Xylazine, also known as “tranq,” is a veterinary tranquilizer that is increasingly being added to illicitly sold opioids such as fentanyl and heroin. Xylazine causes very strong drowsiness that can make it difficult or impossible for people to stay awake. When xylazine is found alongside opioids, the combined sedation can increase the risk of an adverse medical incident or overdose. Repeat exposure to xylazine is also associated with skin problems like ulcers, abscesses, necrosis, and other complications. These may appear far away from injection sites, and can also happen via smoking, snorting, swallowing, and other routes of administration.