Tusi, also known as "pink cocaine," "tucibí," or "tusibí," is a recreational drug mixture that has recently gained popularity in the United States, particularly in urban nightlife scenes such as New York City nightclubs. Despite its name, Tusi rarely contains actual cocaine or the psychedelic 2C-B drug it is sometimes confused with. Instead, it is typically a concoction of ketamine combined with other substances such as MDMA (ecstasy), methamphetamine, cocaine, opioids, and various new psychoactive substances. The powder is dyed pink with food coloring, which contributes to its nickname, "pink cocaine."
Why Tusi Is Especially Dangerous
Tusi is considerably more dangerous than many other synthetic drugs due to its highly unpredictable and variable composition. Unlike single-compound synthetic drugs such as pure MDMA, ketamine, or 2C-B, Tusi is a mixture that can contain a wide range of substances, including ketamine, MDMA, methamphetamine, cocaine, synthetic cathinone ("bath salts"), benzodiazepines, opioids like fentanyl, and other new psychoactive substances. This inconsistency in ingredients makes Tusi uniquely hazardous.
Each batch of Tusi can differ dramatically in its chemical makeup, meaning users cannot know what or how much they are ingesting. This unpredictability significantly raises the risk of overdose and severe adverse reactions compared to more standardized synthetic drugs.
Some Tusi samples have been found to contain fentanyl, a synthetic opioid 50 times stronger than heroin. Fentanyl contamination poses an extreme overdose risk, especially since users often assume they are taking only stimulants or dissociatives.
A 2024 study focusing on adults attending electronic dance music (EDM) nightclubs in New York City estimated that about 2.7% of this population reported using Tusi in the past year. Hispanic individuals were found to have higher odds of Tusi use compared to white individuals.
Warning Signs of a Tusi Overdose
If someone has taken too much Tusi, you might notice these signs:
Tusi combines dissociatives (ketamine), stimulants (MDMA, methamphetamine), hallucinogens, and opioids in one substance. This combination can cause unpredictable interactions, intensify side effects, and complicate medical treatment in overdose situations. Users may experience hallucinations, paranoia, anxiety, aggressive behavior, cognitive impairment, memory loss, seizures, abnormal heart rhythms, and respiratory depression.
Common overdose symptoms include:
Severe confusion or delirium: The person might seem extremely confused, have hallucinations, or act paranoid.
Loss of consciousness: They might pass out or become unresponsive.
Breathing problems: Respiratory depression can occur due to ketamine and opioid components, potentially leading to coma or death.
Heart problems: Elevated heart rate, high blood pressure, abnormal heart rhythms, or chest pain can increase the risk of cardiac arrest.
High body temperature (hyperthermia): Overheating and dehydration are common due to stimulant effects and physical activity in party settings.
Seizures: Uncontrolled shaking or convulsions.
Extreme agitation: Being unusually aggressive, panicky, or unable to calm down.
Loss of coordination: Inability to walk straight or control movements.
Nausea and vomiting: Persistent or severe vomiting can lead to dehydration.
The presence of fentanyl and other synthetic opioids in some samples has led to fatal overdoses, raising serious public health concerns.
The Complex Nature of Tusi Overdoses: A Serious MatterThe mixture of stimulants and depressants sends conflicting signals to the body, making symptoms unpredictable and sometimes rapidly worsening.
Because Tusi's contents vary and often include novel psychoactive substances, it can evade standard drug tests, complicating diagnosis and treatment in emergency settings. The presence of fentanyl or other opioids can cause sudden respiratory failure, which is life-threatening.
Users often underestimate the potency or dose due to the unknown composition, increasing overdose risk.
The common practice of combining Tusi with alcohol or other drugs can amplify sedative effects and increase the risk of blackouts, respiratory failure, and cardiovascular complications, further elevating danger.
Expert Perspective
Dr. Keith Ablow, a psychiatrist, has commented on the dangers of polydrug mixtures like Tusi: "The unpredictable nature of street drugs is magnified exponentially when multiple substances are combined by dealers with no quality control. Users are essentially playing a deadly version of Russian roulette, with no way to know what toxic combination they're actually consuming."
What To Do in an Emergency
If you suspect someone is overdosing on Tusi:
Call 911 immediately
Stay with the person
Put them in the recovery position (on their side) if they're unconscious
Tell emergency responders exactly what was taken if you know
Don't leave them alone, even if they seem to improve
The Drug Enforcement Administration (DEA) and poison control centers have issued warnings about the dangers of Tusi. The DEA has seized numerous samples of pink powders marketed as pink cocaine in major US cities with active nightlife scenes, such as Miami, New York, and Los Angeles.
These powders often contain no cocaine but a mixture of other psychoactive substances. The variability and complexity of Tusi complicate drug testing, law enforcement efforts, and harm reduction strategies. Advanced drug detection technologies, such as mass spectrometry and high-performance liquid chromatography, are being employed to identify the multiple substances present in Tusi without exposing officers to dangerous powders.
Remember that getting medical help quickly can save someone's life. Many overdose deaths happen because people are afraid to call for help. By being informed about Tusi and its dangers, you can play a crucial role in raising awareness and promoting safety in your community.
