This presentation will review the history of US street drug markets since the early 1990s to explain the emergence of xylazine, fentanyl, and crystal methamphetamine in regional markets formerly dominated by heroin and cocaine. It will examine the relationship between each of these newly prevalent synthetic substances and describe what we know so far about their impact on HIV and related comorbidities. Finally, it will assess how the public health impact of recent transformations to the US narcotics supply relates to the experience of drug consumption and the way that people use drugs in their everyday lives. January 9, 2024.
