Philadelphia has seen a sharp rise in the presence of xylazine, a veterinary tranquilizer not approved for human use, in its illicit drug supply. By late 2023, more than 90 percent of fentanyl samples tested in the city contained xylazine. The drug is associated with unique and severe wounds that are prone to infection and difficult to heal, presenting new challenges for health care workers.
Xylazine’s effects go beyond physical harm. Many individuals affected by it avoid or leave hospitals early due to stigma and withdrawal symptoms, making wound care outside clinical settings increasingly important. Even as medetomidine—a different sedative—begins replacing xylazine in street drugs, the complications from xylazine-related wounds persist.
At Pennsylvania Hospital, nurse Pattie Lamoreaux has responded by distributing wound care kits since 2023 to patients at high risk of infection from xylazine use. The kits contain gauze, bandages, rinse-free soap, instructions, and other supplies. Funding came from a Penn Medicine CAREs grant. Lamoreaux said: “Nine out of ten times the patient will choose to accept the kit. They are very appreciative and interested in using the supplies. We’ll sit down with them and show them everything in the bag and answer any questions.” She added: “Many patients who are experiencing housing insecurity may not have access to running water to wash the wounds. Rinse-free soap is a safe solution to properly clean bacteria.”
Lamoreaux works with wound care specialists and pharmacy staff to select appropriate materials for these kits and seeks feedback from both staff and patients for improvement. “We want patients to feel seen and know that we care about them,” she said. “We hope that it’s helping people, even if it’s saving one patient from serious infection.”
Community-based harm reduction efforts are also underway through organizations like the Everywhere Project in Kensington. James Sherman and Emily Seeburger volunteer there each weekend alongside others to provide wound care services for over 300 individuals seeking help.
Seeburger said: “Consistently showing up for folks, who otherwise may not have that support, goes a long way… When folks see that we’re there, no matter if it’s raining, below freezing, or blinding sun, it’s a powerful way of saying ‘I care.’” Sherman explained his motivation: “Being on the receiving end of [the Everywhere Project] meant a lot to me… When I entered recovery, I wanted to be a part of it and help others.”
Both volunteers connect their work at Penn Medicine with their outreach activities. Sherman coordinates overdose prevention education at Penn Medicine’s Center for Addiction Medicine and Policy (CAMP), sharing research findings on xylazine’s impact on patient care and training employees on naloxone use. He also supports patients moving from emergency departments into addiction treatment services at Penn Presbyterian Medical Center (opened 2023) and the Hospital of the University of Pennsylvania (HUP), which launched its own consult service in January 2025.
Sherman noted: “I may see a participant at the Everywhere Project one day, and then they become a patient another day… I think having them see a familiar face makes them feel more comfortable in the hospital.” Seeburger analyzes data related to overdose interventions at Penn Medicine centers focused on emergency care policy and health justice: “The knowledge I’ve gained from volunteering and speaking with participants has helped me to think more thoughtfully about the data I’m looking at… Data may seem cold and sterile, but there’s a real human element—it’s people’s lives.”
Rachel McFadden serves as an emergency department nurse at HUP while also working part-time at Prevention Point Philadelphia providing wound care services. She emphasizes building trust through conversation during visits: “It’s more about how we deliver care,” she said.
McFadden involves participants directly in their own treatment decisions when possible—including allowing them to apply dressings themselves—and discusses additional needs such as clothing supplies funded by another Penn Medicine CAREs grant in summer 2024.
She notes reluctance among many participants toward hospital referrals due to fears around withdrawal symptoms or shame about their condition: “They’re put in this highly vulnerable position.” McFadden uses insights gained through her community work to inform practices within hospital settings.
In 2022, McFadden collaborated with HUP addiction medicine staff on developing an evidence-based protocol using opioid agonists for withdrawal management—a practice now included on Penn Pathways clinical guidance tool used across Penn Medicine. She also educates nursing staff on resources available for treating patients with xylazine-associated wounds; some units now provide discharge kits containing both wound-care supplies and naloxone.
“My experiences at both Prevention Point and at Penn have created this nice conversation between the two settings,” said McFadden. Her advocacy was recognized by Philadelphia Business Journal’s 40 Under 40 list.
