Episode 35: Xylazine and Other α2 Agonists – Clinical and Forensic Perspectives

This week on The Tox Lab, we're diving into the world of α2 adrenergic receptor agonists. We explore how xylazine, when combined with heroin, can both potentiate drug-seeking behaviour after abstinence and attenuate heroin consumption and motivation during use.

We also review a study investigating naloxone and atipamezole as potential treatments for fentanyl–xylazine toxicity and examine two forensic case studies detailing tizanidine and medetomidine concentrations to support interpretation in toxicology casework.

Join us as we unpack the clinical, toxicological, and forensic implications of this increasingly encountered drug class.

Note: In this episode, we mentioned tizanidine acting on imidazole receptors (26:58) when we meant imidazoline receptors!

Hope you enjoy!

Links to papers we discussed:

https://www.sciencedirect.com/science/article/abs/pii/S0091305725000991

https://www.tandfonline.com/doi/full/10.1080/29947448.2025.2493044

https://academic.oup.com/jat/advance-article-abstract/doi/10.1093/jat/bkaf056/8165439?redirectedFrom=fulltext&login=false

https://academic.oup.com/jat/advance-article-abstract/doi/10.1093/jat/bkaf040/8127063?redirectedFrom=fulltext&login=false

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