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It is most likely Fentanyl, or some other form of opiate. Prolonged abuse causes them to lose control of their muscles around their core and this is the result.
I used to work near a hot spot for homelessness and drug use in San Francisco and witnessed it everyday. The things these people go through with that addiction are downright horrendous and the "Fentanyl Fold" or "Fent Bent" is actually one of the lesser symptoms. The skin infections, kidney problems, and digestive issues can become pretty severe. I've seen quite a few screaming in agony because their kidneys are messed up and they can't urinate. People with infected swollen hands or feet. You can literally smell them rotting. Too much to list here honestly. It is a terrible drug that does permanent damage to people at best, and is just a slow agonizing death at worst.
God that sounds horrific. I had no idea.