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After just 15 minutes on the streets of Philadelphia’s Kensington neighbourhood, an encounter that was everything. 

It was illustrative of a crisis out of control, it was reflective of a profound personal struggle, it was instructive of the power of addiction, and it was deeply, deeply sad.

“I really didn’t have anybody taking me seriously,” Christophe said to me as he explained why he was where he was.

“I was this young guy, a semi-pro athlete.”

He explained how it had all begun with an injury.

Painkillers, prescribed at first, then self-medicated. Then illicit opioids. Now this new drug, Tranq.

He was fluent, eloquent, thoughtful, and as he told me his truncated life story, he was injecting himself in the left arm.

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It didn’t take long. Seconds. He trailed off. A mumble.

Then nothing. His body stooped.

The hit had hit. He was almost out. He stumbled over to the curb and slumped down. Less than a minute later, he was unconscious.

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Christophe injected Tranq while speaking to Sky News

Stone - Philadelphia
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Christophe slumped to the floor after his hit

I was last here in Philadelphia in February.

We’d gone then to investigate a new street drug which was leaving the most horrific wounds on those who use it. What we found then was shocking, devastating and truly depressing.

I’ve come back now because there’s news that the story of the so-called “zombie drug” has taken a turn.

America’s top drug prevention officials have been analysing nationwide data to see if this new drug, which had first emerged in these Philadelphia streets, is actually more widespread than they had thought.

What they have discovered is alarming.

New analysis of data stretching back to 2019 now shows a jump in Xylazine-related deaths of 276% nationwide. Deaths are more than doubling every year across America.

The drug, a cattle tranquiliser that is mixed by dealers into the existing opioid street drug supply, has now been detected in 48 of the 50 US states. Less than a year ago, they thought it had only been found in Philadelphia.

Regular unadulterated opioids are already killing more than 100,000 Americans every year. So news that xylazine is now so widespread is devastating for users, for volunteers and for the authorities who by our judgment have no control of this crisis.

Read more:
How drug leaves million-dollar streets strewn with bodies
‘Tranq’ designated ‘threat to the nation’
What is fentanyl?

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Christophe eventually passed out

In Philadelphia, I wanted to see how the users and volunteers I’d met back in February were doing and what they made of a major new “action plan” that President Biden has asked his officials to initiate.

Before Christophe had succumbed to his latest hit, he had seemed encouraged by the news from the White House.

Access to addiction treatment was key, he’d said.

Our guide through these dangerous streets was Ronnie Kaiser, who runs the charity Angels in Motion. She’d shown us around back in February and was keen to do so again.

I watched as she checked on Christophe.

“He has a pulse. He’s not overdosing at the moment,” she said.

The hopelessness here is breathtaking. There are people openly injecting on every street corner; far more than back in February, for sure.

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Ronnie checks Christophe after he injects Tranq

Their addiction is more powerful than the recognition to treat the wounds which appear all over their bodies. Access to treatment – both physical and mental – is so hard. And there is so little in the way of a safety net in America.

“It’s gotten worse,” Ronnie said as we drove past one group of people, all unconscious.

Users must navigate America’s complex and expensive health system if they are to stand a real chance of recovery.

The government’s national plan involves access to prevention, harm reduction treatment and recovery support, as well as bold actions to disrupt the supply from China via Mexico.

“I’m glad they’re finally implementing something. I just hope that the implementation is fast enough and it’s the correct one. Most people here have either mental health or trauma that’s been in their life,” Ronnie told me.

She pointed to the perennial American problem of medical insurance and the “for profit” medical facilities.

“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.

Officials in the Biden administration do seem to be recognising the scale of the problem, but now with such profound challenges facing them.

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Dr Rahul Gupta is the White House’s drug policy lead

Joe Biden’s director of national drug control policy, Dr Rahul Gupta, agreed to talk to us.

“On the streets here it looks like failure,” I said to him. “It looks like you have not remotely got a grip of the crisis here in Philadelphia and across the country.”

He conceded: “I think what you’re seeing and what I have seen on the streets of Philadelphia, specifically on Kensington Avenue, is an example of what does happen when we are not implementing those policies.”

“What I’ve seen is so much suffering. A lot of the people do not have homes. A lot of the people need help in an urgent way,” Dr Gupta said.

But he insisted the changes are having an impact: “The policy change that has occurred with prioritising harm reduction, prioritising treatment, meeting people where they are is working.”

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Christophe took a few minutes to come around. The hits are intense, but they are short and, of course, highly addictive.

“Sorry,” he said. He wanted to finish his story.

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Hurricane Helene kills at least 40 – as dozens trapped on roof of flooded Tennessee hospital

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Hurricane Helene kills at least 40 - as dozens trapped on roof of flooded Tennessee hospital

At least 40 people have been killed across four states after Hurricane Helene barrelled its way across southeastern US.

Emergency crews are racing to rescue people trapped in flooded homes after Helene struck the coast of Florida as a highly destructive Category 4 storm.

It generated a massive storm surge, wreaking a trail of destruction extending hundreds of miles north.

Millions are without power in Florida and neighbouring states.

Meanwhile, dozens of people are trapped on the roof of a flooded Tennessee hospital, with a “dangerous rescue operation” under way.

The Unicoi County Hospital is engulfed in “extremely dangerous and rapidly moving water”, according to Tennessee’s Ballad Health.

Patients and staff at Unicoi County Hospital are trapped on the roof Friday due to flooding caused by Tropical Storm Helene. (Pic: Erwin Police Chief Regan Tilson)
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Patients and staff are trapped on the roof of Unicoi County Hospital. (Pic: Erwin Police Chief Regan Tilson)

It said 54 people were relocated to the roof of the Unicoi County Hospital, while seven were in rescue boats.

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“The situation at the hospital is very dangerous and TEMA [The Tennessee Emergency Management Agency] and National Guard resources are engaged in what can only be described as a dangerous rescue operation,” Ballad Health added.

Local official Michael Baker told Sky News people are being moved from the roof “little by little”, describing the flooding as “unprecedented”.

“We’ve never seen anything like this,” he said.

A drone view shows a flooded and damaged area, following Hurricane Helene in Steinhatchee, Florida, U.S., September 27, 2024. REUTERS/Marco Bello
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Steinhatchee in the Big Bend area of Florida. Pic: Reuters

An vehicle, golf cart and playhouse are submerged from flooding Friday, Sept 27, 2024, in Atlanta. (AP Photo/Jason Allen)
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Flooding has severely damaged property in Atlanta. Pic: AP

As of early afternoon, Helene, which has been downgraded to a tropical depression, was packing maximum sustained winds of 35 mph (55 kph) as it slowed over Tennessee and Kentucky, the National Hurricane Center said.

It struck overnight with maximum sustained winds of 140 mph (225 kph) in the rural Big Bend area, the northwestern part of Florida.

The National Hurricane Center said preliminary information shows water levels reached more than 15ft above ground in that region.

US President Joe Biden has approved emergency declaration requests from the governors of several southern states affected by Helene.

Georgia, Florida, Alabama, North Carolina and South Carolina are being supported by emergency response personnel including search and rescue teams, medical support staff and engineering experts.

Georgia Governor Brian Kemp has said dozens of people are trapped in buildings damaged by the storm, with multiple hospitals in southern Georgia without power.

In western North Carolina, Rutherford County emergency officials have told residents near the Lake Lure Dam to immediately evacuate to higher ground, warning “Dam failure imminent”.

Meanwhile, Florida Governor Ron DeSantis said the damage from Helene in the area appears to be greater than the combined damage of Idalia and Hurricane Debby in August. “It’s demoralizing,” he said.

Halle Brooks kayaks down a street flooded by Hurricane Helene in the Shore Acres neighborhood Friday, Sept. 27, 2024, in St. Petersburg, Fla. (AP Photo/Mike Carlson)
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Getting around by kayak is easier than car in St Petersburg, Florida. Pic: AP

This photo provided by Venice Police Department rescue crews assist residents after  conducting door-to-door wellness checks, in coastal areas that were flooded by Hurricane Helene on Friday, Sept. 27, 2024 in Venice, Fla . (Venice Police Department via AP)
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Rescue teams in Venice, Florida. Pic: Venice Police Department

Many stranded in places like Tampa could only be reached by boat, with officials warning the water could contain live wires, sewage, sharp objects and other debris.

More than four million properties are without power across Florida, Georgia, the Carolinas, Virginia, Kentucky, Tennessee and Ohio, according to the logging website, PowerOutage.

Why this hurricane season is defying forecasts



Tom Clarke

Science and technology editor

@t0mclark3

Despite Helene’s power, this hurricane season has been more remarkable for its lack of activity.

At the start of the hurricane season, which runs from 1 June to 30 November, sea surface temperatures were (and remain) off-the-charts warm.

It’s this ocean heat that fuels tropical storms.

This combined with a developing La Nina phenomenon led the US forecasters to predict 2024 would be a major hurricane season. Between 17 and 24 storms were expected, with eight to 13 developing into hurricanes.

Hurricane Beryl grazed the coast of Jamaica in July as a Category 5 hurricane. It was the earliest storm of that size ever recorded and was seen as a harbinger of the prediction. But, so far at least, it’s failed to materialise.

There have been just six hurricanes so far this year – slightly below average. But why?

It seems to be due to what’s happening on the other side of the Atlantic where ocean warming forced the African monsoon further north than usual.

This led to catastrophic flooding in central and west Africa displacing millions, but it also shifted the weather system that usually spawns hurricanes and spins them across the Atlantic.

There’s already abundant evidence our warming oceans and atmosphere are making storms more intense – but predicting where they will occur and how often is never simple – and perhaps getting even harder as our planet gets hotter.

Prior to the hurricane making landfall, officials in Florida begged residents to evacuate. The sheriff’s office in rural Taylor County issued a chilling warning to those who refused to leave.

“Please write your name, birthday, and important information on your arm or leg in a permanent marker so that you can be identified and family notified,” the post on Facebook said.

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Child and dog rescued from floods

Forecasters now expect the storm to continue weakening across Tennessee and Kentucky.

It is feared heavy rain over the Appalachian Mountains could cause mudslides and flash flooding.

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Hurricane Helene: ‘Extremely dangerous’ storm strengthens as it makes landfall in Florida

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Hurricane Helene: 'Extremely dangerous' storm strengthens as it makes landfall in Florida

Helene has made landfall in northwestern Florida as a Category 4 hurricane, with forecasters warning of a “catastrophic” storm surge.

The National Hurricane Centre in Miami said Helene struck near the mouth of the Aucilla River in the Big Bend area of Florida’s Gulf Coast at around 11.10pm local time.

High winds, possibly in excess of 140mph (225kph), and flash floods are possible, the weather service said.

Florida Governor Ron DeSantis told reporters one person had died while driving on a motorway when a sign fell on to their car.

“When Floridians wake up tomorrow morning, we’re going to be waking up to a state where, very likely, there’s been additional loss of life. And certainly, there’s going to be loss of property,” Mr DeSantis said.

waves impact a house seawall as Hurricane Helene intensifies before its expected landfall on Florida...s Big Bend, in Eastpoint, Florida, U.S. September 26, 2024.  REUTERS/Marco Bello
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Florida’s Big Bend, where Helene has made landfall. Pic: Reuters

“You’re going to have people that are going to lose their homes because of this storm. So please keep those folks in mind, keep them in your prayers.”

Two other people are reported to have been killed in a possible tornado in neighbouring south Georgia as the storm approached, the Associated Press reported.

‘Unsurvivable scenario’ to play out

More than one million homes and businesses were already without power shortly after the hurricane made landfall, according to tracking website poweroutage.

States of emergency have been declared in Florida, Georgia, and the Carolinas, with hurricane and flash flood warnings in place as far away as south-central Georgia.

Officials pleaded with residents in the path of the storm to heed mandatory evacuation orders or face life-threatening conditions.

Flood water from Hurricane Helene batters cars in Florida
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Traffic cameras showed waves overtopping roads in St Pete Beach, Florida. Pic: Florida Department of Transportation

The surge caused by the hurricane – the wall of seawater pushed on land by hurricane-force winds – could rise as high as 20ft (6.1m) in some spots, as tall as a two-storey house, Michael Brennan, director of the hurricane centre, said in a video briefing.

“A really unsurvivable scenario is going to play out” in the coastal area, Mr Brennan said, with water capable of destroying buildings and carrying cars pushing inland. Millions of people are under the current flood watch.

Forecasters warned the storm surge could be particularly “catastrophic and unsurvivable” in Apalachee Bay.

Hurricane Helene in the Gulf of Mexico moving towards Florida. Pic: NOAA via AP
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Hurricane Helene in the Gulf of Mexico moving towards Florida. Pic: NOAA/AP

‘It’s going to cause a lot of damage’

Residents in the city of Tallahassee told Sky’s US partner NBC News that they stocked up on sandbags, food and supplies, before leaving their homes.

The city’s mayor John Dailey urged people to take the evacuation warnings “extremely seriously”, calling Helene “the biggest storm in the history of the city to hit us head-on”.

Speaking to NBC News on Wednesday, Mr Dailey said though they are “very prepared”, he was also “very nervous, and I hope everyone is nervous”.

He added: “This is a big storm. It is going to cause a lot of damage.”

Surfers take advantage of heavy winds along Higgs Beach in Key West, Florida, on Thursday, Sept. 26, 2024. Despite passing the Florida Keys by hundreds of miles, sustained winds over 40 mph churned up the usually calm, nearshore waters. (Rob O'Neal/The Key West Citizen via AP)
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Surfers taking advantage of heavy winds in Key West. Pic: Rob O’Neal/The Key West Citizen/AP

Melvin Juarbe, right, attempts to assist an unidentified driver whose car stalled in floodwaters from Hurricane Helene Thursday, Sept. 26, 2024 in Madeira Beach, Fla. The men tried to pull the car to dry land with their pickup truck but have opted to call AAA after several failed attempts. (Max Chesnes/Tampa Bay Times via AP)
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Flooding has already hit Madeira Beach, Florida. Pic: Max Chesnes/Tampa Bay Times/AP

Jared Miller, sheriff of Wakulla County, went further – calling the storm “not a survivable event for those in coastal or low-lying areas”.

The county has issued a mandatory evacuation order, but one resident, Christine Nazworth from Crawfordville, which is located about 25 miles (40km) from Apalachee Bay, said her family would be sheltering in place.

She said: “I’m prayed up. Lord have mercy on us. And everybody else that might be in its path.”

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A view shows the damage caused by Tropical Storm Helene in Puerto Juarez, Cancun, Mexico September 25, 2024. REUTERS/Paola Chiomante TPX IMAGES OF THE DAY
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Damage caused by Tropical Storm Helene in Puerto Juarez, Cancun, Mexico. Pic: Reuters/Paola Chiomante

People traverse a flooded street with a horse-drawn carriage after the passage of Hurricane Helene in Guanimar, Artemisa province, Cuba, Wednesday, Sept. 25, 2024. (AP Photo/Ramon Espinosa)
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Helene caused streets to flood in Guanimar, Cuba. Pic: AP/Ramon Espinosa

Leslie Powell, from Quincy, a city a similar distance from Tallahassee, told NBC she was leaving her mobile home to go to a shelter with her eight-month-old baby and six-year-old daughter.

She said simply: “I’m scared. I’ve got a lot of trees around my home, so it’s not safe for me and my kids.”

Helene is expected to remain a full-fledged hurricane as it rolls through the Macon, Georgia, area on Friday, forecasters said.

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Sir Keir Starmer to meet with Donald Trump to ‘establish a relationship’

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Sir Keir Starmer to meet with Donald Trump to 'establish a relationship'

Sir Keir Starmer is to meet with Donald Trump later tonight.

It is believed to be the first meeting between the current UK prime minister and former – and potentially future – US president.

The pair are set to meet overnight UK time, which is the evening in New York, where Sir Keir is currently located while on a visit to the UN.

David Lammy, the Labour foreign secretary, has met Mr Trump‘s vice presidential candidate, JD Vance.

Speaking to journalists, Sir Keir reiterated he wanted to meet both Mr Trump and Kamala Harris ahead of the November vote.

However, meeting the Democrat is hard due to the “usual diary challenges”.

Sir Keir said: “It’ll be really to establish a relationship between the two of us.

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“I’m a great believer in personal relations on the international stage.

“I think it really matters that you know who your counterpart is in any given country, and know them personally, get to know them face to face.

“So it’s really along those lines. I won’t go into what we’ll actually discuss, obviously, but that’s the purpose of it, as you’d expect, ahead of the election.”

Britain's Prime Minister Keir Starmer gives a media interview while attending the 79th United Nations General Assembly at the United Nations Headquarters in New York, U.S. September 25, 2024. Leon Neal/Pool via REUTERS
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Sir Keir is in New York at the United Nations. Pic: Reuters

Asked if a Trump presidency would leave Ukraine exposed, Sir Keir said the nature of the “special relationship” between the UK and US “always sits above whoever holds the particular office”.

“The US people will decide who they want as their president, and we will work with whoever is president,” he added.

“I’m not going to speculate on what any particular issues may be on the other side of the election.”

Speaking ahead of the meeting, Mr Trump said he thought Sir Keir was “very nice”.

He said: “I actually think he’s very nice. He ran a great race, he did very well, it’s very early, he’s very popular.”

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Mr Trump went on to praise Reform UK leader Nigel Farage as well, saying: “I think Nigel is great, I’ve known him for a long time.”

“He had a great election too, picked up a lot of seats, more seats than he was allowed to have actually.

“They acknowledged that he won but for some reason you have a strange system over there, you might win them but you don’t get them.”

This appears to be a misunderstanding of how the UK’s first past the post system for elections chooses MPs – Reform won fewer seats compared to its vote share because it came second in many seats.

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