ├─ used  claim/4e9b83f1-0e23-4f4f-ad57-9f34b6a252d9  Claim in pharmacology — inconclusive  working
    ├─ used  claim/fed9a7ea-1687-4d81-a295-c296a3a25ef9  Claim in safety — inconclusive  working
    ├─ used  claim/11c932b2-4674-4a7f-ae17-b8334cdf6071  Claim in pharmacology — inconclusive  working
    ├─ used  claim/00f6ea66-6c6d-4a00-90c4-7fd6bb6a020e  Claim in pharmacology — inconclusive  working
    ├─ used  claim/6fd79c4a-3079-4706-8622-b906f419bee6  Claim in pharmacology — inconclusive  working
    └─ used  claim/c231732f-2bdc-4972-a788-c41cb1f69080  Claim in pharmacology — inconclusive  working
… closure truncated at 200 nodes

indented by distance from this node, not by parentage

1Provenance card

the boundary, as counts

Sources

5042 with DOI

3 strong · 37 moderate · 10 weak

Compilations

22026-05-08T08:15:12.524Z

pipeline-v5 · prompt hash not recorded — run predates 2026-09

Decisions

24last ruled 2026-06-04

0 awaiting a ruling

Issued documents

42026-10-19T20:34:26.306Z

notice · info card · emergency

Searches

00 with no results

queries and counts on the build

Claims checked

2283 supported

3 supported · 225 not

Correspondence

0received

consent field ships in Phase 4

Edges

543

derivations recorded for this entity

Complete over 50 sources, 2 compilations, and 24 decisions.Not here: the private journal (never).Working material — drafts, discards, unsupported claims — is listed below and readable on the working page.Cite: psychedex.org/substances/xylazine/archive

2Build

one panel per compilation run

generation run 2026-05-08

27 min failedmodel not recordedplan not recordedrun/cd995cb0…

research

no artifact

draft

no artifact

audit

no artifact

verify

no artifact

simplify

no artifact

publish

no artifact

Selection

results seen0

selected by the model0

consumed as sources50

Verification

claims checked0

supported0

partially supported0

not supported0

inconclusive0

record
seen / partial
working

The model's own caveats

none raised on this run

Reproduce

inputs: 50 source keys (listed under Sources)
plan: not recorded — template version, prompt hash and git SHA are written from 2026-09 onward
model: not recorded
streams: none — agent transcripts are persisted from 2026-09 onward

generation run 2026-05-08

44 min completedmodel pipeline-v5plan not recordedrun/048c817b…

Selection

results seen0

selected by the model0

consumed as sources50

Verification

claims checked228

supported3

partially supported0

not supported0

inconclusive225

record
seen / partial
working

The model's own caveats

taper_unassessed

Reproduce

inputs: 50 source keys (listed under Sources)
plan: not recorded — template version, prompt hash and git SHA are written from 2026-09 onward
model: pipeline-v5
streams: none — agent transcripts are persisted from 2026-09 onward

228 claims by section — every cited sentence, checked against its source

safety98 · 2 ok

Claim in safety — inconclusiveinconclusiveworking →
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Additive CNS and respiratory depression constitutes the principal mechanism for increased overdose severitysupported
Fentanyl and xylazine exhibit additive cardiorespiratory depression. Naloxone reversed fentanyl but was slower and less effective against mixtures. Need for novel treatment strategies for fentanyl-xylazine overdoses. j.jpet.2025.103711
Claim in safety — inconclusiveinconclusiveworking →
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In vitro drug-drug interaction studies in rat and human liver microsomes document metabolic interactions between oxycodone and xylazine, indicating that polydrug contexts may alter the metabolic clearance of either compoundsupported
Oxycodone frequently co-consumed with xylazine, etizolam, diazepam, and methamphetamine. In vitro DDI studies in rat and human liver microsomes. 0113892002446297260217075246
Claim in safety — inconclusiveinconclusiveworking →
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pharmacology44 · 0 ok

Claim in pharmacology — inconclusiveinconclusiveworking →
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summary18 · 0 ok

Claim in summary — inconclusiveinconclusiveworking →
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comparative-pharmacology14 · 0 ok

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history14 · 0 ok

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neuroscience12 · 0 ok

Claim in neuroscience — inconclusiveinconclusiveworking →
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receptor-pharmacology12 · 0 ok

Claim in receptor-pharmacology — inconclusiveinconclusiveworking →
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pharmacokinetic-detail10 · 1 ok

Claim in pharmacokinetic-detail — inconclusiveinconclusiveworking →
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In vitro drug-drug interaction studies in rat and human liver microsomes document metabolic interactions between oxycodone and xylazine, indicating that polydrug contexts may alter the metabolic clearance of either compoundsupported
Oxycodone frequently co-consumed with xylazine, etizolam, diazepam, and methamphetamine. In vitro DDI studies in rat and human liver microsomes. 0113892002446297260217075246
Claim in pharmacokinetic-detail — inconclusiveinconclusiveworking →
Claim in pharmacokinetic-detail — inconclusiveinconclusiveworking →
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clinical-evidence4 · 0 ok

Claim in clinical-evidence — inconclusiveinconclusiveworking →
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effects-overview2 · 0 ok

Claim in effects-overview — inconclusiveinconclusiveworking →
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3Sources

50 consumed · sorted by year · feeds = sections resting on it

Sources 1 to 30
year	source	tier	status	feeds
2026	Emergence of xylazine in accidental overdose deaths, impaired drivers, sexual assaults, and public intoxications within San FranciscoDevincenzi T, Rodda LN · International Journal on Drug Policydoi:10.1016/j.drugpo.2026.105184	moderate	consumed	1 section
2026	Evidence that xylazine disrupts skin homeostasis by acting on epithelial cells through the kappa opioid receptorRobertson TF, Horn A, Smith FM, Huttenlocher A · Disease Models & Mechanismsdoi:10.1242/dmm.052600	moderate	consumed	4 sections
2026	In Vitro Drug-Drug Interactions between Oxycodone and Commonly Co-Consumed Drugs in Rat and Human Liver MicrosomesGu W, Tyndale RF · Current Drug Metabolismdoi:10.2174/0113892002446297260217075246	moderate	consumed	2 sections
2026	Pharmacologic Reversal of Xylazine-Induced Unconsciousness in RatsPark GH, Smith EM, Obert DP, et al. · Anesthesia and Analgesiadoi:10.1213/ane.0000000000007589	moderate	consumed	cited only
2026	Xylazine Exposure and Association With Early Physiological and Withdrawal Symptoms in People With Opioid Use DisorderStrickland JC, Bergeria CL, Huhn AS, et al. · Journal of Addiction Medicinedoi:10.1097/adm.0000000000001659	moderate	consumed	cited only
2026	Xylazine Use in Pregnancy: A Case Report and Narrative ReviewKasemodel K, Ilstrup S, Avenido J, et al. · Journal of Addiction Medicinedoi:10.1097/adm.0000000000001641	weak	consumed	cited only
2026	Xylazine-Associated Wounds: A Scoping Review of Clinical Presentation and ManagementVaile JR, Connolly WC, Zavitsanos AP, et al. · Advances in Skin & Wound Caredoi:10.1097/asw.0000000000000436	strong	consumed	cited only
2026	Xylazine's kappa opioid agonist activity is not shared with other FDA-approved alpha2-adrenergic agonistsHuang XP, Krumm BE, Bedard ML, et al. · bioRxivdoi:10.64898/2026.03.04.709652	moderate	consumed	4 sections
2025	Antagonism of the antinociceptive effects of fentanyl and the veterinary anesthetic xylazine in miceCakir K, Etkins J, Nguyen ML, et al. · Journal of Pharmacology and Experimental Therapeuticsdoi:10.1016/j.jpet.2025.103397	moderate	consumed	3 sections
2025	Case Series: Magnitude and duration of fentanyl and xylazine detection in the urine of persons with opioid use disorderBird HE, Clarke WA, Hendrix CW, et al. · American Journal on Addictionsdoi:10.1111/ajad.70015	weak	consumed	1 section
2025	Detecting Xylazine: Prevalence, Pharmacokinetics, and Analytical ConsiderationsTroike KM, McShane AJ · Clinics in Laboratory Medicinedoi:10.1016/j.cll.2025.01.011	moderate	consumed	2 sections
2025	Interactions between cardiorespiratory effects of fentanyl and xylazine and their reversalPuzovic G et al. · Journal of Pharmacology and Experimental Therapeuticsdoi:10.1016/j.jpet.2025.103711	strong	consumed	2 sections
2025	Medetomidine-Associated Opioid Overdoses in Chicago, Illinois: A Report of 3 CasesNayani Z, Reese T, Armstrong A, et al. · Journal of Addiction Medicinedoi:10.1097/adm.0000000000001500	weak	consumed	cited only
2025	Performance of Xylazine Qualitative Immunoassays Designed for Drug Checking in Urine SamplesPattillo E, Xie Y, Monteiro A, et al. · Journal of Addiction Medicinedoi:10.1097/adm.0000000000001633	moderate	consumed	cited only
2025	Point-Of-Care Drug-Checking: Assessing the Rhode Island Drug Supply Using FTIR Spectroscopy to Detect Fentanyl, Xylazine and Other SubstancesUjeneza M, Tardif J, Thompson E, et al. · Drug and Alcohol Reviewdoi:10.1111/dar.70037	moderate	consumed	1 section
2025	Temporal and spatial patterns of xylazine and medetomidine detected in the DEA NFLIS reportsZhu DT, Mitragotri S, Cano M · Social Science & Medicinedoi:10.1016/j.socscimed.2025.118521	moderate	consumed	1 section
2025	The first report from Ankara on the presence of xylazine abuse in blood and urine samples using a validated LC-HRMS methodErol Öztürk Y, Yeter O, Aslilyüksek H, et al. · International Journal of Legal Medicinedoi:10.1007/s00414-025-03562-7	moderate	consumed	1 section
2025	UK ACMD Amendment Report: Use and Harms of Xylazine, Medetomidine and Detomidineurl:a40ebed4f313bda7	weak	consumed	cited only
2025	Xylazine Pharmacokinetics in Patients Testing Positive for Fentanyl and XylazineLin Y, Farnsworth CW, Azimi V, et al. · Clinical Chemistrydoi:10.1093/clinchem/hvae163	moderate	consumed	1 section
2024	Combined treatment with naloxone and atipamezole reversed brain hypoxia induced by a fentanyl-xylazine mixture in a rat modelChoi S, Irwin MR, Noya MR, et al. · Neuropsychopharmacologydoi:10.1038/s41386-023-01782-2	moderate	consumed	3 sections
2024	Enhancing fentanyl antinociception and preventing tolerance with alpha-2 adrenoceptor agonists in ratsYildiz Pehlivan D, Kara AY, Koyu A, Simsek F · Behavioural Brain Researchdoi:10.1016/j.bbr.2023.114726	moderate	consumed	2 sections
2024	Establishing a research agenda for the study and assessment of opioid withdrawalDunn KE, Strain EC · The Lancet Psychiatrydoi:10.1016/s2215-0366(24)00068-3	moderate	consumed	cited only
2024	Management of Xylazine-Induced Soft-Tissue Necrosis: A Review of 20 CasesRetrouvey H, Meyer MA, Ipaktchi K, et al. · Journal of the American Academy of Orthopaedic Surgeonsdoi:10.5435/jaaos-d-24-00125	moderate	consumed	cited only
2024	NIDA Clinical Trials Network Meeting Report: Managing Patients Exposed to Xylazine-Adulterated OpioidsPerrone J, Haroz R, D'Orazio J, et al. · Annals of Emergency Medicinedoi:10.1016/j.annemergmed.2024.01.041	moderate	consumed	3 sections
2024	Xylazine is an agonist at kappa opioid receptors and exhibits sex-specific responses to opioid antagonismBedard ML, Huang XP, Murray JG, et al. · Addiction Neurosciencedoi:10.1016/j.addicn.2024.100155	moderate	consumed	6 sections
2024	Xylazine suppresses fentanyl consumption during self-administration and induces a unique sex-specific withdrawal syndrome not altered by naloxone in ratsKhatri SN, Sadek S, Kendrick PT, et al. · Experimental and Clinical Psychopharmacologydoi:10.1037/pha0000670	moderate	consumed	3 sections
2024	Xylazine Toxicity - StatPearlsMultiple authorsurl:bb3252139fde5103	weak	consumed	cited only
2024	Xylazine-Induced Necrotic Skin Ulcers in a Fentanyl-Injecting Individual in South FloridaCervantes J, Khorsandi J, Patel KS, et al. · Cureusdoi:10.7759/cureus.66609	weak	consumed	1 section
2024	Xylazine: A Drug Adulterant of Clinical ConcernEdinoff AN, Sall S, Upshaw WC, et al. · Current Pain and Headache Reportsdoi:10.1007/s11916-024-01211-z	moderate	consumed	3 sections
2023	Illicitly Manufactured Fentanyl-Involved Overdose Deaths with Detected Xylazine - United States, January 2019-June 2022Kariisa M, O'Donnell J, Kumar S, et al. · MMWR Morbidity and Mortality Weekly Reportdoi:10.15585/mmwr.mm7226a4	moderate	consumed	2 sections

Show all 50 sources — 20 more

Sources 31 to 50
year	source	tier	status	feeds
2023	Postmortem toxicology findings from the Camden Opioid Research InitiativeKusic DM, Heil J, Zajic S, et al. · PLoS Onedoi:10.1371/journal.pone.0292674	moderate	consumed	1 section
2023	Prevalence of xylazine in overdose cases: An analysis of Miami-Dade County medical examiner case dataPotoukian RB, Gonyea J, Shoff EN, et al. · Journal of Forensic Sciencesdoi:10.1111/1556-4029.15375	moderate	consumed	1 section
2023	Reducing the harms of xylazine: clinical approaches, research deficits, and public health contextZagorski CM, Hosey RA, Moraff C, et al. · Harm Reduction Journaldoi:10.1186/s12954-023-00879-7	moderate	consumed	2 sections
2023	Self-reported Xylazine Experiences: A Mixed-methods Study of Reddit SubscribersSpadaro A, O'Connor K, Lakamana S, et al. · Journal of Addiction Medicinedoi:10.1097/adm.0000000000001216	moderate	consumed	3 sections
2023	State and Federal Actions to Respond to Xylazine - National Governors Associationurl:fffcaeb4f34aedee	weak	consumed	cited only
2023	Xylazine in the Opioid Epidemic: A Systematic Review of Case Reports and Clinical ImplicationsAyub S, Parnia S, Poddar K, et al. · Cureusdoi:10.7759/cureus.36864	strong	consumed	3 sections
2023	Xylazine-associated Wounds: Clinical Experience From a Low-barrier Wound Care Clinic in PhiladelphiaMcFadden R, Wallace-Keeshen S, Petrillo Straub K, et al. · Journal of Addiction Medicinedoi:10.1097/adm.0000000000001245	moderate	consumed	1 section
2022	Xylazine spreads across the US: A growing component of the increasingly synthetic and polysubstance overdose crisisFriedman J, Montero F, Bourgois P, et al. · Drug and Alcohol Dependencedoi:10.1016/j.drugalcdep.2022.109380	moderate	consumed	2 sections
2022	Xylazine-Induced Skin Ulcers in a Person Who Injects Drugs in Philadelphia, PennsylvaniaMalayala SV, Papudesi BN, Bobb R, Wimbush A · Cureusdoi:10.7759/cureus.28160	weak	consumed	1 section
2021	Increasing presence of xylazine in heroin and/or fentanyl deaths, Philadelphia, Pennsylvania, 2010-2019Johnson J, Pizzicato L, Johnson C, Viner K · Injury Preventiondoi:10.1136/injuryprev-2020-043968	moderate	consumed	2 sections
2021	Xylazine detected in unregulated opioids and drug administration equipment in Toronto, CanadaBowles JM, McDonald K, Maghsoudi N, et al. · Harm Reduction Journaldoi:10.1186/s12954-021-00546-9	moderate	consumed	1 section
2013	Alpha2-Adrenergic agonists including xylazine and dexmedetomidine inhibit norepinephrine transporter function in SK-N-SH cellsPark JW, Chung HW, Lee EJ, et al. · Neuroscience Lettersdoi:10.1016/j.neulet.2013.02.022	moderate	consumed	3 sections
2013	Xylazine induced central antinociception mediated by endogenous opioids and mu-opioid receptor, but not delta- or kappa-opioid receptorsRomero TR, Pacheco Dda F, Duarte ID · Brain Researchdoi:10.1016/j.brainres.2013.02.030	moderate	consumed	1 section
2011	Xylazine (veterinary sedative) use in Puerto RicoTorruella RA · Substance Abuse Treatment, Prevention, and Policydoi:10.1186/1747-597x-6-7	moderate	consumed	cited only
2009	alpha(2)-Adrenoceptor agonist xylazine induces peripheral antinociceptive effect by activation of the L-arginine/nitric oxide/cyclic GMP pathway in ratRomero TR, Duarte ID · European Journal of Pharmacologydoi:10.1016/j.ejphar.2009.04.031	moderate	consumed	2 sections
2006	Systemic toxicity after an ocular exposure to xylazine hydrochlorideVelez LI, Shepherd G, Mills LD, Rivera W · Journal of Emergency Medicinepmid:16740450	weak	consumed	3 sections
2001	Severe intoxication from xylazine inhalationCapraro AJ, Wiley JF, Tucker JR · Pediatric Emergency Carepmid:11753193	weak	consumed	1 section
2000	Cross-tolerance between analgesia produced by xylazine and selective opioid receptor subtype treatmentsWare TD, Paul D · European Journal of Pharmacologypmid:10688982	moderate	consumed	2 sections
1985	Inhibition of glucose-induced insulin release by xylazineAbdel el Motal SM, Sharp GW · Endocrinologypmid:2986946	moderate	consumed	2 sections
1981	Xylazine-induced hyperglycemia in cattle: a possible involvement of alpha 2-adrenergic receptors regulating insulin releaseHsu WH, Hummel SK · Endocrinologypmid:6266810	moderate	consumed	2 sections

4Docket

one filing per activity — decisions, correspondence, reports

0012026-05-08revisionRevision 1
Initial LLM generation (v5 pipeline, wiki, prose phase)
psx:substance/xylazine/version/1
0022026-06-04proposal22 value proposals approved together
one review action inferred from a shared reviewer and instant — the graph records one activity per proposal
22 items in this filing
- contraindication · respiratory
- contraindication · cardiovascular
- contraindication · metabolic
- contraindication · pregnancy_breastfeeding
- toxicity
- dependence · full
- withdrawal
- tolerance
- dose_tier · threshold
- dose_tier · light
- dose_tier · common
- dose_tier · strong
- dose_tier · heavy
- timeline · intravenous · onset
- timeline · intravenous · peak
- timeline · intravenous · resolution
- timeline · intravenous · afterglow
- dosage · intravenous
- duration · intravenous · onset
- duration · intravenous · total
- duration · intravenous · aftereffects
psx:substance/xylazine/proposal/contraindication/340f7a75-f38e-4a3d-80cb-4002e3e7ab29
0032026-06-04publicationPublication — backfill
psx:substance/xylazine/pub/ca1fac57-4716-44ee-a4cc-47146cf602c5

5Issued documents

what the notice, info card and emergency page said, by hash

Issued documents
document	content hash	issued	from version	superseded
info_card	5b1088216a366327b1edc189…	2026-10-19 20:34	Revision 1	current
emergency	777b5863d801327b008f5610…	2026-09-04 04:32	Revision 1	current
info_card	28136b1670ce281a49e1bc99…	2026-09-04 04:32	Revision 1	superseded2026-10-19
notice	75296dca25159c5d9b812acb…	2026-09-04 04:32	Revision 1	current

Xylazine

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