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TL;DR: not sure right now.
https://fallout.fandom.com/wiki/Karma_syringe_barrel_(Fallout_76)
https://fallout.fandom.com/wiki/Flavors_of_Mayhem
If you have completed Flavors of Mayhem, its a Barrel Mod option in the Weapons Bench. My brief research says it is not exclusive to Roses Syringer.
Alot of mods to learn for this weapon ... .