Drug users in the Philadelphia neighbourhood of Kensington have increasingly been turning towards a drug called xylazine, or “tranq”, a veterinary sedative often mixed with other drugs such as heroin or fentanyl. But when people begin to use the substance, it quickly causes horrific damage to their bodies – including necrosis and skin tissue rotting. Authorities in Philadephia and across the nation are getting increasingly worried about the drug's spread and the damage to victims.
The footage widely shared on both TikTok and Twitter (examples here, here and here) show people in frightening states – men and women, doubled over, seemingly sleeping standing up. People with their limbs wrapped in bandages. People shaking and jerking uncontrollably or, in other cases, lying on the ground, inert.
The people in the footage are users of a substance called xylazine – often called a “zombie drug”. The videos were all filmed in the Kensington neighbourhood of Philadelphia.
Drug users, many of them homeless, often go to this neighbourhood, called a “Walmart of heroin” by the New York Times. But, in some ways, heroin is becoming a drug of a past era – these days, Kensington is a painful epicentre of the American opioid epidemic.
For the past few years, fentanyl, a painkiller 50 to 100 times stronger than morphine, has been one of the most widely trafficked drugs here. In 2021, the public health department of the city of Philadelphia reported that 77 percent of deaths by overdose in its territory were linked to fentanyl.
‘I thought it was a fentanyl crisis, but it was a tranq problem’
When he launched his YouTube channel “Jeff’s High On Life”, 43-year-old Jeffrey Weeks was hoping to raise awareness about fentanyl use. But that’s not what he found when he went back to the streets of Kensington – a place that he himself used to haunt before he became sober seven years ago.
When I first went down there [to Kensington last November], I thought it was a fentanyl crisis, but it was a tranq problem. Fentanyl and tranq are two different drugs. You see a lot of people bent over, almost sleeping standing up, not in the real world – that’s tranq. Fentanyl doesn’t do that.
The terrifying symptoms visible in Jeffrey’s videos are a result of the so-called “zombie drug”, xylazine, also known as “tranq”. Initially developed as a tranquilliser for animals, people looking to get high also take it – sometimes alone or sometimes mixed with other drugs.
There are a lot of people taking other drugs that are cut with fentanyl, and they’re also putting tranq stuff in all of it: 90 percent of the drugs tested here are positive for fentanyl and xylazine. I used to use regular heroin. When I interview people, I ask if they can find regular heroin and they say no.
The spread of tranq is not just happening in Kensington, but also at a national level. On March 23, 2023, the US Drug Enforcement Administration (DEA), the agency tasked with combatting drug trafficking, posted a rare public health alert about xylazine.
“The US Drug Enforcement Administration is warning the American public of a sharp increase in the trafficking of fentanyl mixed with xylazine,” the statement begins. “Xylazine and fentanyl drug mixtures place users at a higher risk of suffering a fatal drug poisoning. People who inject drug mixtures containing xylazine also can develop severe wounds, including necrosis – the rotting of human tissue – that may lead to amputation.”
‘She went into the hospital for an amputation and they took four fingertips from her left hand’
In his videos, Weeks invites people suffering from addiction to sit in his car for a filmed interview. During these conversations, he’s seen the terrible physical repercussions of xylazine use firsthand.
The problem I run into in interviewing people on tranq is the smell, because of the wounds. Around 80 percent of the people have sores, they’re living in filthy conditions and a lot of them have the same bandage for many weeks. I help them with that. It’s a specific symptom of these wounds: shooting up in the same spot starts to damage the skin, there’s not enough blood so it starts rotting
Weeks talks about the connections he’s made with the people he interviews – connections that have enabled him to follow them as they seek help for the violent addiction they are suffering from.
I posted an interview that I did a few months ago with Kim. She went into the hospital for an amputation and they took four fingertips from her left hand. One of the fingertips broke off the day before the surgery. She left one hour after the surgery, because she felt sick from withdrawals.
Withdrawal with no real medical solution
Severe anxiety is another symptom experienced by people addicted to xylazine. It’s hard to treat this addiction because of the lack of a recognised treatment option, something that does exist for people embarking on the hard battle to escape heroin or fentanyl addiction.
For the most part, national and local institutions have recommended that people trying to get off of xylazine use a number of drugs to help manage terrible withdrawal symptoms. Some institutions, however, continue to use the “cold turkey” method, which involves stopping drug use without substitutes or any other kind of medical support.
That’s the route that First Stop Recovery takes. This non-profit organisation has been operating in Kensington for the past 20 or so years. Our team spoke to Tony Gardner, a chiropractor and addiction counsellor responsible for the medical side of First Stop. He told our team how patients are treated.
We get people mostly from the street. They have a 30-day blackout – we take their cellphones. We detox you “cold turkey”, except if you are on alcohol or benzodiazepines, which could be dangerous. The reason is that if detox is easy, you will just relapse. If it’s a painful experience, you won’t do it again
The patients are fully cared for during a period of 90 days, which allows them to focus on their withdrawal and therapy
Your job is recovery until day 90. After day 90, you have to get a job and start paying rent. When you’re in our programme, you can learn job skills, and when you feel ready, you can step out.
There is some debate about the efficacy of this method for treating addiction to all kinds of drugs. But Gardner says they encounter specific issues with xylazine in particular
They have to be addressed a lot differently, because of open wounds and diseases. That is something we are working on right now. It will depend on the degree of the wound. If it’s deep, it can become septic and we need to send them to the hospital.
'It’s out there on the streets, becoming more and more popular'
Gardner sees the fact that tranq users almost always end up in hospital as an obstacle to getting them through the rehab program. He says he is worried about what will happen to this growing number of users in the coming months.
It’s a nasty, nasty drug. We don’t see a lot in our programme, because it’s summer, but when it gets cold we will see more people. It’s out there on the streets, becoming more and more popular.
Weeks is also concerned by the growing grip that tranq has on the streets of Kensington – and the people it brings to the neighbourhood.
It’s more crowded than ever down there. There are new faces, that’s the scary part. I saw a girl as young as 18 looking for dates, trying to make some money.
A few days after speaking to our team, Weeks documented this out-of-control situation for his YouTube channel. On July 27, he published a short video of a young woman lying inert on the ground, her arm bleeding.
While this victim did survive after receiving first aid from Weeks and other passersby, many more will never have this chance. In 2021, the public health department in Philadelphia indicated that 1,276 people had died of overdoses in the past year, a 10-year record.
