New figures show a shocking rise in deaths on US streets linked to a drug which rots the skin of those who use it.
Xylazine, often referred to as Tranq or the zombie drug, has spread across America at such alarming speed that the White House has now released a new six-point action plan to tackle the crisis.
The drug, an animal tranquillizer, is increasingly mixed or “cut” by drug dealers into supplies of fentanyl which itself is already killing over 100,000 Americans every year.
According to the most recent data from 20 US states and the District of Columbia, the monthly percentage of fentanyl-associated deaths where xylazine was detected has increased from 2.9% to 10.9% – a jump of 276%.
Revealing the new figures and announcing the action plan, Dr Raul Gupta, the White House director of national drug control policy, said: “This administration recognises the grave threat that fentanyl combined with xylazine presents to our nation.”
The latest numbers are stark, shocking and suggest that the skin-rotting animal tranquiliser is now firmly established in America’s drug market.
In the 12 months ending in January, 109,000 Americans died from a drug overdose. Nearly seven in ten of those deaths were attributed to synthetic opioids like fentanyl and a growing number were linked to xylazine.
The Drug Enforcement Agency (DEA) has seized xylazine-fentanyl mixtures in 48 of the 50 US states. And according to the DEA laboratories, in 2022, 23% of fentanyl powder and 7% of fentanyl tablets contained xylazine.
Spelling out the scale of the crisis, Dr Gupta said: “As a physician, I’ve never seen one this bad, at this scale… I visited the wound care clinic in Kensington neighbourhood of Philadelphia, one of the hardest hit communities in the nation.”
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He added: “So what I want everyone to understand is this: if we thought fentanyl was dangerous, fentanyl combined with xylazine is even deadlier.”
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On block after block in the Kensington district we saw people suffering from addiction who were increasingly finding their opioid supply was being cut by dealers with xylazine.
We saw the open wounds, the rotting skin and the volunteer outreach workers overwhelmed by the scale of the challenge.
Speaking to Sky News four months since we visited, one of the volunteers we met said the situation is now much worse.
“The hospitals can’t keep the patients comfortable – because of their addiction – to keep them long enough to get the wounds under control,” Ronnie Kaiser told me.
When the wounds caused by the xylazine get to a certain stage, the user may either admit themselves to the hospital or be taken to hospital. But their urge for another ‘hit’ will often be greater than the recognition that the wounds need to be treated. It is a cruel and vicious cycle of addiction.
“There’s always new people and sadly some we’ve seen for years and, of course, there’s some who passed.” Ronnie said.
Image: Sky News visited Kensington in Philadelphia to investigate the impact of Tranq
According to Neera Tanden, the domestic policy adviser at the White House, the new six-point plan seeks to: “Aggressively expand access to prevention, harm reduction, treatment and recovery support for those with substance use disorders. And [take] bold actions to disrupt the supply of illicit drugs, especially fentanyl that is harming communities or all across the country.”
The plan, released on Tuesday, focuses on six pillars of action: testing, data collection, evidence-based prevention, harm reduction/treatment, supply reduction, scheduling (categorising the drug) and research.
The White House’s drug policy director, Dr Gupta said: “We’re calling on Congress to fully fund President Biden’s historic $46.1bn (£35.7bn) budget request for national drug control programs, including key funding to address illicit fentanyl and emerging threats like xylazine.”
Image: Ronnie, who runs the Philadelphia-based charity Angels in Motion, speaking to Sky News earlier in 2023
The reaction on the streets
Ronnie, who runs the Philadelphia-based charity Angels in Motion, welcomed the fact that the federal government was finally recognising the scale of the crisis.
“Perhaps awareness is there now. It’s good that solutions are being looked at,” she said.
But she questioned the practicalities of the proposals: “Test strips? Why? Do they think the dealer will take the bag [of drugs] back if it comes up positive?!”
“We need more help with prevention, harm reduction, rehab and recovery houses – these should be the absolute solution now!” she said.
“Those of us on the ground know that these are the things needed. Unfortunately, I think funding goes to certain people, not so much to the boots on the ground.”
She pointed to the perennial American problem of medical insurance and the ‘for profit’ medical facilities. Even those living on the streets and suffering from addiction are required to navigate the country’s complex health system if they are to stand a real chance of recovery.
“We need federal rehabs, federal recovery houses, the ability for longer rehab stays and definitely all insurances to be accepted at all rehabs,” she said.
“That’s what we need so that all ‘for profit’ places go away. There are recovery houses that are so bad – throwing people out because they can’t find a job to pay fast enough.”
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In February, Philadelphia’s substance use prevention and harm reduction chief, Dr Andrew Best, warned that cities across America should brace for xylazine and called on the federal government to do more.
“Right now there’s no state or federal funding available,” he told Sky News. “I don’t want this to spread to other cities.”
The Biden administration has also announced plans to disrupt the supply of both fentanyl and xylazine into the country. The precursor products come from China and are mostly converted to tablet or powder form by cartels in Mexico as Sky News exposed earlier this year.
The fear now, given the ever-growing supply of xylazine-adulterated fentanyl, is that it will infiltrate other sectors of society.
US troops will not be used to secure the peace in Ukraine following any ceasefire deal with Vladimir Putin, Donald Trump’s new defence secretary has declared, as he signalled a dramatic shift in American foreign and defence policy away from Europe.
Pete Hegseth also said it is “unrealistic” to think Ukraine can return to its pre-2014 borders and he ruled out NATO membership as way to guarantee Kyiv’s security.
Image: Defence secretaries Pete Hegseth and John Healey meeting in Brussels.
Pic: Reuters/Johanna Geron/Pool
Mr Hegseth said Washington must focus on the threat posed by China and securing its own borders.
He added: “Stark strategic realities prevent the United States of America from being primarily focused on the security of Europe.
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“As the United States shifts its attention to these threats, European allies must lead from the front,” Mr Hegseth said in opening remarks at the gathering of NATO and non-NATO countries that are providing military support to Ukraine.
NATO spending
Mr Trump – a long-time critic of the alliance, which he sees as containing freeloaders that benefit from American military strength without investing in their own security – has said all NATO allies should increase defence spending to 5% of GDP.
This is more than double the current target. The UK is only spending 2.3%.
While still supportive of NATO, Mr Hegseth warned that America’s patience was limited.
“Our transatlantic alliance has endured for decades. And we fully expect it will sustained for generations more. But this won’t just happen,” he said.
He continued: “It will require our European allies to step into the arena and take ownership of conventional security on this continent.
“The United States remains committed to the NATO alliance and to the defence partnership with Europe.
“Our relationship will prioritise empowering Europe to own responsibility for its security.”
Ukraine-Russia war
Mr Hegseth also had strong words about Russia’s war in Ukraine, which he said “must end”.
Speaking frankly, he dismissed a fundamental Ukrainian goal to recapture all its territory – including Crimea and swathes of the Donbas that were seized by Russia in 2014 when Mr Putin first invaded his neighbour. This aim had previously been backed by the UK and other allies.
“We want… a sovereign and prosperous Ukraine. But we must start by recognising that returning to Ukraine’s pre-2014 borders is an unrealistic objective,” he said.
“Chasing this illusory goal will only prolong the war and cause more suffering.”
The US defence secretary said that a durable peace must include robust security guarantees to ensure that the war won’t begin again – but he made clear that the US would not be part of that effort on the ground and it could not be a NATO operation.
It was not immediately clear, however, whether the US military may help to provide protection from a distance.
“These security guarantees should not be provided through NATO membership, but must instead be backed by capable European and non-European troops,” the US defence secretary said.
“If these troops are deployed as peacekeepers to Ukraine at any point, they should be deployed as part of a non-NATO mission and not covered under Article 5. There also must be robust international oversight of the line of contact.”
Image: Pete Hegseth stands with German defence minister Boris Pistorius.
Pic: Reuters/Johanna Geron/Pool
Article 5 of NATO says an armed attack on one member is considered an attack on all.
The retreat of the US from its leadership role in Ukraine was clear in the choreography of the Ukraine Defence Contact Group meeting – an alignment of allies gathered together by Washington under Joe Biden and his defence secretary Loyd Austin after Russia launched its full-scale invasion almost exactly three years ago.
Future of European security
The regular meetings have until now always been chaired by the US.
Wednesday’s meeting, however, was led by John Healey, the UK defence secretary.
Mr Hegseth made clear that European allies would need to step up and take on much more of the effort to provide Ukraine with weapons and non-military support.
“Safeguarding European security is an imperative for European members of NATO. As part of this, Europe must provide the overwhelming share of future lethal and nonlethal aid to Ukraine,” he said.
This means donating more ammunition, expanding Europe’s defence industrial base and rallying the public to be willing to respond to the threat the continent faces.
“Part of this is speaking frankly with your people about how this threat can only be met by spending more on defence and investing strategically,” Mr Hegseth said.
“Increasing your commitment to your own security is a down payment for the future.”
Earlier, NATO Secretary General Mark Rutte said he agreed with US president Donald Trump on the need for Washington and European allies to share the burden of military aid for Ukraine more equally.
Elon Musk joined Donald Trump in the Oval Office as the US president signed an executive order allowing the tech billionaire to make large-scale reductions in the federal workforce.
As head of the Department of Government Efficiency (DOGE), an advisory group, Mr Musk says he wants to add “common sense controls” to government and ensure taxpayer money is spent wisely.
The executive order requires government agencies to work with DOGE, in some cases so they can be “eliminated or combined because their functions aren’t required by law”.
In addition, the agencies have been told to “hire no more than one employee for every four employees that depart from federal service”, with exceptions for immigration, law enforcement and public safety.
Answering reporters’ questions in the Oval Office, Mr Musk was asked to respond to accusations he is orchestrating a “hostile takeover” of government in a non-transparent way.
Image: Elon Musk told reporters in the Oval Office that ‘the public voted for major government reform’. Pic: AP
The Tesla CEO and owner of X said “the public voted for major government reform… and they’re going to get what they voted for. And that’s what democracy is all about”.
“We have this unelected, fourth unconstitutional branch of government, which is the bureaucracy, which has in a lot of ways, currently more power than any elected representative,” he added, while stood alongside his son X Æ A-12.
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Mr Musk also spoke about what he described as a lack of Treasury controls. “Your tax dollars need to be spent wisely on things that matter to the people… it’s just common sense. It’s not draconian or radical”.
Image: Elon Musk brought his son to the White House for Oval Office news briefing. Pic: Reuters
When challenged about what checks and balances are in place to ensure accountability for Mr Musk, who is unelected, he replied: “We are trying to be as transparent as possible… I don’t know of a case where an organisation has been more transparent”.
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Another reporter raised the possibility of conflicts of interest, pointing out Mr Musk has received billions of dollars in federal contracts.
“All of our actions are fully public,” he says, adding that he fully expects to be “scrutinised nonstop” – comparing it to “a daily proctologist exam” – but also admitting “we will make mistakes, but we’ll also fix the mistakes very quickly”.
“Some of the things that I say will be incorrect and should be corrected,” he said. “So nobody can bat 1,000.”
Musk’s awkward, full-scale assault on federal government
This was the most awkward news conference starring the most awkward man, with his son picking his nose.
It was quite a remarkable event. The president of the US was justifying a full-scale assault on the federal government in the Oval Office with Elon Musk by his side.
There was little in the way of accountability, even if the country did vote for Donald Trump.
Nobody saw Elon Musk coming. Nobody saw the half dozen young men that have been sent into these federal agencies to sack people by the thousands.
Musk’s description of bureaucracy as an unconstitutional branch of government is “a stretch to say the least”.
Over many years, the will of the people has been to construct a bureaucracy to deal with their interests, whether that’s social security payments or high finance.
At the same time, team Trump is attempting to “railroad” their legislation through the courts despite the objections of judges.
Earlier on Tuesday, Mr Musk posted an attack aimed at judges who have issued rulings that paused Mr Trump’s executive actions.
“Democracy in America is being destroyed by judicial coup,” Mr Musk wrote on X.
The president voiced a similar complaint in the Oval Office alongside Mr Musk.
Donald Trump has doubled down on US plans to take over Gaza in a meeting with Jordan’s King Abdullah II at the White House.
The meeting came the day after the president said he would withhold aid to Jordan, Egypt and other Arab countries if they refused to take in people forcibly displaced from Gaza.
King Abdullah’s “steadfast position” – as he laid out on X after the news conference – was “against the displacement of Palestinians.”
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He said Jordan, which is already home to millions of Palestinians, will take in 2,000 children who have cancer or are otherwise unwell.
But on taking in more Gazans, he stressed a solution that was “good for everybody” – including Americans, the “people in the region” and Jordanians – was his priority.
However, the King sat quietly as Mr Trump reiterated his plans to displace two million Palestinians, which he said was a “very small number of people”.
Mr Trump also said he believes there will be “parcels of land” in Jordan, Egypt and “someplace else” where Palestinians will live “happily and very safely”.
Image: Pic: Reuters
“They only want to be in the Gaza Strip because they don’t know anything else, they’ve never had an alternative,” Mr Trump said.
“They are being killed there at levels that nobody has ever seen – no place in the world is as dangerous as the Gaza Strip.”
He claims – contrary to what Gazans have said – that “not one person” wants to stay in Gaza.
Asked to respond to the widespread view among experts in international law that his plan amounts to ethnic cleansing, Mr Trump said: “We are moving them to a beautiful location.”
Image: Pic: Reuters
However, Trump appeared to ease off his previous threat to withdraw aid to countries that refused to take in people from Gaza.
“Well, I don’t want to say that… we don’t have to threaten that, I do believe we’re above that,” he said.
In the same news conference, Mr Trump said the US won’t buy Gaza, it will simply “have it”.
“We don’t have to buy, there’s nothing to buy,” he said.
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0:51
‘Palestinians don’t want to be on Gaza Strip’
“It’s a war-torn area, we’re going to hold it, we’re going to take it… Gaza the way it is, civilisation has been wiped out in Gaza. It’s going to be a great economic development.”
He declined to answer how that would work – and how he can avoid spending US taxes running it.
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“We’re going to run it very properly and eventually we’ll have economic development at a very large scale”, he said, promising “peace in the Middle East”.
“With the United States in control of that piece of land… you’re going to have stability in the Middle East for the first time.
“The Palestinians, the people who live now in Gaza, will be living beautifully in another location.
“They are going to be living safely – they’re not going to be killed, murdered and having to leave every 10 years.”
Trump added that he is 99% sure he will work out a deal with Egypt.