ORN Summer 2026 - An Overview of Tusi (“Pink Cocaine”): A Novel Drug Concoction that Typically Contains Both Ketamine and Stimulants-Handout - ORN summer 2026

Handout - ORN summer 2026 - Palamar

Pdf Summary

This presentation explains Tusi, also called “pink cocaine,” as a misleading name for a novel drug concoction rather than a single drug. Although the term comes from “2C” or “2C-B,” most samples do not contain 2C-B. Instead, Tusi typically includes ketamine mixed with stimulants such as MDMA, cocaine, methamphetamine, and sometimes other drugs. Composition varies widely by batch and location, making it highly unpredictable and potentially dangerous.<br /><br />Internationally, testing has found that Tusi often contains ketamine, with MDMA also common; in the U.S., seized pink powders have rarely contained 2C-B and more often included ketamine, MDMA, methamphetamine, cocaine, fentanyl, or xylazine. The slide deck emphasizes that fentanyl may sometimes be present, but evidence is limited and batch-specific.<br /><br />The presentation reviews the main effects and risks of the component drugs. Ketamine can cause dissociation, hallucinations, impaired judgment, memory problems, urinary damage, and risk of accidents or assault. MDMA and stimulants like cocaine and methamphetamine can produce euphoria, energy, and sociability, but also raise body temperature, blood pressure, paranoia, dehydration, and risk of heart attack, stroke, or death. Combining these drugs can create unpredictable effects and added cardiovascular strain.<br /><br />Tusi is difficult to study because surveillance systems often do not ask about it specifically, and poison/death data usually do not identify the exact powder form or contents. Reported harms include overdose cases and deaths, including a Miami case series in which colored powders contained ketamine plus various other drugs.<br /><br />A New York City nightclub study estimated 5.8% lifetime, 2.7% past-year, and 0.8% past-month Tusi use among attendees, suggesting it is emerging in party settings. The overall message is that Tusi is an evolving, poorly monitored polydrug market with serious health risks, and better surveillance and public education are needed.

Keywords

Tusi

pink cocaine

ketamine

MDMA

polydrug

stimulants

drug adulteration

overdose risk

surveillance

party drug