Brennen Padgorski put off going to the hospital for weeks because he was too embarrassed by the smell of his rotting skin.

“It smelled horrible. You could probably smell it from 200 feet away,” he said.

Padgorski finally relented because he didn’t want to lose his arm. It’s a fear for many who are using xylazine and don’t get medical help.

“It’s nothing to see people in wheelchairs with their legs cut off,” he said a day after being released from a Philadelphia hospital.

Padgorski lives on the streets of Kensington, a community about 20 minutes north of downtown Philadelphia that many consider to be ground zero for the explosion of xylazine into the illicit drug supply.

The neighborhood is a large, open-air drug market where bright orange caps to needles litter the streets and sidewalks.

5 INVESTIGATES recently traveled to Pennsylvania to understand the impact xylazine could have as it becomes more prominent in Minnesota’s drug supply.

The Minnesota Department of Health reports that the number of deadly overdoses involving xylazine is roughly doubling every year.

In March, Hennepin County sent out an “overdose spike alert,” alerting its partners about the dangers of the drug that’s new to the scene.

In Philadelphia, Sarah Laurel started sounding the alarm about the effects of xylazine several years ago after the horse tranquilizer started being mixed into fentanyl to make the high last longer.

“It’s sad that in a first-world country, we are at this level of desperation,” said Laurel, who runs the non-profit Savage Sisters. 

“It is overwhelming. It is now the supply,” she said.

Emerging Threat

As xylazine spreads into the drug supply in other parts of the country, including in Minnesota, the devastating impacts are becoming more apparent and alarming. 

Related: A horse tranquilizer is making Minnesota’s fentanyl crisis even more dangerous

The Biden administration started developing a national response to xylazine and fentanyl in March after declaring the combination an “emerging threat.”

It’s the first time such a designation has been used and signals how serious the next chapter of the nation’s drug epidemic may be.

“It ruined my life, absolutely ruined my life,” said Kari Lamb, who is now in recovery and lives at a sober home in Philadelphia. She spent a month in the hospital after xylazine caused abscesses on her kidneys and lungs. “I see people losing limbs, losing their lives over this.”

Xylazine is not an opioid, so the life-saving reversal drug, Narcan, has no effect on it. Users often fall into a deep sleep and develop severe withdrawal symptoms if they stop using the drug.

“It’s very difficult to try and convince individuals that we’re worth saving,” Laurel said about her ongoing fight to get more widespread testing and treatment options for the people who walk through her doors.

But the gruesome, gaping skin wounds are considered the hallmark trait. The wounds can appear months after use and don’t always show up at the site of injection.

Savage Sisters has a black privacy curtain at the back of the storefront where people come to get their wounds cleaned and freshly wrapped by a nurse.

“The more frequently the dressing is changed, the better chance it has at healing,” said Bethany Gayda as she carefully cleaned and applied a new bandage to a client’s wounds.

“These are very gnarly wounds, obviously even for like a hospital setting,” she said.

Asked what Minnesota should prepare for, Laurel said it will get worse before it gets better.

“Get prepared for those wounds, update your wound care protocol based on the wounds specifically, and advocate for updating withdrawal protocols and good luck.”