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Actually, it looks like folks are doing both at the same time.  Seems like a bad idea.

There’s a new drug beginning to spread rapidly through the street drug supply of the United States: Xylazine, an animal tranquilizer, increasingly used as a synthetic cutting agent for opioids like heroin. We recently published a study, based on years of research across the U.S., which found that xylazine is popping up in cities all over the country. Use of the drug is increasing at exponential rates where it lands, causing outbreaks of skin infections and overdoses.

The national spread of xylazine is a public health threat. It also foreshadows the future of the overdose crisis—increasingly driven by powerful synthetic compounds mixed into potent combinations.

Xylazine is almost never seen by itself. Instead, it is typically added to drug formulations containing fentanyl—a family of powerful opioids made in underground labs. Over the past 10 years, synthetically produced fentanyl has largely taken over the illicit opioid market that was previously dominated by agriculturally produced heroin; fentanyl can be several hundred times more potent than heroin by weight.

https://time.com/6164652/xylazine-overdose-crisis/

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