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.”
Image: Tranq is devastating communities in the US
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.”
He added: “So what I want everyone to understand is this: if we thought fentanyl was dangerous, fentanyl combined with xylazine is even deadlier.”
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.
The White House six-point plan
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.
The producer of Charlie Kirk’s podcast has claimed that a “miracle” stopped more people being killed by the bullet that hit the right-wing influencer.
Andrew Kolvet claimed to have spoken to a surgeon that tried to save Mr Kirk’s life, and posted on social media to discuss the apparent lack of an exit wound.
A prominent right-wing figure in the US, Mr Kirk was a staunch ally of President Donald Trump and was known for his conservative viewpoints on abortion, religion and LGBT issues.
Mr Trump and other public figures are expected to be in Arizonaon Sunday for a memorial service for Mr Kirk which is expected to draw 100,000 people.
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0:50
Prosecutors detail case against Charlie Kirk’s alleged killer
Mr Kolvet, executive producer of the Charlie Kirk Show, apologised for the “somewhat graphic” nature of his post on X.
In it, he discussed what he said was a lack of an exit wound from the bullet, despite it being “a high powered, high velocity round”.
Mr Kolvet included what he said were quotes from a surgeon who operated on Mr Kirk.
“It was an absolute miracle that someone else didn’t get killed,” Mr Kolvet quoted the surgeon as saying.
“His bone was so healthy and the density was so so impressive that he’s like the man of steel. It should have just gone through and through. It likely would have killed those standing behind him too.”
Mr Kolvet said what happened was “remarkable” and “miraculous”.
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0:55
Crowds chant at Charlie Kirk vigil at Texas university
President Trump and JD Vance are expected to be among the prominent MAGA members who will pay tribute to Mr Kirk at the memorial event.
It will take place at State Farm Stadium, the home of the Arizona Cardinals NFL team, amid a heavy law enforcement presence.
Image: State Farm Stadium in Arizona. Pic: Reuters
President Trump has blamed the “radical left” for the death of Mr Kirk, whom he credited for helping him win the 2024 presidential election.
It comes as the death of Mr Kirk has turned into a debate over the First Amendment.
While they have repeatedly criticised what they claim are assaults on free speech, members of the MAGA movement appear to be taking a different stance when the subject is one of their own, launching attacks on people they deem to be making disparaging comments about Mr Kirk.
Dozens of people, from journalists to teachers, have already lost their jobs for allegedly making offensive comments about the podcaster.
Late-night chat show host Jimmy Kimmel was pulled from the air indefinitely by ABC following a backlash from the Trump-appointed head of the Federal Communications Commission over the comedian’s remarks about Mr Kirk.
The State Department also has warned it would revoke the visas of any foreigners who celebrated his assassination.
Lawyers for Luigi Mangione have called on a judge to block federal prosecutors from seeking the death penalty against him.
Mangione’s legal team says the 27-year-old’s case has been turned into a “Marvel movie” after a failed bid by the US Justice Department to indict him on terrorism charges over the fatal shooting of UnitedHealthcare chief executive Brian Thompson in New York on 4 December.
New York state judge Gregory Carro said there was no evidence that the killing, which took place as Mr Thompson walked into an investor conference at the New York Hilton Midtown hotel, amounted to a terrorist act.
But Judge Carro upheld second-degree murder charges, which suggest there was malicious intent – but not that it was premeditated.
US Attorney General Pam Bondi has called for Mangione to face capital punishment, describing the charges against him as a “premeditated cold-blooded assassination that shocked America”.
But in the new court filing, Mangione’s legal team argues federal prosecutors have “violated Mr Mangione’s constitutional and statutory rights” by “staging a dehumanizing, unconstitutional ‘perp walk’ where he was televised, videotaped, and photographed clambering out of a helicopter in shackles” on the way to his first court appearance.
The legal team, led by former Manhattan prosecutor Karen Friedman Agnifilo, also claims the death penalty case has been “fatally prejudiced” after President Donald Trump commented on it on Fox News.
Despite laws that prohibit any pre-trial commentary that could prejudice the defendant’s right to a free trial, he told the network on Thursday: “Think about Mangione. He shot someone in the back, as clear as you’re looking at me or I’m looking at you.”
Image: UnitedHealthcare chief executive Brian Thompson.
Pic: UnitedHealth Group/AP
The defence team’s 114-page court filing reads: “There is a high bar to dismissing an indictment due to pretrial publicity.
“However, there has never been a situation remotely like this one where prejudice has been so great against a death-eligible defendant.”
Federal prosecutors have until 31 October to respond to the documents.
Mangione has pleaded not guilty to all the state charges against him, which cannot result in the death penalty and only life imprisonment, unlike federal ones. He has also pleaded not guilty to the federal charges.
He is due back in court for a pre-trial hearing in the state case on 1 December and the federal case on 5 December.
The 27-year-old was arrested five days after Mr Thompson was killed – when he was spotted at a McDonald’s in Altoona, Pennsylvania, around 230 miles west of New York City.
Journalists at the Pentagon have been told they could be barred if they gather or report information that officials haven’t approved first.
Reporters’ access to the iconic building, the headquarters of the US defence department, is also being curtailed.
Pete Hegseth, the defence secretary, posted on X: “The ‘press’ does not run the Pentagon – the people do.
“The press is no longer allowed to roam the halls of a secure facility. Wear a badge and follow the rules – or go home.”
A memo announcing the changes was sent to reporters on Friday, informing them “information must be approved for public release by an appropriate authorizing official before it is released, even if it is unclassified”.
They must sign an agreement agreeing to the new rules or face having their press pass revoked.
Journalists’ groups said it was a dangerous move that would seriously restrict their ability to hold defence officials to account.
The National Press Club called it “a direct assault on independent journalism at the very place where independent scrutiny matters most: the US military”.
The Society of Professional Journalists said it “would deny the American people the transparency and accountability they deserve”.
“This policy reeks of prior restraint – the most egregious violation of press freedom under the First Amendment – and is a dangerous step toward government censorship,” it said.
“Attempts to silence the press under the guise of ‘security’ are part of a disturbing pattern of growing government hostility toward transparency and democratic norms.”
Image: The Pentagon is home to the newly rebranded Department of War
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The first year of US President Donald Trump’s second term has seen several embarrassing episodes for the Pentagon.
A journalist revealed in March that he had accidentally been included on a group chat, which included the defence secretary and vice president, discussing plans to attack Houthi rebels in Yemen.
The Pentagon said no classified information had been shared but opponents said it showed a worryingly lax approach that could endanger US troops.
Doubts were also raised about America’s bombing of Iran’s nuclear sites earlier this year after a leaked intelligence report suggested the attack had only set the regime back “by months”.
President Trump and the CIA both hit back hard against the report, with the president insisting the underground facilities had been “blown to kingdom come”.