Xylazine users are more likely to be male, under the age of 30, living in a rural area, and injecting versus inhaling xylazine. Xylazine has similar behavioral consequences as heroin, thus it is commonly used as an adulterant. Xylazine is also frequently found in speedball. The combination of heroin and xylazine produces a stronger high than administration of heroin alone. Concomitant use of xylazine with speedball may potentiate or prolong the effects of these drugs, which can lead to adverse consequences.