UPMC Grand Rounds: Caring for Individuals with Xylazine Associated with SUD-9.11.24 Final Slides

9.11.24 Final Slides

Pdf Summary

The document discusses the comprehensive approach to caring for individuals with Xylazine-associated substance use disorder, facilitated by the Maryland Addiction Consultation Service (MACS) and the Center for Harm Reduction Services (CHRS). The MACS provides support to healthcare providers, pharmacists, and healthcare teams in Maryland for the identification and treatment of substance use disorders (SUDs) and chronic pain management through free services including phone consultations, education, referrals, and technical assistance. <br /><br />CHRS aims to create a Maryland in which healthcare and social service systems comprehensively meet the needs of people who use drugs (PWUD) without stigma or discrimination, and where PWUD have equitable access to high-quality care. They focus on reducing substance-related morbidity and mortality by optimizing services.<br /><br />The overview provided includes epidemiology, inpatient withdrawal management, medication-assisted treatment (MOUD), multimodal pain management, and wound care identification and management. The document highlights the need for epidemiological surveillance to understand Xylazine's prevalence in Maryland, noting that the Maryland Emergency Department Drug Surveillance Program (MD-EDDS) collects de-identified health records and urine samples from hospitals for drug screening.<br /><br />For withdrawal management and MOUD, various protocols such as buprenorphine “micro-dosing” induction and sublingual high-dose induction protocols are detailed to manage acute withdrawal symptoms effectively. Methadone induction guidelines allow for starting at 50mg with a three-day rule to facilitate connection to care.<br /><br />Additionally, the document outlines the typical progression of Xylazine wounds, from initial presentation to open sores, highlighting the importance of proper wound care including dressing changes and maintaining compliance with treatment.<br /><br />Lastly, the document emphasizes the importance of establishing linkages between hospitals and community resources for ongoing wound care, reiterating that recovery involves restoring community integration.

Keywords

Xylazine-associated substance use disorder

Maryland Addiction Consultation Service

Center for Harm Reduction Services

substance use disorders

chronic pain management

epidemiology

medication-assisted treatment

wound care management

withdrawal management

community integration