Reported xylazine exposure highly associated with overdose outcomes in a rapid community assessment among people who inject drugs in Baltimore

Almost two-thirds (61.5%) reported experiencing xylazine effects. There were no differences by socio-demographics, but xylazine effects were more commonly reported among those who reported injecting alone and daily fentanyl use. Those reporting xylazine exposure was three times as likely to report overdose and twice as likely to have used naloxone. They also more commonly reported knowing someone who died of an overdose and to report an abscess requiring medical attention. These associations were higher among respondents who specifically named xylazine and those who used fentanyl more frequently, but fentanyl frequency did not fully explain the heightened associations with xylazine effects.