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Updated: Jun 10, 2026
10:13
Fentanyl Analog Screening using LC-TIMS-TOF MS/MS
Published on: November 8, 2024
Case Report: Oral-Nasal Damage in a Person Using Fentanyl and Xylazine.
Journal of Addiction Medicine
|June 8, 2026
Summary
Intranasal use of fentanyl combined with xylazine can cause severe nasal and palate damage. Early recognition and treatment are crucial for patients misusing these substances to prevent further destruction.
Area of Science:
- Toxicology
- Otolaryngology
- Substance Use Disorders
Background:
- Xylazine (an alpha-2-adrenergic agonist) has been increasingly combined with illicit fentanyl.
- Intranasal drug use is prevalent and linked to damage of nasal and palatal structures.
- No prior case reports have documented intranasal damage from combined fentanyl and xylazine use.
Purpose of the Study:
- To report a case of severe intranasal damage secondary to the co-use of fentanyl and xylazine.
- To highlight the importance of recognizing this type of damage in clinical practice.
Main Methods:
- Case report of a 39-year-old female with a history of intranasal opioid and xylazine use.
- Patient presented with nasal septum perforation and oral-nasal fistulas.
- Otolaryngology referral for evaluation of palate damage attributed to intranasal fentanyl and xylazine.
Main Results:
- The patient exhibited extensive damage to her palate, nasal structures, and skull base.
- This damage was suspected to be a direct result of intranasal fentanyl and xylazine co-use.
Conclusions:
- Intranasal co-use of fentanyl and xylazine can lead to significant damage to the nose, palate, and skull base.
- Clinicians must be aware of this association and promptly refer patients for substance use disorder and otolaryngology treatment to mitigate further harm.
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