First Detection of Xylazine in Texas Wastewater and Its Association with Fentanyl Use

Details

• Journal Article:
  ACS ES&T Water
• Personal Author:
  Joseph, Katherine M. ; Qin, Xuan ; Parikh, Dhvani ; Li, Feng ; Balliew, John ; Mena, Kristan D. ; Wu, Fuqing
• Description:
  The United States is dealing with an escalating drug overdose crisis intensified by emerging threats, particularly xylazine, a veterinary sedative increasingly found as an adulterant in illicit drug supplies. To investigate the prevalence of xylazine and examine its spatial correlation with fentanyl consumption, we employed wastewater-based epidemiology to analyze 124 samples from four wastewater treatment plants serving El Paso, Texas, over 13 months (June 2023 to July 2024). Samples were analyzed for xylazine and norfentanyl (fentanyl metabolite) using liquid chromatography-tandem mass spectrometry, with population-normalized mass loads calculated for spatial comparisons. Xylazine was detected in three of four treatment plants, showing detection rates of 29.0, 12.9, 9.7, and 0% across different sewersheds. All samples tested positive for norfentanyl, confirming city-wide fentanyl use. Peak population-normalized loads reached 110 +/- 40 µg/day/1000 people for xylazine and 2400 +/- 300 µg/day/1000 people for norfentanyl. Statistical analysis revealed that sewersheds with higher xylazine detection rates exhibited significantly elevated norfentanyl loads (p < 0.05), suggesting a community-level association between xylazine and fentanyl use. This study provides the first evidence of xylazine in Texas wastewater and reveals spatially clustered distribution patterns that may inform targeted public health interventions to mitigate the growing threat of xylazine within the opioid crisis. Description provided by NIOSH
• Subjects:
  • Illicit Drugs
  • Occupational Health
  • Public Health
  • Safety
  • Water Purification
  • Xylazine
• Keywords:
  • Waste treatment; Water sampling; Epidemiology; Surveillance; Drug use; Opioids; Public health;
  • Author Keywords: xylazine; fentanyl; illicit drugs; wastewater-based epidemiology; border communities
• Source:
  ACS EST Water 2026 Feb; 6(2):946-953
• ISSN:
  2690-0637
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Dallas Region OSHA ; Texas
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  15 pdf pages
• Volume:
  6
• NIOSHTIC Number:
  nn:20071658
• Contact Point Address:
  Fuqing Wu, Department of Environmental and Occupational Health Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston, Texas 77030, United States
• Email:
  fuqing.wu@uth.tmc.edu
• CAS Registry Number:
  • Fentanyl (CAS RN 437-38-7)
  • Xylazine (CAS RN 7361-61-7)
• Federal Fiscal Year:
  2026
• Performing Organization:
  University of Texas Health Science Center, Houston
• Peer Reviewed:
  True
• Start Date:
  20050701
• End Date:
  20260630
• Download URL:
  https://stacks.cdc.gov/view/cdc/259431/cdc_259431_DS1.pdf
• File Type:
  [PDF - 1.67 MB]
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:0075358d3b04fe940fcb0baed64f2fab761bd90705ec3b66550c1b4754d2f483b1df49781abb8c121bb25f0a687aad2abc2d30b5fab7af43a0df022453797bf3