A harm reduction van is parked in Baltimore’s Carrollton Ridge neighborhood. The van provides a place for people to exchange their used needles for clean needles.
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A harm reduction van is parked in Baltimore’s Carrollton Ridge neighborhood. The van provides a place for people to exchange their used needles for clean needles.
Kellen Carrion/NPR
In a van parked outside a church in Baltimore’s Carrollton Ridge neighborhood, Gerald A. Hill Sr. prepares a wound care kit for an opioid addict.
Baltimore’s Harm Reduction Van has long been a place for people to exchange their used needles for clean needles. In recent months, more people have come to Baltimore’s two mobile harm intervention vans requiring treatment for serious injuries caused by a drug called xylazine. It is commonly called Tranq among users.
Xylazine has been used for decades by veterinarians to sedate large animals, and is used by drug dealers to enhance the effects of fentanyl and other opioids. In humans, the drug causes deep cuts in the flesh, sometimes even to the bone.
“People who use the drug [their] Poor circulation often,” Mr Hill said. “Sometimes when they come in our van, I can smell their wounds. It smells really bad.”
The Centers for Disease Control and Prevention found that xylazine was responsible for 11% of opioid overdoses in the Northeast from 2019 to 2022. The Biden administration has designated the drug as a new threat.
Introducing clean needles and wound care products
The wound care kits that Hill distributes in his Baltimore harm reduction van include first aid supplies such as medical tape, gauze and disinfectant. Hill says the vehicle allows him to easily see 70 people a day. Some people come to the hospital with an infected arm that has swollen two or three times, or a sore that has turned black with pus. Not all scars are caused by xylazine, Hill said, but the drug is increasing the number of people who need care.
Local health educator Lashonda Jefferson (left) talks with a woman who throws used needles into the trash bin of her van.
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Local health educator Lashonda Jefferson (left) talks with a woman who throws used needles into the trash bin of her van.
Kellen Carrion/NPR
Mr. Hill is trying to educate people about xylazine by handing out kits and changing needles. One man, who asked to remain anonymous because he uses the drug, said he had never heard of the drug but was aware of the symptoms and wondered if his recent pain was caused by xylazine.
Another woman, who did not want to be named for the same reason, said she had extensive experience with the drug.
“It literally just ate away the front layer of skin on my leg. The skin just died,” she said.
An open wound can also be exorbitant for those seeking addiction treatment. Many rehab centers do not admit people with major injuries.
A man came into the van with a severe arm injury from using the drug xylazine, also known as Trunk.
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A man came into the van with a severe arm injury from using the drug xylazine, also known as Trunk.
Kellen Carrion/NPR
“Xylazine made wound care even more complicated,” said Yani Varonia, a spokeswoman for the Baltimore Department of Health. “Most rehabilitation facilities are ill-equipped to deal with severe injuries from xylazine, so severely injured people are referred to hospital emergency rooms for emergency treatment.”
Tranq is also cunning in other ways. It causes many of the dangerous symptoms of opioids, such as slowed breathing and heart rate.
“Pour gasoline on the fire”
Xylazine is also dangerous in other ways. It causes many of the dangerous symptoms of opioids, such as slowed breathing and heart rate.
“Throwing in these two drugs is basically pouring gasoline on the fire.” [xylazine and opioids] They act together in the system at the same time,” says Keith Humphries, professor of behavioral sciences at Stanford University.
Up: Community health educator Kenneth Pearson (right) hands a customer a plastic bag containing a clean needle, tourniquet, mitigation kit and fentanyl strip test. Bottom left: This van can collect up to 7,000 needles per day. Used syringes are placed in a biohazard container and destroyed. Bottom right: Pearson packs the kit.
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Up: Community health educator Kenneth Pearson (right) hands a customer a plastic bag containing a clean needle, tourniquet, mitigation kit and fentanyl strip test. Bottom left: This van can collect up to 7,000 needles per day. Used syringes are placed in a biohazard container and destroyed. Bottom right: Pearson packs the kit.
Kellen Carrion/NPR
Naloxone, a drug that reverses opioid overdose, cannot compete with xylazine, increasing the risk of accidental overdose.
Xylazine found in 48 states
The Drug Enforcement Administration announced that xylazine was found in opioids in 48 of the 50 states.
This drug is more prominent in Maryland. CDC says 80% of opioids tested Xylazine was found to have been contaminated at eight needle replacement facilities in the state.
On the other hand, it is being detected more frequently in western states, where the drug’s prevalence continues to grow.
In Baltimore, in addition to hard reduction vans, SPOT vans also provide a wider range of care for those suffering from wounds. The vehicle is literally a mobile clinic with two labs, a blood test area and a waiting room. SPOT vans are staffed by nurses who can draw blood, perform tests, prescribe medications and provide primary care.
Kenneth Pearson doing a blood test in the van. SPOT vans are staffed by nurses who can draw blood, perform tests, prescribe medications and provide primary care.
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Kenneth Pearson doing a blood test in the van. SPOT vans are staffed by nurses who can draw blood, perform tests, prescribe medications and provide primary care.
Kellen Carrion/NPR
Tiffany has been using opioids since she was a teenager. To protect her privacy, we will only use her first name. She is now in her 30s and is riddled with xylazine-induced sores.
Nurses in the SPOT van tend to her injuries and give her bandages to take home to ensure her safety. Wounds do not become infected.
“It turned black,” Tiffany said of one of the scars. “I have more sores on the soles of my feet and they have been telling me to go to the hospital. I had a big sore here.
Ms. Tiffany pointed out scars the size of about a quarter or more on her arms, legs and abdomen. There are bandages on her shins, so bad that they can’t remove her bandages to show her nurses.
SPOT van nurse Molly Rice said she is seeing more of these cases.
Pearson disposes of the used needle-filled container in a cardboard box lined with biohazard bags for disposal.
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Pearson disposes of the used needle-filled container in a cardboard box lined with biohazard bags for disposal.
Kellen Carrion/NPR
“I’m getting more and more of what looks like a pretty aggressive bruise that I think is due to xylazine,” she says. “Whether they have any injuries or are actually patients, unfortunately many patients are on the streets and live in abandoned buildings. It’s very big even if you look at it.” Higher. “
The city of Baltimore is trying to raise awareness of the dangers of trunks as evidence mounts that the drug is illegally sourced.
“We are increasing the number of wound care products we offer,” said Rania Muhammad, assistant director of community risk reduction services at the Baltimore Department of Health.
The city has purchased newly available xylazine test strips and continues to distribute leaflets.
“Xylazine seems to have spread across the country much faster than other drugs,” Humphries said.
He added that as the whole country is feeling the impact, it could spill over to Washington and lead to further action by the White House and Congress. The Biden administration has a plan to stop this drug. Congress is also considering legislation to regulate the substance, but has taken no action since the bill was introduced.
