A Drug by Many Names: Unraveling the Rising Phenomenon of “Tusi” in Nightlife Scenes
Over the past decade, a new psychoactive substance known colloquially as “Tusi,” “tucibí,” or “pink cocaine” has emerged as a significant presence across Latin America, Europe, and increasingly, the United States. Recently documented in a pivotal study published by the internationally acclaimed journal Addiction, Tusi’s viral spread in urban nightlife environments signals a concerning evolution in the landscape of recreational drug use. In 2024, researchers estimated that roughly 2.7% of adults attending electronic dance music (EDM) nightclubs in New York City have used Tusi within the prior year. This prevalence, while seemingly moderate, underscores an alarming trend, notably highlighting increased use among Hispanic populations and poly-drug users within these social settings.
The origins and etymology of “Tusi” reflect the complex confusion surrounding this drug. The name “Tusi” itself is a phonetic reinterpretation linked to the “2C” family of psychedelic substances, especially 2C-B, with which it is frequently mistaken. The label “tucibí” and variants like “tusibí” derive directly from this phonetic adaptation, feeding into a widespread misconception that the drug contains classic psychedelics. Concurrently, the term “pink cocaine” (“cocaína rosada” in Spanish) adds another layer of ambiguity, implying the presence of mostly unadulterated cocaine, or a cocaine analogue dyed pink for branding. These misnomers have critical implications; users often consume Tusi under the false assumption that they are ingesting primarily psychedelics or cocaine, a misunderstanding that exponentially increases the risks to their health due to the actual chemical composition.
Contrary to popular assumptions, analytical tests of Tusi samples reveal the substance to be hardly psychedelic and rarely contains 2C-family drugs. Instead, the hallmark of Tusi is its chemical cocktail, predominantly a combination of ketamine and MDMA (3,4-methylenedioxymethamphetamine), sometimes augmented with cocaine. Ketamine is a dissociative anesthetic that induces trance-like states and altered perceptions, while MDMA is known for its empathogenic and stimulant properties. The blend thus creates a complex, unpredictable physiological and psychological impact, particularly because the ratios and purity of these constituents vary significantly across batches and producers. This unpredictable mixture dramatically raises the potential for adverse or unexpected effects in users, including overdose, toxic interactions, or acute psychiatric episodes.
Dr. Joseph Palamar, lead researcher and associate professor at New York University Grossman School of Medicine, elucidates the public health challenge posed by Tusi: “Tusi is not merely another street drug; it embodies the quintessential problem of adulteration in the illicit drug market. Because it usually contains multiple active substances that are not clearly disclosed or understood by users, it sharply increases the dangers associated with consumption. The conflation of Tusi with 2C-series psychedelics or cocaine greatly exacerbates this risk, misleading consumers regarding dosage, effects, and safety.” Dr. Palamar’s observations highlight how drug adulteration, masquerading under familiar or trusted names, exploits user expectations and complicates harm reduction efforts.
The 2024 observational study at the heart of these insights surveyed 1,465 adults from 124 NYC electronic dance music events over nearly a full calendar year. Participants completed digital questionnaires immediately before entering nightclubs, providing self-reported data on their drug use—including recent Tusi consumption. This methodology allowed researchers to estimate Tusi prevalence accurately among the nightclub-attending demographic, a previously understudied population concerning this emerging substance. The study’s findings mark one of the first comprehensive analyses of Tusi use prevalence in a major US metropolitan nightlife scene, breaking new ground in both epidemiology and drug surveillance.
Internationally, trends in Tusi usage have surfaced over the past several years, particularly in Spanish-speaking countries where the substance was initially identified. Since around 2018, users in Spain reported encounters with ketamine/MDMA mixtures marketed as “tucibí” or “pink cocaine.” In Latin America, government-sponsored drug-checking programs have gradually incorporated Tusi into their testing protocols—Argentina since 2019, Uruguay since 2020, and Colombia and Chile since 2021. However, despite these advances, systematic drug checking and detailed chemical analyses of Tusi have remained notably sparse within the United States, leaving a dangerous knowledge gap regarding the substance’s content, distribution, and health effects domestically.
Tusi’s notoriety is not only grounded in its pharmacology but also in the sociocultural dynamics that facilitate its spread. Electronic dance music scenes, characterized by high energy, communal experiences, and widespread recreational drug use, provide fertile ground for Tusi’s popularity to grow. Within these milieus, drug culture often involves experimentation and poly-substance use, where drugs are consumed in combination or sequentially to modulate effects. Tusi’s multifaceted nature—melding stimulant and dissociative properties—may explain its appeal yet simultaneously increases the unpredictability and dangers intrinsic to its consumption.
The pharmacological unpredictability of Tusi is particularly concerning given the complex interactions between its constituent drugs. Ketamine’s NMDA receptor antagonism induces dissociation and altered cognition, while MDMA’s action on serotonin, dopamine, and norepinephrine pathways promotes euphoria, empathy, and stimulation. When combined, these substances may potentiate cardiovascular strain, neurotoxicity risk, and impaired judgment. Furthermore, the occasional presence of cocaine—a potent stimulant with a distinct mechanism involving dopamine reuptake inhibition—further complicates the physiological burden. These overlapping yet distinct pharmacodynamics result in a cocktail wherein dosage titration and effect prediction become exceedingly difficult, posing significant challenges for emergency medical intervention when adverse reactions occur.
Public health authorities face considerable hurdles in addressing Tusi’s rise. The drug’s mislabeling and clandestine distribution chains obscure its detection, complicating outreach and harm reduction strategies. Many users remain unaware of the true nature of what they are ingesting, which hinders informed consent and safe usage practices. The study by Palamar et al. calls for expanded drug-checking services, educational campaigns about the risks of Tusi’s multi-drug composition, and improved surveillance to monitor evolving trends. Enhanced analytical capacity—including rapid on-site chemical assays—could empower users and health workers alike to make more informed decisions and reduce potential harms.
This growing landscape of adulterated and polydrug mixtures such as Tusi also reflects broader transformations within the illicit drug market. The commodification of novelty, exotic branding, and synthetic blends appeals to a generation immersed in digital and festival cultures seeking distinct psychoactive experiences. Yet this innovation comes at a cost—heightened uncertainty regarding drug content and safety, as well as increased incidences of unintentional overdoses and poisonings. Addressing these challenges requires interdisciplinary collaboration encompassing public health, law enforcement, social services, and communities—a multifaceted response to an increasingly complex drug environment.
Finally, the documentation of Tusi’s emergence within a US context has significant implications for future research and policy. The New York City study offers a critical starting point for deeper longitudinal tracking, biochemical analyses, and qualitative assessments of user perceptions. It demonstrates the need for culturally sensitive approaches, especially as use patterns differ by ethnicity and incorporate other substances. Policymakers and health authorities must recognize the shifting terrain of recreational drugs, moving beyond traditional paradigms to anticipate new risks embedded within substances like Tusi. Timely adaptation, data transparency, and community engagement will be the cornerstones of effective responses to this evolving challenge.
In conclusion, Tusi exemplifies the complexities posed by modern illicit substances that defy simple categorization or expectation. Its misleading branding as a psychedelic or cocaine analogue not only confuses consumers but raises profound health risks owing to its true composition as a poly-drug concoction predominantly featuring ketamine and MDMA. The unfolding public health concerns highlighted by Dr. Palamar and colleagues underscore the urgency of improved detection, education, and harm reduction strategies to safeguard nightlife populations. By shedding light on this hidden facet of urban drug culture, the study catalyzes awareness and action against an often invisible but increasingly impactful public health threat.
Subject of Research: People
Article Title: Tusi Use among the New York City Nightclub-Attending Population
News Publication Date: 21-Apr-2025
Web References:
https://onlinelibrary.wiley.com/doi/10.1111/add.70069
http://dx.doi.org/10.1111/add.70069
References:
Palamar JJ, Abukahok N, Acosta P, Krotulski AJ, Walton SE, Stang B, and Cleland CM. Tusi Use among the New York City Nightclub-Attending Population. Addiction. 2025. DOI: 10.1111/add.70069
Keywords: Tusi, tucibí, pink cocaine, ketamine, MDMA, electronic dance music, nightclub drug use, drug adulteration, 2C drugs, public health, polydrug mixtures, drug epidemiology
