Xylazine, Nitazenes, and the Changing Street Drug Landscape: What Pain Physicians Should Know

Friday, November 14, 2025

3:30 PM - 3:38 PM CT

Location: Griffin Hall - Screen 06

Introduction: Patients in pain may often resort to self-medicating using illicit opioids, sometimes combined with other substances when bought from unregulated street suppliers. The street drug supply is increasingly contaminated with potent synthetic agents that complicate clinical care. Xylazine, nitazenes, medetomidine, and related compounds are now common in heroin, fentanyl, stimulants, and counterfeit pills. This review highlights the most clinically relevant adulterants and examines regional patterns to help guide risk assessment and care planning.

Submitting Author(s)

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Omar Hamza, MD

Resident Physician
Harvard Medical School/Cambridge Health Alliance
Somerville, Massachusetts, United States

Co-Author(s)

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Ahmed Basharat, MD

Emergency Medicine Resident Physician
Yale New Haven Hospital/Yale Medical School, United States

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Sudheer Potru, DO

Director of Complex Pain Clinic; Supervising Attending
Atlanta VA Healthcare System, United States