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How Baltimore is trying to keep its people safe from xylazine


The Biden administration has designated xylazine as an emerging threat to the nation. As its street use spreads across the country, some of those who take it are suffering from dangerous flesh wounds. Baltimore is seeing an influx of the drug as dealers mix it with opioids. And WYPR's Scott Maucione reports on how the city is dedicating resources to try to keep people safe.

GERALD A HILL SR: Have a seat. How many you got?


HILL: Sixty. Longs or short?


HILL: You can put them in there. You're familiar with xylazine?

SCOTT MAUCIONE, BYLINE: Gerald A. Hill Sr. is handing out a flyer on a new drug called xylazine to a man who's exchanging used needles for new ones. Hill works on Baltimore's mobile harm intervention team in an RV that travels across the city. The team can see as many as 70 people in a day, and it exchanges hundreds of needles for people addicted to opioids. Hill is no stranger to the struggles of opioid addiction. He's 31 years sober himself. But he shakes his head when he talks about the deep flesh wounds showing up all over people's bodies.

HILL: It's a dangerous situation because they pass out at curbside. The blood circulation is poor. A lot of times - and even when they come to our van, at times you could smell their wounds. It's really a horrible smell.

MAUCIONE: Hill and his coworker, Kenneth Pearson, are trying to inform people about the dangers of the drug. Xylazine, known on the street as tranq, is a large animal tranquilizer used by veterinarians. But the Drug Enforcement Administration says it's seen xylazine mixed with opioids in 48 states now.

KEITH HUMPHRIES: Basically pouring gasoline on the fire by putting these two drugs together in your system at the same time.

MAUCIONE: Stanford University professor, Keith Humphries, says overdoses involving xylazine are particularly dangerous.

HUMPHRIES: Naloxone, which - or sometimes called Narcan, works very well on fentanyl in terms of reversing the opioid aspects of repressed breathing. But it doesn't have any effect on those caused by xylazine. So that makes our overdose response more challenging.

MAUCIONE: Molly Rice is one of the nurse practitioners working on Baltimore's mobile harm reduction team. She provides basic health care and prescriptions to people in need. Rice says the number of people seeking care for sores from tranq is increasing.

MOLLY RICE: I definitely would say that we have seen, even since I started six months ago, more and more of these just, like, pretty aggressive wounds that seem to be from xylazine.


MAUCIONE: Inside the mobile clinic, Tiffany's waiting to be seen by a nurse in a makeshift exam room. She's been addicted to opioids since she was a teenager. She's now in her 30s and is a regular at the spot van. We're using only her first name to protect her medical privacy. She has open sores on her arms, legs and stomach from what she suspects is tranq.

TIFFANY: It turned black. I haven't been to the doctors yet. But I went to wound care yesterday, and I got enough dressing and stuff. But 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.

MAUCIONE: One of the sores on her leg is so bad that she can't even take off the dressing for the nurse practitioner to look at. Spot nurse practitioner Molly Rice says those wounds can easily become dangerous.

RICE: With any wound, or really with any of our patients, unfortunately, they - a lot of them are on the street. They're living in abandoned buildings or abandoned houses. You know, the risk just of infection just on a day-to-day basis is so much higher.

MAUCIONE: The city of Baltimore is taking action to help opioid users identify xylazine as the drug's prevalence continues to rise. Rania Muhammad is in charge of risk reduction services in Baltimore.

RANIA MUHAMMAD: We are increasing the number of wound care supplies we are providing, so making sure that people have, you know, more supplies in order to address the wounds every day.

MAUCIONE: The city's also giving out xylazine test strips and trying to keep people informed on the dangers of the drug. For NPR News, I'm Scott Maucione, in Baltimore.

(SOUNDBITE OF ALEX VAUGHN SONG, "SO BE IT") Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Scott Maucione
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