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Growing Xylazine Supply in NC: A Community-Based Investigation of Exposure and Health Consequences

Award Number: R21DA061167
ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 07/15/2024
PERIOD OF PERFORMANCE END DATE: 06/30/2026

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Growing Xylazine Supply in NC: A Community-Based Investigation of Exposure and Health Consequences - PROJECT SUMMARY/ABSTRACT We propose a community-based, longitudinal, mixed-methods study to investigate the growing crisis of xylazine exposure among people who use drugs (PWUD) in the southeastern US. The Office of National Drug Control Policy recently listed xylazine as an emerging threat and the Centers for Disease Control and Prevention (CDC) warned of xylazine’s growing involvement in fentanyl overdose deaths. Among all US regions in 2020–2021, the south experienced the largest increase in xylazine-involved overdose (OD) deaths and the largest rise in xylazine-positive drug seizures. Yet, there remains a paucity of information on adulteration patterns in local markets, the impact of (un)witting exposure among consumers, how consumers are responding to xylazine, and drug use behaviors placing people at increased risk for atypical ODs and novel wounds. CDC recommends testing illicit drugs for xylazine to clarify prevalence in drug supplies and provide actionable intelligence to inform response. Community-based drug checking (CBDC) will expand the scientific impact of the proposed study by allowing us to identify patterns of xylazine adulteration within and across drug classes without having to rely on self-report to identify study participants exposed to xylazine, thus strengthening our scientific capacity to measure its psychosocial and physiological impact. Aim 1: To employ CBDC to determine xylazine’s overall prevalence in the illicit drug supply and its relative prevalence in specific drugs consumed by study participants; Aim 2: To explore knowledge and discernment strategies among consumers of illicit drugs as they navigate an illicit drug supply increasingly adulterated with xylazine; Aim 3: To examine the drugs and drug use behaviors of PWUD to determine the psychosocial consequences, behavioral risks, and adverse sequalae associated with xylazine exposure; Aim 4: To disseminate real-time CBDC results (Aim 1) and rapidly-analyzed study findings (Aims 2–3) to the state/county health departments and community-based organizations to inform public health response . To achieve these aims, we will recruit PWUD from two study sites and their surrounding counties. The study will be led by Principal Investigator Jon Zibbell, a National Institute on Drug Abuse–funded behavioral scientist with many years of experience studying injection drug use and infectious disease risk among PWUD. The team also includes Arnie Aldridge, a National Institutes of Health–funded statistician; Bradley Ray, a research sociologist; and Sarah Duhart Clarke, an applied psychologist. Findings from the proposed study will help clarify prevalence of xylazine and illicit markets and identify associated behaviors, observations, and adverse sequalae by Drug, Set, and Setting factors. The proposed study is poised to directly inform local and national efforts for combatting harms associated with xylazine use by disseminating findings to community members and decisionmakers in real-time.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $176,948 )
2025	2025	RESEARCH TRIANGLE INSTITUTE	3040 CORNWALLIS RD	DURHAM	NC	27709	DURHAM	USA	Drug Use and Addiction Research Programs	001	2	6/3/2025	NON-COMPETING CONTINUATION	$176,948
2025	2024	RESEARCH TRIANGLE INSTITUTE	3040 CORNWALLIS RD	DURHAM	NC	27709	DURHAM	USA	Drug Use and Addiction Research Programs	000	1	11/22/2024	NEW	$0
														Subtotal = $176,948

Issue Date FY: 2024 ( Subtotal = $204,243 )
2024	2024	RESEARCH TRIANGLE INSTITUTE	3040 CORNWALLIS RD	DURHAM	NC	27709	DURHAM	USA	Drug Use and Addiction Research Programs	000	1	7/5/2024	NEW	$204,243
														Subtotal = $204,243

Grand Total All Awards = $381,191

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Growing Xylazine Supply in NC: A Community-Based Investigation of Exposure and Health Consequences

Award Number: R21DA061167

ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 07/15/2024

PERIOD OF PERFORMANCE END DATE: 06/30/2026

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