Across the United States, a quiet but urgent battle is being waged against the tide of prescription and synthetic drug abuse. In cities from Philadelphia to Milwaukee, the consequences of this crisis are visible on street corners and in emergency rooms, where the effects of powerful drug cocktails—sometimes laced with substances like fentanyl, methamphetamine, and xylazine—are leaving users in a state that many observers have described as "zombie-like." While the images are shocking, the underlying causes and possible solutions are rooted in both longstanding public health strategies and new, daunting challenges.
One of the most consistent and community-driven efforts to curb drug misuse in the U.S. has been the biannual Take Back Days. Over the past 15 years, these events have provided Americans with a safe, anonymous way to dispose of unused prescription medications, aiming to keep dangerous drugs out of the wrong hands. According to Straight Arrow News, the 28th Take Back Day, held in April 2025, saw an astonishing 620,321 pounds—310 tons—of discarded drugs collected. Since the program's inception, nearly 19,821,000 pounds (or 9,910 tons) of medications have been removed from households across the country.
Bill Padula, a professor of pharmaceuticals and health economics at the University of Southern California, told Straight Arrow News, "I go by the evidence, and there is strong evidence to show that Take Back Days work." He emphasized the growing problem of "medicine cabinet diversion," where unused prescription drugs are taken from homes and end up on the illicit market. Lawsuits related to the opioid epidemic, particularly those targeting Purdue Pharma and its OxyContin product, have highlighted how easily these substances can slip from legitimate use into dangerous circulation. As Padula put it, "The best way to prevent medicine cabinet diversion is to obviously not have it there past when it’s medically necessary."
The urgency of these efforts is underscored by sobering statistics. Dr. Kristin Bigos, a professor of pharmacology at Johns Hopkins School of Medicine, explained to Straight Arrow News that "16 million people in the U.S. have misused a prescription in the past year, and that roughly half of those misused prescriptions came from someone the user knows." She added, "About half of misused prescription drugs are from a family member or friend, whether given, sold, or stolen." Adult men, according to Bigos, are 20% more likely than women to abuse prescription opioids.
But the prescription drug problem is only one side of a much darker coin. As reported by Jim DeLillo in NewsBreak, a new synthetic drug cocktail combining fentanyl, methamphetamine, and xylazine—a veterinary tranquilizer—has emerged as a devastating force in many American communities. Dubbed "the zombie drug," this mixture is responsible for scenes that resemble a horror movie: people frozen mid-stride, skin ulcerated and gray, seemingly caught between life and death.
Why does this happen? The answer lies in the pharmacological effects of the drugs involved. Fentanyl, a synthetic opioid up to 50 times stronger than heroin, is now implicated in more than 70% of U.S. overdose deaths, according to the CDC. When combined with xylazine, which is not an opioid, the result is a coma-like stupor in which users may appear catatonic or "frozen." Xylazine also constricts blood flow, causing tissue necrosis—"rotting flesh"—that can lead to ulcers and even amputations, sometimes in areas where the drug was never injected. Methamphetamine, added to the mix to counteract the sedative effects, brings its own dangers: hallucinations, paranoia, violent behavior, and a "zombie-like, vacant stare."
Dr. Caleb Alexander, an epidemiology and medicine professor at Johns Hopkins Bloomberg School of Public Health, highlighted the lethal potential of these drugs. "One pill can kill with these medicines," Alexander said. "If you give a young kid or someone that’s opiate naive an 80 milligram tablet of OxyContin, they may be lucky to wake up and see another day." The risk is compounded by the fact that, as tolerance builds, addicts require ever-larger doses to stave off withdrawal—a cycle that can end suddenly and fatally due to the unpredictable potency of street drugs.
Efforts to counteract this crisis face significant obstacles. There is currently no approved antidote for xylazine. While naloxone (Narcan) can reverse fentanyl overdoses, it does nothing for xylazine, meaning users can remain unconscious even after intervention. Hospitals are left to provide supportive care—oxygen, IV fluids, wound treatment, and long-term rehabilitation. The DEA and CDC recommend that anyone encountering a suspected victim should call 911 and administer naloxone anyway, since fentanyl is almost always present.
The spread of these synthetic cocktails has been facilitated by both cheap synthesis and hidden substitution. Dealers often lace traditional opioids with xylazine to "stretch" their product, and counterfeit pills are easily pressed and distributed. The crisis, which first drew national attention in Philadelphia’s Kensington Avenue scene, has now reached Wisconsin, Illinois, Michigan, and beyond, according to the National Institutes of Health.
Given these grim realities, why don’t more people simply throw away their unused medications? According to Alexander, "The right way to get rid of these pills isn’t to wash them down the toilet. It’s to take them to drop boxes that are increasingly found in pharmacies and hospitals and ambulatory clinics and so on." Yet, many people procrastinate, are unaware of proper disposal methods, or keep medications "just in case"—a practice that can have deadly consequences. Elderly individuals are particularly at risk, as their medicine cabinets often fill up with a confusing array of prescriptions. "We’ve seen from the evidence that people lose track of which drugs they’re supposed to hold on to and which they don’t need anymore," Padula noted. "That piles up over time, and it creates a complicated situation at home."
Despite these challenges, there are reasons for cautious optimism. Public awareness of the opioid epidemic and its devastating toll has grown dramatically in recent years. "Fortunately, we’re at a point in time where there’s now widespread recognition of the opioid epidemic," Alexander said. "We’re a long way down the road compared to where we were a decade ago or 20 years ago, when tens of thousands of Americans were dying, but there wasn’t widespread awareness and consensus regarding the magnitude of the problem or what should be done about it."
Community action remains a critical part of the solution. Padula encourages people to make use of convenient disposal options at pharmacies like CVS and Walgreens, which are well-equipped to handle proper drug disposal. "It’s good housekeeping. It’s the right thing to do to take those medicines and to discard them, and discard them safely. And that’s exactly what these Take Back programs are intended to do," Alexander affirmed.
As the nation prepares for the next Take Back Day on October 25, 2025, the message is clear: safe disposal of prescription drugs is not just a personal responsibility, but a public imperative—one that could help stem the tide of a crisis that continues to claim lives and devastate communities.
