Overdoses Involving Xylazine Mixed with Fentanyl: Clinical and Public Health Implications

At a glance

During this COCA Call, presenters will discuss the epidemiology of overdoses involving xylazine mixed with fentanyl, the current understanding of health risks related to these overdoses, and acute treatment strategies.

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Free Continuing Education

Overview

The non-opioid drug xylazine has been found in the U.S. illegal drug supply and is associated with overdose deaths from fentanyl. Xylazine is not approved for use in people and can cause sedation and other adverse health effects. During this COCA Call, presenters will discuss the epidemiology of overdoses involving xylazine mixed with fentanyl, the current understanding of health risks related to these overdoses, and acute treatment strategies. Presenters will also review the state of laboratory testing, outline potential harm reduction activities, and provide an example of an ongoing public health and clinical partnership to mitigate harms from xylazine mixed with fentanyl.

Presenters

Josh Schier, MD, MPH
CAPT, U.S. Public Health Service
Senior Medical Officer, Health Systems and Research Branch
Division of Overdose Prevention
National Center for Injury Prevention and Control
Centers for Disease Control and Prevention

Lewis Nelson, MD
Chair, Department of Emergency Medicine
Director, Division of Medical Toxicology and Addiction Medicine
Rutgers New Jersey Medical School

Rachel S. Wightman, MD
Associate Professor Emergency Medicine and Epidemiology
Alpert Medical School of Brown University
Consultant Medical Director, Rhode Island Department of Health

Call Objectives

COCA Call Objectives

At the conclusion of the session, the participant will be able to accomplish the following:

  1. Cite background information on the topic covered during the presentation.
  2. Discuss CDC's role in the topic covered during the presentation.
  3. Describe the topic's implications for clinicians.
  4. Discuss concerns and/or issues related to preparedness for and/or response to urgent public health threats.
  5. Promote health improvement, wellness, and disease prevention in cooperation with patients, communities, at-risk populations, and other members of an interprofessional team of healthcare providers.

Activity-Specific Objectives

  1. Discuss the history and epidemiology of xylazine in the drug supply and among overdoses.
  2. Describe the current understanding of adverse health effects from exposure to xylazine mixed with fentanyl and acute overdose treatment strategies.
  3. List laboratory testing options and harm reduction activities to minimize disease and death from overdoses involving xylazine mixed with fentanyl.
  4. Identify opportunities for public health and clinical partnerships to improve communication, outreach, and outcomes in people exposed to xylazine mixed with fentanyl.

Additional Resources

Continuing Education

Instructions for Obtaining Continuing Education (CE)

To receive continuing education (CE) for WC4520R—Overdoses Involving Xylazine Mixed with Fentanyl: Clinical and Public Health Implications—please visit CDC TRAIN and search for the course in the Course Catalog using WC4520R-022924. Follow the steps below by April 1, 2024.

To receive continuing education (CE) for WD4520R—Overdoses Involving Xylazine Mixed with Fentanyl: Clinical and Public Health Implications—please visit CDC TRAIN and search for the course in the Course Catalog using WD4520-022924. Follow the steps below between April 2, 2024, and April 2, 2026.

  1. Register for and complete the course.
  2. Pass the post-assessment at 75%.
  3. Complete the evaluation.
  4. Visit Your Learning to access your certificates and transcript.

Accreditation Statements

In support of improving patient care, The Centers for Disease Control and Prevention is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

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CDC is a Jointly Accredited Provider in Interprofessional Continuing Education.

CME: The Centers for Disease Control and Prevention designates this live activity for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AAPA CME: Credit Designation Statement – Live
The Centers for Disease Control and Prevention has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1 AAPA Category 1 CME credits. PAs should only claim credit commensurate with the extent of their participation.

CNE: The Centers for Disease Control and Prevention designates this activity for 1 nursing contact hours.

CPE: The Centers for Disease Control and Prevention designated this Knowledge-based event for pharmacists to receive 0.1 CEUs in pharmacy education. The Universal Activity Number is JA4008229-0000-24-011-L04-P and enduring JA4008229-0000-24-012-H04-P.

CEU: The Centers for Disease Control and Prevention is authorized by IACET to offer 0.1 CEUs for this program.

CECH: Sponsored by the Centers for Disease Control and Prevention, a designated provider of continuing education contact hours (CECH) in health education by the National Commission for Health Education Credentialing, Inc. This program is designated for Certified Health Education Specialists (CHES®) and/or Master Certified Health Education Specialists (MCHES®) to receive up to 1 total Category I continuing education contact hours. Maximum advanced level continuing education contact hours available are 1. Continuing Competency credits available are 1. CDC provider number 98614.

AAVSB/RACE: This program has been submitted (but not yet approved) for 1 hours of continuing education credit in jurisdictions which recognize AAVSB RACE approval; however, participants should be aware that some boards have limitations on the number of hours accepted in certain categories or restrictions on certain methods of delivery of continuing education.

For Certified Public Health Professionals (CPH): The Centers for Disease Control and Prevention is a pre-approved provider of Certified in Public Health (CPH) recertification credits and is authorized to offer 1 CPH recertification credits for this program.

DISCLOSURE: In compliance with continuing education requirements, all planners and presenters/moderators must disclose all financial relationships, in any amount, with ineligible companies over the previous 24 months as well as any use of unlabeled product(s) or products under investigational use.

CDC, our planners, and presenters/moderators wish to disclose they have no financial relationship(s) with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Content will not include any discussion of the unlabeled use of a product or a product under investigational use.

CDC did not accept financial or in-kind support from ineligible companies for this continuing education activity.

Target Audience

  • Physicians
  • Nurses
  • Pharmacists
  • Veterinarians
  • Physician Assistants
  • Health Educators
  • Other Clinicians

Additional Information

  • Contact Information: coca@cdc.gov
  • Support/Funding: Centers for Disease Control and Prevention, Office of Emergency Risk Communication
  • Method of Participation: You may participate in the educational activity by viewing the program information above.
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