A healthcare professional wearing gloves and wrapping bandages around a hand

From compassionate connections to infection prevention: addressing the xylazine crisis

To address the xylazine crisis in Philadelphia, Penn Medicine employees are offering support within the health system and in the community.

  • Julie Wood
  • July 1, 2025

In 2020, Philadelphia emerged as the epicenter of the xylazine crisis. By the end of 2023, this drug was found in more than 90 percent of illicit fentanyl samples in the city. Over these years, this non-opioid veterinary tranquilizer, also known as “tranq,” has brought new and challenging complications to those in the health care community who work to help people whose use of illicit opioid drugs now exposed them to additional risks.

Xylazine, which is not intended for human use, is linked to fatal overdoses and can result in distinct soft tissue wounds on the body that can become deep and difficult to heal. And many individuals who experience severe wounds may avoid treatment in hospitals—or may leave a hospital before completing treatment—due to the stigma around substance use and distress from withdrawal symptoms. Their untreated wounds are more susceptible to infection.

Even as xylazine is now being supplanted by the sedative medetomidine— which has resulted in a dramatic increase in people requiring ICU-level care for withdrawal—addressing xylazine-related wounds remains a big challenge. At the front lines, Penn Medicine staff in Philadelphia are working to support people with xylazine-related wounds, both within hospitals and through volunteer efforts in the community.

Wound care kits for Penn Medicine patients 

Pattie Lamoreaux standing in a hospital hallway and holding a tote bag and bandages
Pattie Lamoreaux, BSN, RN, holding a wound care kit 

One such effort is led by a nurse at Pennsylvania Hospital.

Whether a patient is discharged after wound treatment or chooses to leave against medical advice with untreated wounds, Pattie Lamoreaux, BSN, RN, a Medical/Surgical Resource Float Pool nurse, wants to help patients care for themselves and manage wounds outside of clinical settings. She does so by offering wound care kits.

Since 2023, Lamoreaux has distributed wound care kits to patients who are identified with a heightened risk of infection from xylazine use.

“Nine out of ten times the patient will choose to accept the kit. They are very appreciative and interested in using the supplies,” she said. “We’ll sit down with them and show them everything in the bag and answer any questions.”

A 2023 Penn Medicine CAREs grant funded the materials for the kits, including gauze, bandages, printed directions for wound care, and a tote bag. Lamoreaux collaborated with wound care specialists and pharmacy staff for guidance on appropriate items for the bags. They also include rinse-free soap, which patients are particularly happy to receive, said Lamoreaux. “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.”

So far, Lamoreaux has distributed 55 wound care kits. She continually asks for feedback from staff and patients to help improve the kits and best meet patients’ needs.

“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.”

A powerful way of saying ‘I care’ 

James Sherman standing outside next to a table with a CPR manikin
James Sherman, CRS, CHW 

James Sherman, CRS, CHW, and Emily Seeburger, MPH, spend their Saturday afternoons in Kensington, serving the more than 300 individuals who arrive each weekend seeking care through the Everywhere Project, a Philadelphia-based nonprofit that provides harm reduction services to those experiencing substance use. Together, they organize a team of fellow volunteers to staff wound care and harm reduction.

However, the most valuable part of these services is being able to support participants’ journeys over time, said Sherman.

“Consistently showing up for folks, who otherwise may not have that support, goes a long way,” said Seeburger. “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, a clinical research coordinator at Penn Medicine's Center for Addiction Medicine and Policy (CAMP), was inspired to volunteer with the Everywhere Project after his own experiences overcoming addiction. “Being on the receiving end of [the Everywhere Project] meant a lot to me,” he said. “When I entered recovery, I wanted to be a part of it and help others.”

Emily Seeburger standing in front of a mural on a wall
Emily Seeburger, MPH 

Seeburger had previously volunteered at homeless shelters and drug and alcohol rehabilitation centers in college. She wanted to continue this service in addition to her role as a data analyst at the Center for Emergency Care Policy & Research and the Center for Health Justice. “I do a lot of research focused on substance use and overdose prevention,” she said. “As useful as that work is, I wanted to be on the ground and help folks in a material way.”

Sherman and Seeburger find that their roles at the Everywhere Project and Penn Medicine are intertwined.

For Sherman, overdose prevention education is a crucial part of his work at CAMP. He leads employee training sessions, providing insight into CAMP’s research on the detection of xylazine and fentanyl in the city’s drug supply and its impact on patient care, and demonstrates how to use naloxone for overdose reversal. Also a certified recovery specialist, Sherman advocates for patients experiencing substance use in the ER and helps them transition to being admitted to Penn Presbyterian Medical Center’s addiction consult service, which opened in 2023. The Hospital of the University of Pennsylvania (HUP) launched its own consult service in January 2025.

“I may see a participant at the Everywhere Project one day, and then they become a patient another day,” he said. “I think having them see a familiar face makes them feel more comfortable in the hospital.”

Part of Seeburger’s work involves analyzing neighborhood and environmental interventions and their impact on fatal and non-fatal overdoses. Evaluating the data helps determine which interventions are most beneficial to helping save people’s lives, or what can be improved to further promote recovery and treatment. “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,” she said. “Data may seem cold and sterile, but there’s a real human element—it’s people’s lives.”

‘Voices from community’ shape hospital patient care 

Rachel McFadden holding a Philadelphia Business Journal plaque at an award ceremony next to James Sherman
Rachel McFadden, MPH, BSN, CEN, at Philadelphia Business Journal’s 40 Under 40 award ceremony

Conversation is important every step of the way when it comes to helping individuals experiencing substance use, said Rachel McFadden, MPH, BSN, CEN. An emergency department nurse at HUP, McFadden also serves as a part-time Wound Care Clinic nurse at the Philadelphia-based nonprofit Prevention Point.

While wound care is an essential part of her work at Prevention Point, “it’s more about how we deliver care,” she said. During a wound care visit, McFadden will start by spending time talking to the participant to make them feel comfortable, and to understand why they’re visiting and what they may need. She encourages participants to be engaged with their own care, asking if they would prefer to apply the dressing, since they’re aware of any sensitive spots on their body. They also discuss supplies that may be helpful to take with them, like gauze or ointment, or seasonal clothes.

“Many participants have shared that the wounds soak and stain clothes, which can be super distressing,” she said. With a Penn Medicine CAREs grant in Summer 2024, McFadden supported this need by supplying more sweatshirts and sweatpants for Prevention Point participants.

McFadden may also suggest further treatment at a hospital for severe cases, although participants often decline the referral due to concerns of withdrawal symptoms and “feeling shame and fear around their wounds,” she said. “They’re put in this highly vulnerable position.”

Through these interactions, she’s able to “bring voices from the community into the hospital” to help improve practices and get patients the care they need.

In 2022, McFadden, along with HUP addiction medicine and pharmacy staff, piloted a novel withdrawal treatment protocol to address withdrawal being a deterrent to seeking higher levels of care. The protocol involves using medications like opioid agonists to safely reduce withdrawal symptoms. It is now listed as an evidence-based practice on Penn Pathways, a tool offering Penn-approved clinical guidance to support decisionmaking in patient care.

McFadden also led education during nursing huddles, and annual skills days, to reiterate the resources available for staff to treat patients and offer wound care education on xylazine-associated wounds. Some units at HUP now provide a kit of supplies for patients to manage wounds after discharge, which includes naloxone as an overdose prevention measure.

“My experiences at both Prevention Point and at Penn have created this nice conversation between the two settings,” said McFadden, whose 10-plus years of advocacy were recognized in Philadelphia Business Journal’s 40 Under 40 list. “I can confidently tell participants in the community what they can expect for treatment, which has led to a lot more success having them go to the hospital and stay longer for care.”

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