Tranq-Related Wounds Are Healable, So Why Are Doctors Still Amputating?
Trigger Warning: The article you are about to read contains graphic depictions and images of limb loss, amputations, and drug use. Discretion is advised.
In part 1 of this series, we exposed how doctors are opting to amputate homeless substance-use patients even when their limbs could be saved.
Experts like Kelsey León, Billy Ray Boyer, and Sarah Laurel cite two main causes: ignorance of complex wounds caused by Xylazine (tranq) and harmful stereotypes about homeless individuals with substance use disorder. As a result, many young homeless people in Kensington are undergoing unnecessary amputations, further compounding the hardships they face.
In this installment, we explore the devastating effects of these avoidable amputations, the struggles of surviving homelessness with disabilities, and the systemic healthcare and housing failures that perpetuate this crisis.
“What we do know about these wounds is that they do heal.”
Harm Reductionist Kelsey León in an exclusive interview with Invisible People.
Homelessness with Preventable Disabilities: Here’s a Look at Life After Tranq-Related Amputations
There are alternative options to amputating, but apparently, not if you’re homeless.
The smell of rotting flesh and infection permeates Kensington Ave and Alleghany, a notorious section of Philadelphia where Fentanyl flows freely and is often laced with a deadly veterinary sedative scientifically referred to as Xylazine. On the streets, we call it tranq.
Nobody takes tranq on purpose. But those who are unfortunate enough to find it in their drug supply, along with whatever substance they are using, enter a truly nightmarish scenario.
The leading side effect of the contaminant is a condition some people call the “Zombie Drug Walk” or the “Tranq Walk,” which is every bit as ominous as it sounds. Under the influence of Xylazine, a person enters a state of obliviousness that causes them to walk aimlessly through the night. While walking, their bodies exhibit sores that open up and ooze, exposing bones and tendons. If left untreated, the ulcerations can tunnel and spread to the body’s tissue, killing the person in an agonizing way.
According to the Journal of Addiction Medicine, the wounds start out as “dark purple blisters with irregular borders and intact skin, they commonly emerge around injection sites on the posterior forearms or lower legs. These blisters often coalesce and harden into dry, adherent eschar, sometimes opening into deep ulcers.”
The wounds are untraditional and were first seen in Kensington about three years ago. At the time, the general medical consensus was that these infections required the patients, primarily unhoused people suffering from substance use disorder, to have amputations on their limbs in order to survive. However, recent revelations show that with time and proper care, the wounds can heal on their own. The issue is one of relentless misinformation, and it is causing young, otherwise healthy people to become amputees. Once they become amputees, the prospect of exiting or even surviving homelessness is slim.
Exiting Homelessness without Limbs: The Unfathomable Obstacles Faced by People with Disabilities
Exiting or surviving homelessness is a daunting task for anyone, let alone a person who is missing one or more of their limbs.
“Being an amputee means having a lifelong disability that is going to limit their ability to work, to care for themselves, and to build a sustainable life. So, it’s a big concern. We already have so many things to overcome at this point,” said Sarah Laurel of Savage Sisters, who has dedicated the past five years to educating the public about these very specific wounds.
“Having an open wound that obviously needs medical care can cause people to be denied certain services,” Laurel said. “A lot of those wounds smell pretty intensely, reminiscent of rotting flesh. And sometimes there’s a lot of stigma and judgment around giving them services due to those things.”
“Anyone who is in a wheelchair is gonna have a hard time accessing emergency shelters. They are not all ADA compliant,” explained former Prevention Point Wound Care Clinic employee and qualitative researcher Kelsey León, whose special area of study includes barriers to treatment in hospitals.
“This adversely affects their lives in every way,” León said. “It’s a very big scope. For example, having a bad experience in the hospital and losing body parts because you weren’t informed of all of the available options contributes to ongoing mistrust of medical care professionals, and rightly so. This is a community that is already extremely distrustful of medical care staff members due to negative experiences in treatment. So, being an amputee compounds their alienation from care and therefore their access to it.”
“Preemptively amputating unsheltered people due to the lack of resources or potentially, the lack of willingness to treat other underlying issues such as substance use disorder, like, for example, if a patient is unwilling to enter into treatment, they’ll amputate, is obviously something that causes permanent lifelong trauma, and something I am against. I think it’s terrible,” said Sarah Laurel of Savage Sisters.
The unfathomable cruelty of taking people’s legs and then telling them to pull up by the bootstraps is uncanny.
Talk to Your Representatives About the Human Right to Housing and Healthcare
Two things can prevent these unnecessary or preemptive amputations. One of them is housing. The other is healthcare. Talk to your local legislators about the negative impact that criminalizing homeless people has had on the quality of care they receive in the hospital as well as the human right to housing we continue to lack.
Learn more in Part 3 of our Preventable Amputations series.
