BOSTON, MA February 28, 2024 – In December of 2022, The Police Assisted Addiction and Recovery Initiative (PAARI), Brandeis University, and Thomas Jefferson University embarked on a year-long project: Responding to Xylazine (R2X): A Public Health-Public Safety Initiative. R2X was generously funded by the University of Baltimore – Center for Drug Control Policy and Enforcement.
The R2X project team was comprised of members from the following institutions:
- Brandeis University
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- Traci C. Green, PhD, MSc
- Mary Jo Larson, PhD
- Becca Olson, MPH
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- Police Assisted Addiction and Recovery Initiative
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- Zoe Grover, JD
- Liz Leingang
- Travis Rapoza
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- Thomas Jefferson University
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- Tracy Esteves Camacho
- Megan Reed, MPH, PhD
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The R2X project focused on three key components. The first involved the formation of focus groups within communities affected by xylazine. Thomas Jefferson spearheaded this effort, engaging groups in Philadelphia, PA, a region where over 90% of illicit opioids have been found to contain xylazine. 25 participants, among them those who use opioids (PWUO), harm reduction service providers, and harm reduction clinicians, formed these four groups and contributed to the understanding of feasible xylazine interventions.
Recognizing law enforcement’s critical role as first responders to these overdoses, the second component entailed PAARI conducting three 1-hour virtual training sessions on xylazine for its partners and interested community members. Remarkably, 822 attendees from 42 states and Washington, D.C., participated in these webinars, with an overwhelming 89% expressing high satisfaction. One notable outcome included a department’s adaptation of their overdose protocol, shifting to air pumps over rescue breathing post-webinar.
During the third component of the project, PAARI held intensive workshops with police departments and collaborators in Waterville, ME; New Bedford, MA; Plymouth County, MA; Essex County, MA; Rutland, VT; and Augusta, ME. Workshop participants were provided with an in-depth background on xylazine and participated in small group brainstorming of gaps in the current overdose response and the implementation of possible interventions. These workshops facilitated the crafting of tailored community interventions to address the xylazine crisis. Notably, 100% of participants devised two-month action plans and committed to the ongoing distribution of xylazine wound care kits.
The workshops yielded several proposed interventions, including:
- Adapting overdose response protocols for fentanyl/xylazine co-exposure and educating first-responders
- Informing post-overdose clients/families about xylazine in the drug supply plus wound care
- Expanding community knowledge of xylazine by creating, printing, and displaying informational posters in public areas and distributing informational folders to PWUD
- Implementing drug checking through www.info.streetcheck.org
These workshops were followed by a virtual visit from the evaluation team, two months later, to conduct interviews and gather observations on how the developed response was being administered.
On October 10th, PAARI hosted Xylazine 102, marking the final step in the Xylazine Pilot Project. The Xylazine 102 event allowed PAARI staff to share developed resources intended for tackling the emerging threat of xylazine, including in-depth wound care and intervention results from workshop participants. It ensured that PAARI partners were well-informed and equipped with best practices to address the growing presence of this substance in their communities.
Due to the high demand for further xylazine information dissemination, PAARI presented on the substance at their 2023 National Law Enforcement Summit in December. They were also graciously invited to present on xylazine to the Massachusetts Executive Office of Public Safety and Security (EOPSS) in January and the Washington State Criminal Justice Training Commission in June.
The largest success of R2X was the development of novel materials on xylazine and its dissemination to webinar and workshop participants. The project team developed printed materials, shared webinar recordings, and facilitated the creation of videos highlighting experts on overdose response. These resources will continue to be shared post-project completion as the need for informative xylazine materials continues to grow.
“I am proud to have worked on this project that is now more relevant and important than when we started it,” says Dr. Megan Reed. “We hope that the information and resources shared throughout the project will help to reduce stigma and save lives.”
“The attendance at the webinars and participation in this project as a whole far exceeded our projections,” says Liz Leingang. “This project is only the beginning. PAARI will continue to learn and disseminate findings as the presence of xylazine in the drug supply, unfortunately, continues to grow.”
For more information on the project and its outcomes, visit https://paariusa.org/xylazine/.
Written by, Isabella Nowak
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ABOUT PAARI: 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, Mass., Police Department Angel Initiative in June 2015, PAARI has been a driving force behind this rapidly expanding community policing movement. We provide technical assistance, strategic guidance, connection to training resources, and other capacity-building resources to more than 700 police departments in 45 states.
PAARI works 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 tens of thousands of lives, changed police culture, and reshaped the national conversation about the opioid epidemic since its founding in June 2015. Learn more at paariusa.org.
