These are the shocking and horrifying side effects of a drug that has become the latest scourge on American streets: xylazine.
The equine tranquilizer is flooding the US illegal drug market and is increasingly being mixed with fentanyl to create an even deadlier drug cocktail that rots users’ skin from the inside out and leaves them in a zombie-like state.
Doctors have revealed the case of a 32-year-old Philadelphia addict, who has become an epicenter for xylazine in the past year. His body burst inside wounds and skin lesions after three years of injecting fentanyl mixed with xylazine.
The unnamed patient can be seen with pockets of rotten flesh in his leg and chest, exposing bone and tendons underneath, believed to be caused by the constricting effect xylazine has on blood vessels, cutting off oxygen-rich blood supply to tissue.
WARNING: GRAPHIC CONTENT
An unnamed 32-year-old IV drug user had to undergo surgery to repair the wounds on his chest with rashes elsewhere on the body
The flesh-eating drug can affect a person’s skin in areas separate from the injection site. This patient often injected the drug into his neck and arm veins, but he experienced open lesions on his chest and leg
The reason behind xylazine’s carnivorous properties remains unclear, but doctors suspect it has to do with the drug’s constricting effects on blood vessels, restricting oxygenated blood flow to tissues and organs throughout the body, causing that tissue to die.
His case came to light in the New England Journal of Medicine by physicians at the University of Pennsylvania in Philadelphia.
Xylazine, also known as “tranq,” became an insidious fixture in Philadelphia’s illegal drug market, turning the now-infamous Kensington neighborhood into zombie land. 2021 estimates show it was present in 90 percent of Philadelphia’s lab-tested drug samples for fentanyl.
The true prevalence of xylazine is unknown, as hospitals do not test for it. But the federal Drug Enforcement Administration has said that by 2022, about 23 percent of all fentanyl powder and seven percent of fentanyl pills contained the sedative.
Xylazine has been around for decades but only recently exploded in popularity with DEA leaders saying it enters the US from Mexico already mixed with other illicit drugs like heroin and cocaine.
In 2015, xylazine was implicated in less than one percent of drug overdoses in 10 U.S. cities, but by 2020, it rose to seven percent. That year, xylazine was involved in nearly 26 percent of fatal overdoses in Philadelphia alone.
Xylazine is an extremely attractive way for drug dealers to enhance and prolong the high produced by fentanyl or heroin, or both.
Doctors who treated the drug user outlined in the NEJM said his soft tissue around the upper chest became infected and died, making it appear that the space under his neck had been roughly eroded.
The drug is currently spreading nationwide and is readily available online for just $6
The streets of Kensington are littered with syringes, rubbish and homeless camps, with addicts dealing and using drugs in broad daylight
A man with a gaping wound on his arm is slumped in the street. Xylazine often causes wounds that require amputation
Doctors performed a procedure known as wound debridement, or the surgical removal of the diseased, dead tissue.
A CT scan of the Philadelphia man showed that in addition to infected soft tissue, he also had a bone infection in his collarbones and sternum.
Doctors then took skin and fatty tissue from elsewhere on the body and used it as a flap to cover the gaping wounds left on the chest.
He was given a course of antibiotics for at least six weeks after surgery. The patient was also prescribed buprenorphine therapy, a highly effective treatment for opioid addiction.
After six months of follow-up, his wounds had healed and he participated in an outpatient addiction program to stay drug-free.
Xylazine is not an opioid like heroin and fentanyl, but is increasingly used to enhance the high produced by those drugs.
Anne Milgram, Chief of the Federal Drug Enforcement Administration, said earlier this year: “Xylazine poses the deadliest drug threat our country has ever faced, fentanyl, even deadlier.”
It was developed in the 1960s as an anesthetic for veterinary surgery. It was investigated for possible use as a pain reliever and anesthetic for human use, but trials were halted because the drug caused severe respiratory depression and low blood pressure.
Xylazine first originated in the illegal drug supply in Puerto Rico in the early 2000s, where people started injecting the drug, called Anestesia de Caballo (horse anesthetic), and started seeing open skin sores even in areas separated from the injection site.
But it wasn’t until around 2018 that tranq was found on the streets of US cities mainly on the East Coast. Since then, the incredibly cheap counterfeit — available online for as little as $6 — has popped up alarmingly often.
It is not clear why xylazine leads to catastrophic skin ulcers that, if left untreated, can lead to amputation. It is believed to be due to the drug’s ability to constrict blood vessels, slowing or blocking the flow of oxygen-rich blood throughout the body.
Other effects of the drug include blurred vision, disorientation, drowsiness, and being jittery. It can also lead to coma, breathing problems and high blood pressure.
Xylazine is increasingly found in the illicit supply of fentanyl, which alone is 50 times more potent than heroin.
The Drug Enforcement Administration recently reported that the sedative was found in 23 percent of the fentanyl powder it seized in 2022.
Many IV drug users unknowingly take the insidious drug. Because xylazine is not an opiate, Narcan, the overdose reversal spray, might be slightly less effective at saving someone’s life.
Yet people are still encouraged to administer the spray in case of suspected overdose because xylazine is usually combined with opiates.
A record number of nearly 107,000 Americans died from an overdose from August 2021 to August 2022, with 66 percent of them involving a synthetic opioid such as fentanyl.
Estimates of how many fatalities are due to xylazine are not available because this data is not routinely collected by the Centers for Disease Control and Prevention (CDC).