In 2020, Philadelphia emerged as the epicenter of the xylazine crisis. By the end of 2023, this drug was found in more than 90 percent of illicit fentanyl samples in the city. Over these years, this non-opioid veterinary tranquilizer, also known as "tranq," has brought new and challenging complications to those in the health care community who work to help people whose use of illicit opioid drugs now exposed them to additional risks.
Xylazine, which is not intended for human use, is linked to fatal overdoses and can result in distinct soft tissue wounds on the body that can become deep and difficult to heal. And many individuals who experience severe wounds may avoid treatment in hospitals—or may leave a hospital before completing treatment—due to the stigma around substance use and distress from withdrawal symptoms. Their untreated wounds are more susceptible to infection.
Even as xylazine is now being supplanted by the sedative medetomidine— which has resulted in a dramatic increase in people requiring ICU-level care for withdrawal—addressing xylazine-related wounds remains a big challenge. At the front lines, Penn Medicine staff in Philadelphia are working to support people with xylazine-related wounds, both within hospitals and through volunteer efforts in the community.
