OPRC receives new grant on the emergence of xylazine in the drug supply

March 01, 2023

The Opioid Policy Research Collaborative within the Institute of Behavioral Health at the Heller School for Social Policy and Management at Brandeis University in Waltham, MA and its partners, the Police Assisted Addiction & Recovery Initiation (PAARI), and the Center for Connected Care at Thomas Jefferson University were awarded a $267,511 one-year grant from the University of Baltimore's Center for Drug Policy and Prevention (CDPP) to investigate appropriate police and community responses to xylazine in the drug supply.

Xylazine is an animal tranquilizer not approved for human use that is present in the street drug supply of Puerto Rico, historically, and now widespread in Philadelphia. There is evidence it is spreading to other areas in New England and across the US. Philadelphia's first responders and harm reduction workers report that xylazine has complicated responses to suspected overdoses and is leading to serious morbidity in people who use drugs (PWUD). The OPRC team is developing strategies to increase awareness of this public health problem among police departments and their collaborators. Novel concerns emerging in areas with high prevalence of xylazine include:

  1. Acute skin ulcerations are common and can be very severe at injection and non-injection sites (predominantly arms and legs).
  2. Suboptimal overdose response: Heavy sedation and respiratory depression that does not respond to naloxone, a medication commonly administered to reverse the effects of opioid overdose. Thus, though breathing may have resumed, the overdose victim may remain unconscious.
  3. Safety concerns related to extended heavy sedation: Unlike opioid reversal that is immediate, sedation from xylazine may last as long as 8-72 hours, raising safety issues for the sedated individual (victimization through rape, robbery) and risk of morbidity from lack of blood flow to body regions.

The OPRC project, Responding to Xylazine (R2X): A Public Health-Public Safety Initiative, will encourage appropriate police and community responses to xylazine in the drug supply through implementation of several strategies:

  • In-depth focus groups in Philadelphia to hear voices of stakeholders on responses needed.
  • National educational webinars to increase awareness of police departments and other community members and spur them to action.
  • Half-day workshops for 6 police departments who volunteer to work with their community partners to co-develop a plan of action to detect, monitor, and respond to the needs of people who use drugs in their area.

Information from the focus groups will be used to prepare new training content. Brandeis University will conduct a process evaluation and PAARI will implement nationwide training with police departments and conduct workshops with pilot police departments in New England.

The Brandeis team includes Mary Jo Larson, PhD'92 (project director), Becca Olson, MPH (research associate) and Traci Green, PhD (senior advisor). Brandeis is joined by Megan Reed, PhD, a scientist who designs and evaluates structural interventions in partnership with people who use drugs. The PAARI executive director is Zoe Grover, who operates police community initiatives across the nation.

"Police units are first responders to overdoses and can provide critical information to people who use drugs and their family members that helps minimize harm from drug use," said Mary Jo Larson, senior scientist in the Institute for Behavioral Health. "Through the R2X project, we will provide some of the first training specific to xylazine made available to police departments and distribute to them wound kits they can use to engage community members in discussion of this emerging public health threat."

The funds are from a partnership between the Office of National Drug Control Policy (ONDCP) and the Centers for Disease Control, the Combating Overdose through Community-Level Interdiction (COCLI) Initiative. This team is one of fourteen (14) community-based programs across the nation that received awards totaling $2.38 million.


The Police Assisted Addiction & Recovery Initiative (PAARI) is a nonprofit organization with a mission to help law enforcement agencies nationwide create non-arrest pathways to treatment and recovery. Founded alongside the groundbreaking Gloucester MA Police Department Angel Initiative in June 2015, PAARI has been a driving force behind this rapidly expanding community policing movement. We provide technical assistance, coaching, grants, and other capacity-building resources to more than 550 police departments in 35 states. We currently work with more than 130 law enforcement agencies in Massachusetts alone. PAARI and our law enforcement partners are working towards a collective vision where non-arrest diversion programs become a standard policing practice across the country, thereby reducing overdose deaths, expanding access to treatment, improving public safety, reducing crime, diverting people away from the criminal justice system, and increasing trust between law enforcement and their communities. Our programs and partners have saved thousands of lives, changed police culture, reshaped the national conversation about the opioid epidemic and have placed over 24,000 people into treatment since its founding in June 2015. Learn more at paariusa.org.

About the Jefferson Center for Connected Care

The Jefferson Center for Connected Care develops and tests innovative approaches for a patientresponsive care delivery system. Our goal is to create replicable and sustainable models of care to reduce, and ultimately eliminate, health disparities. Learn more at https://research.jefferson.edu/connected-care-center.html.