How a doctor’s persistence helped one man survive Philly’s tranq crisis

The drugs had changed while Joe Kunz was away.

It was 2019, and the carpenter from Woodbury Heights had just relapsed again. He’d battled heroin addiction since his teens, in and out of juvenile hall and prison and rehab.

But whatever he was buying on the street now wasn’t heroin. “I didn’t know what this was,” he said. “It kept knocking me out. I would come to, hours later, in my house.”

» READ MORE: Amputations are on the rise as Philly's tranq crisis wears on.

Within a few years, the mystery drug was in nearly every bag of dope on the street. Kunz learned its name — xylazine, or tranq, an animal tranquilizer never approved for human use. Soon enough, he learned what it does to a body.

Lesions stretched down his legs. An abscess grew in his throat and paralyzed his vocal cords. One day, he injected into an artery in his wrist, causing a clot that blocked the flow of blood to his fingers. Three fingers blackened, and eventually had to be amputated.

Infections and clots are a risk for injection drug users even when they’re not using xylazine. But Kunz had never before seen wounds like the kind he got from tranq.

By last summer, he was living on the streets, and a wound on his foot had reached the bone. Doctors would eventually amputate several toes. He was down to 138 pounds on a frame that had once supported 260, his blue eyes sunken into his skull. He avoided the hospital as long as he could. He hated the withdrawal that awaited him there: the vomiting, sweats, and intense anxiety.

But he also worried about how doctors and nurses would react. “Some make you feel like you’re worth getting better,” he said. “Some make you feel less than human.”

His doctor at Cooper University Hospital, Joseph D’Orazio, was different, Kunz said.

“I saw him probably eight, 10 times, coming in and out of the ER that summer,” he said. “Every time I went, he came and talked to me. Every time, I was worse and worse. He was like, ‘Joe, what do you want to do? You’re dying.’”

In his room at Cooper in early August, Kunz, 47, rubbed at his grown-out buzz cut and salt-and-pepper beard, pulling a blanket around thin legs pocked with wounds.

This time, he’d managed to stay for a week — “That’s a feat,” he said — and was hoping to get back into recovery.

“I’m so sick and tired of being sick,” he said. “To be honest, I don’t care about dying. But I’m afraid of living like this.”

A week later, he was back on the streets.

But one week after that, “I just thought, I gotta give it one more try,” he said.

D’Orazio’s consistent offers of help had stuck with him.

“He really cared — he cared about what happened to me and he cared about my health," Kunz said. “And that was unusual.”

He returned to the hospital, then to detox, then to long-term rehab. At the inpatient treatment center, he hid the open wound on his foot from staff at first: Many treatment centers won’t take patients with xylazine wounds because they can’t provide adequate care for them, and Kunz worried he would be turned away.

He’s been in recovery for eight months now, living in halfway housing in Newark. His wounds have completely healed. He’s reconnected with family and is looking for a job, though he knows he can’t return to carpentry.

Instead, he says, he’s hoping to become a peer recovery specialist: a healthcare worker who helps people with addiction navigate the treatment system.

“I feel like I owe it to my friends who are no longer here, and to the people that still are,” he said.

He hears stories from friends who are still using. One recently had both of his legs amputated at the knee. Another, whose arm was at risk of being amputated, had just left the hospital against medical advice. Kunz remembers that feeling — as if he would never break out of the cycle of addiction.

“It felt like it was impossible to walk away from. Like it was never not going to be a part of my life,” he said. “But as long as you have breath left in you, there’s always another chance.”