The city of Philadelphia has been struggling for several years with a new substance with devastating effects: xylazine. Nicknamed “zombie drug,” it plunges people who consume it into a prolonged state of unconsciousness, in addition to creating strong dependence and irreversible physical damage. The duty went there to document the social impact of this drug which is starting to make its way into the country. First of five texts.
Under the metal rails of the train that overlooks Kensington Avenue, between a pawnbroker and a scrap dealer, Kim Barauskas and his friends wobble under their own weight. They are doubled over, in a semi-comatose state, on the corner of a street strewn with trash. A very agitated woman shouts incomprehensible things, a man is slumped on his grocery cart, looking haggard.
A scene that repeats itself endlessly in the Kensington neighborhood of Philadelphia. In a corridor stretching for more than a kilometer, hundreds of users and sellers – many of whom are hooded – have taken over the avenue, which has become a huge open-air drug market. Some have erected their tents directly on the sidewalks and make fires on the ground to keep warm. It is a difficult sector where practically no one, with the exception of the workers who work there and the police, dares to venture. In the densest area, near the Kensington and Allegheny arteries, known as the K&A, it is definitely not recommended to set foot.
Kim and her friends have just injected themselves with xylazine, or “tranq” as its street name goes. It is also called “zombie drug”. It is a powerful sedative for horses not approved for human use. Drug producers add it to fentanyl — an extremely powerful opioid that has replaced heroin on the streets — to prolong the euphoric effect.
Except that the mixture is so strong that many fall into a deep state of unconsciousness, only to wake up in a painful and painful situation of withdrawal. Xylazine also causes putrid sores that go deep into the flesh in various parts of the body and often lead to amputation, which is why there are so many people walking around in wheelchairs or on crutches in the area. .
Some people try to avoid xylazine, but it is increasingly difficult. In 2021, “tranq” was present in 90% of drug samples tested by Philadelphia Public Health.
Fatal overdoses
“Another big problem is that xylazine causes complications when trying to reverse the effects of an overdose,” says James Latronica, a physician and president of the Addiction Treatment Society of Pennsylvania. Xylazine is not an opioid, so it does not respond to naloxone. So reversing the effects of an overdose has become more difficult on the ground. We have no “antidote” for xylazine. »
In the event of an overdose of xylazine, naloxone is nevertheless administered, in the hope of treating the opioid part. Its use is so common in the industry that the word “Narcan” — the trade name for naloxone — has given rise to a verb that comes up in every discussion with drug users and people who work in the field. They have all already “narcanned” someone or been “narcanned” themselves.
The number of fatal overdoses is constantly increasing in this city of 1.6 million inhabitants, reaching a new record of 1,413 deaths in 2022, according to the most recent figures from Public Health. The vast majority of these overdoses are attributable to fentanyl, and a little more than a third to xylazine combined with fentanyl. And the Kensington sector is, unsurprisingly, the most affected.
Last year, the White House declared the combination of fentanyl and xylazine an “emerging threat” to the nation. A first in the history of the United States.
Professional hitter
Kim, 53, pulls up the bottom of her pants and her bandage revealing a small part of a festering sore on her leg. “We call it “tranq burns,” explains the tall, curly-haired woman in a deep and strangely reassuring voice. It starts as a blister, then it gets bigger and starts eating the flesh. » In reality, it’s more complicated than that. But that’s generally how the sore is described on the street.
Kim, who has been using drugs since the age of 26 – with a few periods of abstinence and just as many relapses – is afraid of losing her leg. She already had to have all five fingers on her left hand amputated last year after an accidental injection into an artery.
She takes antibiotics to treat her wounds, which she disinfects every day at the shelter where she lives. She radically reduced her consumption, going from around fifty bags — which generally contain two milligrams of powder each — to three or four per day. “I no longer do it to be high, but just to feel good, to be able to get up and function every day. »
For years, to meet her needs, Kim has offered her expertise as “ hitter “. There are many in the sector who make a living from this business. For a few dollars or a bag of “tranq”, she gives injections to other users. In the neck. Why the neck? “It’s quick and easy,” she explains.
The risks of falling on an artery and causing medical complications are greater, but that is part of the risks of the job.
“I’m terrified”
Rena Love lived as a prostitute until she lost the use of one of her legs. She now spends her days slumped against the wall of a shop, her leg full of holes under her bandages. “I’m 34 years old and I get around with a walker,” she says in a thin voice, on the verge of tears. She knows that the situation will not improve. “Everyone is in a wheelchair in the corner, it’s even scarier. »
A little further away, Stéphanie, 39, gives herself an injection in her neck using a phone as a mirror. She is afraid of waking up one morning with sores. “I’m terrified,” she confides. She is also afraid of her own addiction. “It’s so scary, the influence of drugs. And at the same time, you are terrified of finding yourself in a state of withdrawal. »
Living on Kensington Avenue, as she has done for three years now, is not easy. “People think that when you live on the street, you have nothing to do with your days. But it is difficult. It’s a daily battle. You have to earn money, find food. You spend your time wondering where you’re going to sleep at night. It’s really difficult. »
Xylazine was first detected in Puerto Rico in the 2000s. Shortly before the pandemic, it appeared in Philadelphia, a port city in Pennsylvania with a large Puerto Rican population. The Kensington neighborhood, a former working-class neighborhood long ravaged by poverty and drugs, has become a recognized open-air market where the mixture of fentanyl and xylazine can be purchased and consumed inexpensively.
“It happened so quickly, I feel like we were overwhelmed by xylazine in one night, and immediately it became hell,” explains Nikki Collins, a user who grew up in an adjacent neighborhood. “They started talking about it in the news and we saw lots of people arriving from all over the country to come and consume. Most of them never left. »
Everyday violence
Things are tough in the Kensington sector. Like everyone else here, Ola Volov constantly has her belongings stolen when she sleeps or when drugs put her into a deep state of unconsciousness. She is no longer able to receive the subsidies to which she is entitled since she no longer has identity cards.
In addition to thefts, others report having been victims or witnesses of attacks, people being stabbed, not to mention the settling of scores and stray bullets.
Pam Higgings, 46, is no taller than three apples. She has beautiful blue eyes and a childlike voice. “What’s it like living on the streets in Kensington, Pam?” » The answer is lost in the dizzying din of the train passing overhead and the horns. “Horrible, scary, embarrassing. It’s very dangerous. I have been attacked several times. »
Pam cries while talking about her children. “I was a very active mother, you know. » Like the majority of people The duty met, she consumes to drown deep pain. She would like to stop, but she feels unable to face the traumas of the past. So, she continues to consume, plunging deeper and deeper into a vicious circle of which she feels trapped. “I’m stuck here,” she said sadly.
The sun in hell
Rosalind Pichardo is one of those people who tries to give a little hope and dignity to people on the streets. She knows the neighborhood, its violence and its distress. This is where she grew up and lived all her life. She survived a murder attempt by an ex-partner, lost her twin sister, who committed suicide, and her brother, who was shot by a thief who ultimately stole a sum of money from him. about $10.
Since then, she has campaigned against gun violence. But she could not turn a blind eye to the other scourge which is ravaging her neighborhood and decimating its inhabitants at lightning speed.
“I’ve never seen anything like it. I have traveled the world, but I have never seen anything worse than here in my own community. Never. And that’s so sad to see. »
Last month, she opened “Maison Soleil” on Kensington Avenue. In her room with colorful walls, those she calls her “sunbeams” can indulge in different art forms, listen to TV while eating a snack, get clean clothes, change their bandages and write in a journal staff. “It helps people escape for a while,” she explains.
It also offers a unique service in the neighborhood: a message center to allow drug users to keep in touch with their families. She also has a missing persons wall in Kensington, to help families find loved ones who haven’t been heard from for too long.
“I wanted to have a centralized location to allow families who are worried about a loved one to not have to look for them on the street. I saw them walking and walking, through all this misery, praying that their child would not be in too bad shape, with a gigantic wound or already in a wheelchair. »
A few blocks away, Beverly Tomczak, head of the narcotics anonymous group The Last Stop, also has a wall. Or rather two. The first displays hundreds of handwritten names of people who have died from overdoses. The second highlights those who have stopped using. “My sister is here,” she said, pointing to the first wall. I’m on the other wall. It’s still crazy, right? »
Berverly thanks God for having stopped before the arrival of the xylazine, otherwise she would no doubt have already joined her sister on the wall of the dead.
This report was financed thanks to the Transat-International Journalism Fund.The duty.