Doctors in Philadelphia have received new guidance to help them deal with an influx of patients addicted to the animal tranquilizer xylazine — known on the street as “Tranq.”
An outreach charity warns that the drug – a muscle relaxant intended for large animals like horses – has “won’t let users walk” and “gashes”.
Philadelphia has become the epicenter for xylazine, which has quickly found its way into the city’s drug supply as a cheap and very potent cutting agent.
It’s most commonly used to cut fentanyl, the powerful synthetic opioid that has replaced most of Philadelphia’s heroin.
Philadelphia is considered ground zero of the xylazine crisis. The city’s health department last month issued guidelines for doctors warning that some users may not even realize they’ve taken the drug as it’s often cut with fentanyl
The drug prolongs the highs felt by heroin but causes users to pass out for hours while the injection sites fester, resulting in grisly sores that spread throughout the body
Accidental drug overdose deaths in Philadelphia have been increasing over the years, hitting a record high in 2021. City officials estimated the death toll in Philadelphia from drug overdoses in 2021 at 1,250, slightly above the 2017 peak. In 2019, about a third of all opioid overdose deaths in the city were xylazine-related
Sarah Laurel, founder of outreach organization Savage Sisters, told The Philadelphia Inquirer: “I’ve never seen people stay in a state like this.
“They have open, gaping wounds, they can’t walk.”
Savage Sisters operates seven convalescent homes in South Philadelphia where those recovering from drug addiction can receive a hot shower, food and wound cleansing.
A patient at a Savage Sisters branch on Kensington Avenue, Nick Gallagher, 43, developed an infected abscess on his arm last spring after years of injecting drugs.
He said the wound on his arm was originally “four fingers wide”. He added, “I know Tranq slowed healing.”
Another patient named CJ, who smokes Tranq-Dope, said, “It takes about a month for a normal wound to heal and they’ll get bigger on their own.”
Xylazine is not approved for human use and is thought to have originally been added to fentanyl to prolong the high.
Last month, the Philadelphia Department of Health released guidelines for physicians, warning that since point-of-care testing for xylazine does not yet exist, drug users may not even realize they have been exposed to the substance.
As Xylazine eats away at the user’s flesh, the drug’s intended purpose – relaxing muscles and relieving pain – leads to further problems as people inject it into the painful lesions to relieve their pain
According to Vice, the problem is so bad that last spring the city tried to hire a field nurse to treat xylazine-related injuries, along with a wound care specialist
The graph above shows the cumulative annual number of drug overdose deaths reported in the United States by month. It also shows that they continue to trend up
Xylazine causes serious wounds that put users at risk of infection or even death, but users don’t sign up for drug treatment because the withdrawal symptoms are so painful and many healthcare providers don’t treat them properly.
Symptoms include chills, sweating, restlessness, anxiety, agitation.
Some users report sores erupting across their body. Many remain disfigured as fingers, arms, feet, legs and toes have to be amputated.
While injection site sores are common, people see sores developing on parts of the body they have never injected, as do drug users who snort or smoke their drugs.
The drug causes “progressive and extensive” skin ulcers full of dead tissue, the new doctor’s recommendation says.
Research on xylazine is limited, but the sores are thought to occur because the drug narrows blood vessels near the injection site, lowering blood pressure. This in turn impairs wound healing elsewhere in the body.
And because xylazine is not an opioid, people who take it with opioids are more difficult to treat with the opioid overdose-reversal drug naloxone.
There is currently no FDA-approved treatment specifically for xylazine withdrawal.
In Philadelphia — considered ground zero for the xylazine crisis — about a third of all fatal opioid overdoses in 2019 were related to the drug.