Fatal overdoses linked to ‘zombie drug’ xylazine skyrocketing in NYC

A powerful animal tranquilizer-turned-dangerous street drug, xylazine — also known as “tranq” — is increasingly being mixed into New York City’s narcotics supply with deadly results, the Daily News has learned.

It’s known as the “zombie drug” for the gruesome sores it causes on people’s bodies and for how it knocks users out right in their tracks — in the middle of the sidewalk or even in the street.

Despite xylazine’s spreading throughout the U.S. — it’s been found in the drug supply in 48 out of 50 states — New York City has not been as affected as the rest of the country. Until now.

Data exclusively obtained by the Daily News show the percentage of fatal overdoses citywide involving xylazine nearly doubled from 2021 to 2023 — spiking from 14% to 23% — according to analyses by the Office of the Chief Medical Examiner.

The jump in tranq-related ODs was particularly high in Manhattan, spiking from 12% to 22%, and Queens, from 11% to 20%. The highest rates in 2023 were in the Bronx and Staten Island, at 26% and 28%, respectively.

The statistics only go through October 2023, but Bridget Brennan, who heads the city’s Office of the Special Narcotics Prosecutor, and others speculate that in 2024 the trend has only continued to skyrocket.

Even starker are statistics in an October report from the city’s Department of Health and Mental Health, showing tranq was present in nearly one-third, or 31%, of opioid-related deaths in 2023, up from 22% in 2022.

Simply put, as Anne Milgram, administrator of the U.S. Drug Enforcement Agency stated, “Xylazine is making the deadliest drug threat our country has ever faced — fentanyl — even deadlier.”

Tranq is the latest dark twist of the opioid crisis that has ravaged the U.S. for more than two decades. The drug has become infamous for the images coming out of Kensington, Philadelphia, where tranq has taken over the narcotics supply, and large numbers of people have been photographed on the streets in a drug stupor with festering wounds on their bodies. The telltale wounds, particularly affecting the lower limbs, sometimes necessitate amputation.

“For a long time we didn’t see it [in New York],” said Special Narcotics Prosecutor Brennan.

“The first time we ever found it in the mix was a big surprise to us,” she said. “And now we see it more and more.”

In early October, for example, authorities busted a suspected drug trafficker with $1 million worth of cocaine and fentanyl hidden in his truck and apartment in Queens. The fentanyl was laced with xylazine. The Special Narcotics Prosecutor’s Office jointly handled the operation, along with the New Jersey division of the U.S. Drug Enforcement Administration.

Xylazine is almost always cut into fentanyl and other drugs, according to Brennan. “We almost never see it alone,” she said. So quantifying the problem can be difficult.

What makes the fentanyl-tranq drug cocktail so dangerous is that xylazine — which is a sedative not an opioid — does not respond to the opioid antidote Narcan, which can save people who have overdosed on heroin or fentanyl.

Despite increased access to Narcan, which recently became available over the counter without a prescription, last year New York City tallied its highest number of overdose deaths on record.

Jasmine Budnella, director of advocacy and outreach at Vocal-NY, a grassroots group focused on issues affecting low-income people, said new approaches are needed to treat tranq ODs.

“Xylazine is not an opiate, and so naloxone is not meant for it,” she said, referring to Narcan’s generic name. “And so we need different strategies on how to respond to overdoses where xylazine may be potentially present.”

Oxygen may be particularly effective in dealing with tranq ODs that don’t respond to Narcan.

“At the overdose prevention centers, the two that are located in Manhattan, they are very serious about utilizing oxygen, which for xylazine is really, really important,” Budnella explained. “We need to make sure that oxygen is continuing to get to people’s brains,” since, as a sedative, xylazine slows people’s breathing.

That xylazine is increasingly being cut into the Big Apple’s drug supply is not just borne out in the data, it’s also apparent on the streets — in the open wounds on users’ arms and legs.

“Prior to xylazine, there were wounds, and it was because people didn’t have access to sterile supplies, or were reusing syringes for a very long time,” Budnella said.

But harm reduction workers serving drug users on the front lines say they have noticed an increase in both the severity of skin lesions and the number of people suffering from them.

“People have a massive amount of wounds on their legs, on their arms,” said Joel Teron, director of harm reduction at Alliance for Positive Change, which runs several needle-exchange programs in the city. “About two years ago we really started seeing an influx. People are definitely worried about it.”

Before 2022, “maybe like three to four people out of every 20 people would either ask us for wound-care items or hygienic items,” Teron estimated. “Now it’s probably 15 out of every 20.”

The surge in people seeking wound care has overwhelmed the Alliance, which can offer basic first-aid kits but doesn’t have fully staffed on-site clinics. “People will show us wounds all the time, and they’re, like, ‘What do you think I should do?’ And I’m, like, ‘Go to urgent care right now,’” Teron said.

Test strips that can tell people if their drugs have been cut with xylazine became available a year and a half ago. Teron said they have quickly become one of the Alliance’s most requested items.

Overdoses are the leading cause of death for homeless New Yorkers. OD rates among Black and brown New Yorkers continue to go up, while white New Yorkers’ rates are stabilizing.