An Epidemic within a Pandemic: An 8-Year-Old Boy with Xylazine-Complicating Fentanyl Poisoning, and Drug Detection Challenges.

Abstract

The Centers for Disease Control and Prevention (CDC) has reported an increase in nonmedical drug use during a short time period in combination with declining mental health and increasing suicidal ideation during the SARS-CoV2 pandemic (1). In 2014, >47 000 people in the United States died as a result of a drug overdose (2). This figure is double the number of fatal drug overdoses reported in 2000 (2) and, as of the final quarter of 2021, rose to >100 000 drug overdose related deaths (3). Furthermore, prior to the SARS-CoV2 outbreak, in 2019, 1150 people died from drug overdoses in Philadelphia, with 80% of overdose deaths involving opioids/opiates (2). A recent study by Korn et al., identified xylazine in 78% of inpatients at Thomas Jefferson University Hospital who had screened positive for fentanyl (4). These figures have likely risen between 2020 and 2022 given the findings by the CDC, although the actual figures are difficult to determine given that testing during the SARS-CoV-2 pandemic significantly declined.