Gerald A. Hill Sr. of Baltimore is known for providing wound care kits to those addicted to opioids using a harm reduction van.
For a while now, Baltimore’s harm reduction vans have served as a drop-off point where individuals can exchange used syringes with clean or sterile ones. However, over the past few months, an increasing number of individuals have been frequenting Baltimore’s two mobile harm reduction vans, requiring serious wound treatment due to a substance known as xylazine, which users call Tranq.
Having been used by veterinarians for many years to sedate large animals, xylazine is now being used by drug users to enhance the impact of fentanyl and other opioids. Xylazine causes deep flesh wounds in humans, which sometimes reach the bone.
Here’s what Gerald Hill had to say, “People who use the drug, [their] blood circulation is poor a lot of times. “When they come to our van at times, you can smell their wounds. It’s really a horrible smell.”
According to the Centers for Disease Control and Prevention (CDC), xylazine contributed to 11 percent of opioid overdose cases in the Northeast between 2019 and 2022. Xylazine has been described as an emerging threat by the Biden administration.
From Clean Needles To Wound Care Supplies
It’s worth noting that the wound care kits that Gerald Hill gives to those who visit Baltimore’s harm reduction vans contain first-aid supplies such as tape, gauze, and disinfectant. According to Hill, the vehicles can see about 70 people a day. Hill also stated, “Some come in with arms ballooned two or three times their size due to infection or with sores that fester and turn black. Not all the wounds are caused by xylazine, but the drug is increasing the number of people needing care.”
A man, who asked to remain anonymous because of his drug use, stated that he was unfamiliar with xylazine. However, he was aware of the symptoms it causes, and wondered if his recent wounds could have been caused by xylazine.
Another woman, who asked to remain anonymous for the same reasons, and who claimed to have a lot of experience with the drug said, “It literally just ate the front layer of skin on my leg. It just killed the skin.”
Open wounds can also be a barrier to addiction treatment. Many rehabilitation facilities will not accept patients with large wounds.
Yianni Varonia, a Spokesperson for Baltimore’s health department, said, “Xylazine has increased the complexity of treating wounds. Most rehabilitation facilities are not equipped to address severe xylazine wounds, and therefore direct individuals with severe wounds to hospital emergency rooms for immediate care.”
Xylazine Exacerbates the Situation
Xylazine also has other side effects. For instance, it triggers dangerous symptoms such as slowed respiration and increased heart rate, which are similar to those caused by opiods.
Keith Humphrey who’s a professor of behavioral sciences at Stanford University had this to say regarding combining opioids and xylazine,”You’re basically pouring gasoline on the fire by putting these two drugs [xylazine and opioids] together in your system at the same time.”
It’s worth noting that naloxone, a drug used to reverse opioid overdoses, doesn’t work against xylazine, making accidental overdose more likely.
Xylazine Use is Prevalent in 48 Out of the 50 States
According to the Drug Enforcement Administration, xylazine is present in opiods across 48 out of 50 U.S. states. However, the drug is more prevalent in Maryland. According to the Centers for Disease Control and Prevention (CDC), 80 percent of opioids tested in eight needle exchange locations in Maryland contained xylazine.
Furthermore, the prevalence of this drug is steadily increasing, with its detection becoming more frequent in western states.
Apart from harm reduction vans, Baltimore offers more comprehensive assistance to individuals with wounds through its SPOT vans. The vans are mobile clinics, and each van is equipped with two examination rooms, an area for blood testing and a waiting area.
The SPOT vans are manned by nurse practitioners who are tasked with drawing blood, administering tests, prescribing medications, and offering certain primary healthcare services.
Tiffany, only identified by her first name for privacy reasons, has been using opioids since she was a teenager. She’s now in her early 30s and suffers from xylazine-related sores.
Here’s what she had to say about one of her wounds. “It turned black. They want me to go to the hospital because I got more on the back of the leg. I got a big one right here. I got one right here. Right there.”
Tiffany was saying this as she pointed at sores on her arms, legs, and stomach, which were around the size of a quarter or even bigger. She had a particularly severe wound on her shin that she couldn’t remove the bandage for the nurse to see.
According to Molly Rice, a nurse with the SPOT van, more and more cases are being reported to her. Here’s what she had to say, “We are seeing more and more of these just like pretty aggressive wounds that seem to be from xylazine. With any wound or really with any of our patients, unfortunately, a lot of them are on the street. They’re living in abandoned buildings. The risk just of infection, just on a day-to-day basis, is so much higher.”
As Baltimore witnesses a growing presence of Tranq in the illegal market, the city is working to raise awareness of the risks associated with the drug.
The Assistant Director for community risk reduction services at the Baltimore Health Department, Rania Muhammad, said, “We are increasing the number of wound care supplies we are providing.”
The city is purchasing new xylazine testing strips and will continue to distribute fliers. Humphreys also reported, “Xylazine seems to have spread quite quickly around the nation relative to some other drugs.”
Humphreys also mentioned that given the widespread impact across the nation, there’s a strong likelihood that the consequences will extend to Washington, where the White House or Congress might be forced to take further action.
The Biden administration has plans to combat its use. Congress has also considered a bill to regulate the substance, though it hasn’t acted on it since it was first introduced.
Citation
https://www.npr.org/2023/08/13/1191389152/xylazine-fentanyl-wounds-treatment