PHILADELPHIA A grim sight. The drug syringe is stuck deep in the woman’s neck.
The woman’s black-gloved hand holds the syringe compulsively, and she makes no move to pull it out.
I have watched the woman’s slow and groping preparation of the drug dose from the car, a few meters away. It took at least five minutes.
Now the business has stopped. Out. The woman’s life seems to have stopped as if at the push of a button.
The arm is raised in front of a pale face illuminated by the winter sun. It seems to be frozen in mid-motion. The eyes are still open.
If the woman wasn’t still sitting in her gray hoodie on the cold asphalt of the sidewalk, I’d imagine she was already dead.
A little further away, a group of young men collaborate by stabbing each other in the neck.
Three others are lying near them, looking lifeless, on chairs dragged to the sidewalk among garbage bags.
One’s head has sagged unnaturally over the back.
Behind the “frozen” woman, someone is holding a transparent plastic bag with both hands. During that time, the drug syringe remains between the teeth.
It’s almost his turn to go on a life-threatening journey into the unknown.
An even more dangerous substance
We are in Philadelphia, a city full of history on the east coast of the United States, with lofty monuments and expensive restaurants in the center.
Located at the bend of the Delaware River, the city has about one and a half million residents and an estimated 70,000 daily users of hard drugs.
A large number of them stay here in the Kensington district, as you can see in the video below:
Just a couple of meters away from the drug gang, traffic flows along Kensington Avenue.
People get up from the subway station, and with accustomed steps they dodge drug users sitting or lying on the ground.
The other year, more than 1,400 of Philadelphia’s hard drug users died of overdose, i.e. almost four people a day.
It was more than ever before. There were well over a hundred thousand drug-related deaths in the entire United States that year.
– This is the center of the opioid trade on the east coast. According to the authorities, the value of the trade is more than one billion dollars a year, says Kevin Moore.
Moore runs a local health clinic called Courage.
Opioids are compounds that act in the body and are used to make powerful painkillers. They are made from opium poppy or completely synthetically.
Moore has two decades of experience in Kensington, often referred to as the largest open-air drug market on the East Coast.
Kensington is in Philadelphia on the US East Coast:
Synthetic opioids such as fentanyl have been the main cause of the explosive increase in fatal overdoses in the United States over the past decade.
Now a new, even more dangerous substance called xylazine has entered the picture. It is a sedative intended for large animals such as horses.
It is not intended for human use, and its effect on humans has not been studied.
On the street, the substance is called tranq. It comes from the English word tranquilizer, which means a calming drug.
– Tranqista goes completely wrong. Afterwards, you don’t remember anything, he says Robert.
In the video below, he opens up about his situation:
Middle-aged Robert is a hardened resident of Kensington. He fell into drugs at the age of 18 as a young believer.
– Women and money blinded me, he says.
The drug of the “living dead”.
Xylazine affects the central nervous system. It relaxes the muscles and paralyzes breathing. A state similar to drowsiness and coma follows.
In Kensington, you will immediately understand why xylazine is also called a zombie drug, i.e. a drug of the “living dead”. Some stand like statues on street corners, others have fallen to the ground, as in the picture below:
Here and there you also come across people balancing in an unnaturally flexible squat or on the front seat, such as the man in the picture below:
– Xylazine is the reason why everyone just falls asleep and looks like this, says Samantha and points around.
Samantha, like Robert, has used drugs for years. In his opinion, tranq has completely changed the essence of Kensington.
– The streets were never this shitty before, and there were never so many people living on them. All the shootings and violence, that wasn’t even there before, says Samantha.
In this video, Samantha opens up about how present death is in her life:
Xylazine entered Samantha’s life a couple of years ago.
– It was not a conscious choice. I didn’t know it was mixed with fentanyl.
Xylazine can be obtained legally from a veterinarian if there is a valid reason for it. If not, you can buy it cheaply online.
– The use of xylazine increases the profits of drug dealers, because due to its psychoactive effect, they can reduce the amount of fentanyl and heroin in the drug mixture, writes the US drug control agency DEA.
More than 90 percent of heroin and fentanyl samples now contain xylazine, according to Philadelphia health officials.
Xylazine was found in more than a third of fatal overdoses. Three years ago, the corresponding figure was only three percent.
– I have no idea what I’m wearing anymore. This is a complete gamble, where your life is at stake, says Samantha.
“Do you want to see my wounds?”
According to the DEA, xylazine mixed with fentanyl increases the risk of fatal overdoses.
– Xylazine has made the deadliest drug even deadlier, Director of the Drug Control Agency Anne Milgram warned in a report published last year.
Since xylazine is not an opioid, the substances used as an antidote for overdoses do not work for it.
– I can’t even say how many of my friends have died. The fingers of both hands are not enough for that, says Samantha.
Another characteristic of xylazine is that it causes open sores on various parts of the users’ body.
This user has a nasty open sore on his ankle.
This wound is already on its way to healing.
– Tranq heats up my body. Now look at my hands. My nail beds hurt. I wash my hands every day, but the pain just doesn’t go away, Robert says with a tear in his throat, pushing his swollen fingers into view.
Robert has so far avoided open wounds. Samantha has not been so lucky.
– Do you want to see my wound? Samantha asks and pulls up the pants gift.
– This is just a scratch like asphalt rash, he says.
In the name of truth, the wound is still terrible. A strip of skin ten centimeters long and a few centimeters wide is missing from the lower leg.
But Samantha assures that the situation was worse a year ago.
– The wound was so deep that the tendons were visible. I saw the tibia move. In the cold weather, the wind hit the nerves, and it hurt quite badly, he describes.
He considers himself lucky because “the xylazine didn’t start eating the whole hand”.
– The danger is not completely over, but hopefully in a couple of months I will only have a scar left.
There is a medical reason for the formation of ulcers, says Kevin Moore, director of the health clinic.
– Xylazine weakens the oxygen export of the capillaries to the tissues. The tissues begin to rot.
Without treatment, the patient has to amputate a finger, hand or even the entire leg.
– We had more amputations last year than in the entire last decade.
– A couple a day, Moore adds without embellishment.
“I want my dignity back”
The US administration realized the seriousness of the situation caused by xylazine and declared the substance an emerging threat last year.
Xylazine was initially most prevalent on the East Coast, such as here in Philadelphia, where the video below is from:
From there it spread south, and now it can be found in almost every state. Drugs have become a significant part of the presidential election campaign.
Republicans and, increasingly, Democrats see the leaky southern border as the biggest cause of the drug epidemic.
The United States accuses China of selling the chemicals needed to make fentanyl to Mexican drug cartels.
Now they want to close the border and rein in China. The US and Chinese authorities have established a working group to deal with the issue.
Kevin Moore advocates human-oriented solution models. He wants more resources for healthcare and mental health work. We also need to get more apartments that even the poor can afford.
In his own clinic, Moore treats wounds and helps users with dry ones. Once that’s done, he’ll support you in finding an apartment and stabilizing your life.
– Most people recover if they survive the overdose phase, says the rescue worker.
Robert has not passed through the danger zone yet. Robert’s family is ready to help, but he still has a long way to go.
– I’m always after drugs. My family shuns me because I’m always stealing money from them and I end up stealing from them and lying to them, Robert confesses, voice full of desperation.
– I want my dignity back. I am slowly but surely losing it.
Samantha is in an equally gloomy mood. He has tried in vain to get dry many times.
– In the endgame, these drugs will kill us all, he says.