In February 2021, the North Carolina Survivors Union and the Opioid Data Lab detected a substance called xylazine alongside heroin, fentanyl, and some sugars (a common filler). Xylazine is a veterinary tranquilizer that causes central nervous system depression. While it was assessed for human use by the FDA several decades ago, it was ultimately not approved for human use. People who inject xylazine may experience unexpected symptoms, including a slowed pulse, slowed breathing, low blood pressure, and excessive fatigue. Xylazine has also been linked to skin ulceration among people who inject xylazine. In order to inform people who use drugs about xylazine, we developed a flyer containing background information and tips.