Kristin Schneider is an epidemiologist whose research focuses on improving access to essential health services for PWUD to prevent overdose and infectious disease transmission.

In recent years, xylazine has emerged as a common adulterant in the illicit opioid supply in North America. It is often in combination with illicitly manufactured fentanyl, significantly contributing to morbidity and mortality for people who use drugs (PWUD). Xylazine-associated wounds have become a major cause of morbidity for PWUD that can lead to life-threatening conditions (e.g., sepsis) if not appropriately managed. Harm reduction organizations have experienced challenges in responding to the growing burden of wounds, including a lack of wound care training and education and difficulties providing medical services in outreach environments. To address this, we sought to develop comprehensive xylazine wound care guidance for harm reduction and outreach settings. We conducted 15 in-depth interviews with wound care providers at harm reduction programs in the mainland United States and Puerto Rico to understand how medical and other service providers approach treating xylazine wounds in harm reduction settings. We also conducted an extensive literature review of strategies for xylazine wound care and wound care frameworks in the grey and academic literature. We synthesized interview findings and extant wound care nursing frameworks into guidance for harm reduction and outreach programs, including how to identify xylazine wounds, recommendations for low-cost supplies, steps for identifying when clients need to be referred to higher levels of care, and how to assess and create a treatment plan for clients based on wound characteristics. This guidance is intended for frontline service providers who engage with clients who may experience xylazine-related wounds; no more than a basic understanding of first aid is expected.

The proposed presentation will synthesize our findings and share concrete guidance on xylazine wound care, as well as communication and education materials that are tailored to the needs of resource-limited and outreach-based harm reduction programs.