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.”

He added: “So what I want everyone to understand is this: if we thought fentanyl was dangerous, fentanyl combined with xylazine is even deadlier.”

The streets of Philadelphia

In March, Sky News revealed the scale of the xylazine crisis in the northeastern city of Philadelphia, where the drug cocktail first emerged, with a report that exposed the true cost of America’s evolving drug challenge.

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.

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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.”

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.”

Too late for America

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 new data shows it’s too late, and in May the first UK death linked to xylaxine was announced.

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.

In May, Sky News saw how small-town communities were struggling with accidental fentanyl overdoses by children in schools