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

Background: Xylazine, a veterinary sedative not approved for human use, has emerged as a consequential adulterant in the U.S. illicit fentanyl supply. Although a growing body of qualitative research has documented the experiences of fentanyl consumers exposed to tranq in large Northeastern cities, little is known about how xylazine is experienced in rural or Southern regions where the evolution of the illicit drug supply often lags behind its urban equivalents. This study examines how fentanyl consumers in west-central North Carolina detect, comprehend and respond to the widespread adulteratio

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