TY - JOUR
T1 - Rising illicit drug Adulterants
T2 - Xylazine and levamisole
AU - Amaral, Pedro E.M.
AU - Beane, Samuel O.
AU - Albarouki, Angie
AU - Tan, Michael J.
AU - Schoenberger, Megan J.
AU - Yao, Yuan
AU - Liu, Li
AU - Uljon, Sacha N.
AU - Zhu, Yusheng
AU - Hall, Donald C.
AU - Qiu, Yinghua
N1 - Publisher Copyright:
© 2025 The Author(s)
PY - 2025/6
Y1 - 2025/6
N2 - The increasing prevalence of xylazine and levamisole as adulterants in illicit drugs presents significant challenges for medical professionals. This review aims to provide an overview of the mechanisms of action, prevalence of adulteration, and detection methods for xylazine and levamisole. Clinical implications associated with xylazine and levamisole-contaminated drugs are also discussed. It provides a comprehensive examination of methodologies for analyzing these emerging contaminants, shedding light on the challenges faced by toxicology laboratories in accurately identifying and quantifying these substances. Various analytical techniques, including but not limited to GC–MS, HPLC-MS, and HPLC-MS/MS, are explored in detail, with a focus on their strengths and limitations. This serves as a valuable resource for clinicians seeking to navigate the complexities of analyzing xylazine and levamisole in illicit drug samples. It also contributes to the existing knowledge on illicit drug adulteration by xylazine and levamisole, providing insights that can inform public health interventions, law enforcement efforts, and treatment strategies aimed at mitigating the risks associated with contaminated substances.
AB - The increasing prevalence of xylazine and levamisole as adulterants in illicit drugs presents significant challenges for medical professionals. This review aims to provide an overview of the mechanisms of action, prevalence of adulteration, and detection methods for xylazine and levamisole. Clinical implications associated with xylazine and levamisole-contaminated drugs are also discussed. It provides a comprehensive examination of methodologies for analyzing these emerging contaminants, shedding light on the challenges faced by toxicology laboratories in accurately identifying and quantifying these substances. Various analytical techniques, including but not limited to GC–MS, HPLC-MS, and HPLC-MS/MS, are explored in detail, with a focus on their strengths and limitations. This serves as a valuable resource for clinicians seeking to navigate the complexities of analyzing xylazine and levamisole in illicit drug samples. It also contributes to the existing knowledge on illicit drug adulteration by xylazine and levamisole, providing insights that can inform public health interventions, law enforcement efforts, and treatment strategies aimed at mitigating the risks associated with contaminated substances.
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U2 - 10.1016/j.clinbiochem.2025.110912
DO - 10.1016/j.clinbiochem.2025.110912
M3 - Review article
AN - SCOPUS:105000100375
SN - 0009-9120
VL - 137
JO - Clinical Biochemistry
JF - Clinical Biochemistry
M1 - 110912
ER -
