"It Just Puts You Out!" Tranq Sleep, Sensory Discernment, and the Experience of Consuming Xylazine-Adulterated Fentanyl in Rural North Carolina

In west-central North Carolina, fentanyl consumers in 25 interviews described sensory strategies to identify xylazine and a distinct “tranq sleep” marked by nearly instantaneous loss of consciousness.

• Why it matters: Rural and Southern experiences with xylazine-adulterated fentanyl are less documented than those from large Northeastern cities, leaving harm-reduction needs insufficiently tailored.
• What they did: From September to December 2025, a seasoned interviewer conducted 25 in-depth semi-structured interviews with consumers recruited from fixed and mobile syringe service programs in Gaston and Burke County, analyzed in QSR NVivo 14.0 using deductive-inductive thematic coding.
• The result: Participants reported sensory cues such as foil residue, bitterness and chemical odor when smoked, and altered viscosity when injected, with a minority unable to detect xylazine; nearly all aversion coexisted with a minority valuing xylazine’s high-amplifying effects.

AI summary of the abstract · may contain errors · not medical advice · read the paper.