Opioid addict Martin saw the deadly fentanyl replace heroin as the drug of choice in New York. He is now trying to avoid “tranq,” a carnivorous drug of increasing concern across America.
“It blows holes in your body, in your skin,” said the 45-year-old, whose wounds on his legs and arms indicate he may have unknowingly injected the animal sedative, officially called xylazine and commonly referred to as a “zombie drug.”
The tranquilizer, approved for veterinary use by the US Food and Drug Administration (FDA), has infiltrated the illegal drug market in the US, with manufacturers increasingly using it to boost fentanyl.
Overdose deaths involving the tranquilizer have soared in recent years, and in April, the White House called the drug an “emerging threat.”
“He eats your flesh, like a crocodile,” said Martin, who declined to reveal his last name, during a visit to St. Ann’s Corner of Harm Reduction, a drug support and needle exchange center in the Bronx.
Xylazine is readily available on the internet and almost always combined with fentanyl, the synthetic opioid 50 times more potent than heroin.
Fentanyl has pushed the number of fatal overdoses in the United States to nearly 110,000 in 2022, a record.
According to the Centers for Disease Control and Prevention (CDC), the estimated number of overdoses involving xylazine in the country rose from 260 in 2018 to 3,480 in 2021.
– Amputation –
While Philadelphia is the epicenter of tranquilizer use, the drug is also gaining traction in New York. City officials say traces of xylazine were found in 19 percent of fatal opioid overdoses, about 419 deaths, in 2021.
“Fentanyl is a short-acting opioid, so people need to use it more frequently,” to prevent withdrawal, explained Courtney McKnight, clinical assistant professor of epidemiology at New York University’s School of Global Public Health.
“The idea is that xylazine has been added to the supply because it can extend the life of fentanyl. However, there are other side effects that come with it that are quite significant,” she added, citing the anxiety.
Health experts also suspect that xylazine causes skin abscesses and ulcers by narrowing blood vessels. In some cases, it can lead to amputation.
St. Ann’s workers see more wounds on their skin when they’re on the streets of the Bronx delivering treatment, equipment, clean syringes, fentanyl tests, food, and sometimes just a few words of advice and comfort.
“Many times people say it looks like little bruises or black marks,” said Jazmyna Fanini, a nurse at the centre. But then “the tissue dies around that area.”
“I’ve seen them a lot more. Sometimes they can get really ugly, even down to the bone,” she added.
The number of fatal overdoses in New York City rose more than 80% between 2019 and 2021 to 2,668 deaths, largely due to fentanyl and the Covid-19 pandemic, which has isolated users and hampered efforts of rescue. African-American and Hispanic communities were hardest hit.
Both the city and drug awareness boards are focusing on naloxone, a nasal spray antidote that reverses an opioid overdose. But xylazine isn’t an opioid, so naloxone doesn’t reverse its effects.
Law enforcement is hampered by the fact that the sedative is not legally classified as a “controlled substance.”
“Even if we found a large stash of it, you wouldn’t be able to prosecute anyone for it,” New York special narcotics prosecutor Bridget Brennan told AFP.
That means “we can’t trace it to its source. We can’t find out how it’s distributed in large quantities,” he added.
– ‘Safe Delivery’ –
At St. Ann’s, where each leaf of a paper tree pinned to the wall represents a loved one lost to drugs, the emergence of these new drug concoctions is seen as the result of policies that criminalize drug users.
“You will continue to find all these different types of substances in the supply until we address the real problem, which is not having a safe supply,” said team leader Steven Hernandez.
“The challenge is simply that people are actually being poisoned,” he added.
The center is participating in a citywide program that encourages consumers to test their drugs before taking them. The initiative should allow health services to monitor developments in the illicit drug market in real time.
Leonardo Dominguez Gomez, a field researcher at the New York City health department, said it was still possible to avoid xylazine because it hasn’t caught on to the market.
“How the city decides to campaign for public health will impact that,” he told AFP.
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