About two months ago, his right ring finger was amputated. In a matter of weeks, he could lose the middle finger on his left hand, which was swollen with a large, maroon-colored sore covering the knuckle when VICE News met him on a recent morning in Philadelphia’s Kensington neighborhood.
A nurse treats Bill's sores in Philadelphia's Kensington neighborhood. Photo by Gilad Thaler/VICE News
While there are some strides being made to help people within the city, the issue has largely flown under the radar, even as tranq spreads to other parts of the U.S., including Maryland, Connecticut, Massachusetts, and North Carolina.“It’s killing us,” said Sam Brennan, 28, a tranq user who is living in a shelter in Kensington. She said conditions in the neighborhood, where residents contend with extreme poverty and drugs are sold openly (samples are sometimes given out for free), have deteriorated with the proliferation of tranq. “It’s something I’ve never seen before anywhere else. People all over the place, sticking needles anywhere they possibly can, passed out. Philly’s going under from tranq.” Tranq first showed up in medical examiners’ reports in Philadelphia in 2006, according to Jen Shinefeld, a field epidemiologist with the city who focuses on substance use. But in the past two years, its reach has exploded. Of the 200 samples of dope (primarily fentanyl) the city has tested since September 2020, all of them have come back with tranq in them, Shinefeld said. A study published recently in Drug and Alcohol Dependence found that in 10 jurisdictions, xylazine’s prevalence skyrocketed from 0.36 percent of overdose deaths in 2015 to 6.7 percent in 2020.“Philly’s going under from tranq.”
Sam Brennan prepares a dose of tranq. Photo by Dan Cain/VICE News
Brennan shoots tranq into her muscles because of the sore she's developed on her neck. Photo by Dan Cain/VICE News
Brennan, whose blue puffer jacket and grey sweats hung loosely off her small frame, said she’s lost at least 40 pounds since she started using tranq—she now weighs around 120 pounds. When she first started, she injected it into her veins. Pulling down her sweater, she revealed a dark sore on her neck that appeared a couple weeks after she started shooting up there. Now she shoots it straight into her muscles, explaining that the drug is so strong she doesn’t even need to find a vein. Last Christmas, she went home to see her family for the first time in four years. She was limping because of the lesions on her leg, so she couldn’t play basketball with her nephew. “It's eating away at my skin,” she said. According to a report published in Injury Prevention last year, information is limited on the effects of chronic xylazine use in the U.S. But in Puerto Rico, where it’s been consumed by drug users since at least the early 2000s, it’s been associated with skin ulcers, abscesses, and lesions. “As skin ulcers are painful, people may continually inject at the site of the ulcer to alleviate the pain as xylazine is a potent α2-adrenergic agonist that… decreases perception of painful stimuli,” the report said. “People may self-treat the wound by draining or lancing it, which can exacerbate negative outcomes.”“It’s eating away at my skin.”
Some regular tranq users require amputations due to soft tissue infections. Photo by Gilad Thaler/VICE News
A man receives wound care at an outreach event for drug users in Kensington. Photo by Dan Cain/VICE News
Brennan said tranq is often a deep purple color. Photo by Dan Cain/VICE News
If you’re struggling with addiction, you can visit the official website of SAMHSA’s National Helpline for treatment information.Follow Manisha Krishnan on Twitter.
