Emerging Health Care Concerns Among People Experiencing Homeless Who Use Xylazine

Xylazine (“Tranq”) first appeared in the opioid drug supply over a decade ago, however, it has now infiltrated over 90% of the drug supply in one large city. This presentation will discuss how the increase in xylazine has impacted the health care concerns among people experiencing homeless (PEH) in several areas: pregnancy/prenatal care, wounds, and MOUD treatment. We will also discuss how we have pivoted our model of care delivery, including increased utilization of Certified Recovery Specialists and people with lived experience , development of inreach resources in hospital settings, increased outreach and street medicine resources, and educating local health care and non-profit entities regarding these emerging health care needs.

Background: Xylazine (“tranq”) has been found in over 90% of the opioid and fentanyl supply in our large city. With the increasing contamination of the opioid supply by novel substances, our street medicine and outreach teams have noticed several emerging health trends.

1) Delayed access to prenatal and pregnancy care, including an increased number of people delivering babies on the street, and not accessing postpartum care.

2) Increasing severity, size, and complications of wounds and soft tissue infections.

3) Challenges completing inpatient medical and substance use treatment due to insufficient withdrawal
management or fear of inadequate management.

Our CRS has been essential in connecting with participants who are fearful or reticent to accept care. We have developed several programmatic innovations to decrease negative health outcomes and improve healthcare engagement. We have also developed in-reach resources in our city’s various hospital systems, including increasing
involvement of CRS’s who work in inpt settings to help facilitate the plans of care.

Speakers: Maire St. Ledger: Project HOME; Monique Taylor: Project HOME; Jovan Cosby

Session Materials: 

Categories: Behavioral Health, Medication Assisted Treatment, Substance Use
Tags: 2023 National HCH Conference
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