This week's NDEWS Hotspot Alerts report shows counties with higher-than-expected counts of nonfatal methamphetamine-involved overdoses between August 1 - September 30, 2024. During this time span, there were 20 alerts across 12 states and 19 counties. Click here to read the full report.

Click here to read more about NDEWS Hotspot Alerts.

What is Tucibi? Tucibi, also known as "tusi" or "pink cocaine," is a polysubstance concoction that has emerged in recent years. Tucibi and Tusi are the phonetic translations of 2C-B and 2C, respectively, but this concoction rarely contains 2C series drugs.

What was found? Since early 2020, there has been a steady upward trend in mentions of Tucibi, which has continued through 2024. The web monitoring team's last report on Tucibi was on July 19, 2024.

How is it being discussed? Online discussions about Tucibi often center on its inconsistent effects and ingredients. Reddit users report that Tucibi is a highly variable mixture of various substances, including MDMA, ketamine, caffeine, “bath salts”, fentanyl, and/or other opioids. There is frequent mention of its popularity as a recreational substance, particularly in rave settings. Discussants often warn about the unpredictability of its effects due to variability in what drugs the mixture contains. The inclusion of highly potent and dangerous substances like fentanyl in some Tucibi mixtures is a particular cause for concern in these discussions. There is also a discussion of distrust towards Tucibi due to its purported origin in Central American cartels.

Expert Insight: NDEWS Deputy Director Joseph Palamar has been investigating Tusi since early 2023 and recently authored a report describing the epidemiology of this concoction. In recent months, Tusi has begun to be widely covered by media stories since the concoction was noted to be used by the artist Diddy and in response to a seizure of over 100 lbs. of Tusi being seized off the coast of California.

Drug Terms: Tucibi, tusi, tussi, pink cocaine, pink tusi

In a recently published article by Dr. Mark S. Gold from Psychology Today, Dr. Linda Cottler provided insight into the polysubstance tusi, which may consist of a mixture of ketamine, ecstasy, methamphetamine, and novel designer drugs that is also known as pink cocaine or tusi. "Tinted with food coloring, this concoction is usually very cheap, which attracts people to use," she said. "It is one more dangerous drug we need to worry about. Parents should show pictures of tusi to their children and explain the dangers of its use."

Dr. Bruce Goldberger was also interviewed and added that the make-up of the substance is variable, which reduces the value of self-testing in reducing harm. “Pink cocaine is a dangerous mix of dissociative, stimulant, and opioid substances," he said. "Which of these substances are present in what a consumer buys and uses varies. Also, the amount of each psychoactive substance varies. The best approach to 2C harm reduction is not to try it.”

According to Dr. Joseph Palamar, “The only ingredient that won’t get users high is what gives the drug its distinctive pink color: food coloring. It’s the new mystery powder to hit nightclubs."

Read the article here. 

Photo credit: Mauríco Mascaro/Pexels

NDEWS Sentinel Site Directors and others have been reporting similar trends, echoing those detailed by reader submissions, following NDEWS' public service announcement regarding non-drug substance, BTMPS, being found in the drug supply:

San Diego, CA: Annick Bórquez, PhD

There have been important, rapid changes in the unregulated drug supply over the past few months in San Diego.

The overall mix of components in a drug seem to remain the same (i.e., drug, adulterants, contaminants), but the amount and quality of these components are changing.

BTMPS has been identified in San Diego and its effects seem to vary from person to person, but some have reported large bruises at the site of injection that disappear after a couple of hours.

Seattle, WA: Jason Williams, PhD

The Center for Community-Engaged Drug Education, Epidemiology & Research (CEDEER) at the University of Washington published a data brief on BTMPS in Washington state.

From June through mid-September, BTMPS was found in 7% of 307 samples collected at community drug checking network sites and 12.5% of 160 samples sold as fentanyl.

All "sold as fentanyl" samples positive for BTMPS were in powder/rock form in Washington, in contrast to other states. BTMPS has also appeared in medical examiner investigations.

Additionally, there appear to be disruptions in the drug supply, such that fentanyl analogues may be present in the absence of fentanyl itself.

Additional Communications:

In addition, the Street Drug Analysis Lab at University of North Carolina supplied the following report. Alice Bell, of Prevention Point Pittsburgh (PPP), reported traces of BTMPS in a counterfeit yellow Xanax pill containing bromazolam without fentanyl.

View the full report on BTMPS trend responses here

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A research article on developing and implementing primarily virtual community-driven research (CDR) projects during the COVID-19 pandemic was recently published in Sociological Methodology. Co-authored by NDEWS Sentinel Site Director Caty Simon, the report provides valuable insights into new approaches for reducing morbidity and mortality during multiple crises. The project involved more than two years of collaboration, including weekly group meetings in National Survivors Union online spaces, as well as group and individual text conversations, phone calls, and shared-document group work.

Read the article here. 

A study published in the Journal of the American Medical Association (JAMA) by Jamie K. Lim and colleagues determined that pre-hospital emergency services (EMS) encounters for opioid overdoses among youth increased at the beginning of the COVID-19 pandemic and remained higher than pre-pandemic levels throughout the pandemic.

Read the study here. 

Dr. Cassidy Loparco, a researcher at George Washington University studying novel psychoactive substances, penned an editorial in Addiction calling for restrictions on the sale of tetrahydrocannabinol-infused beverages.

According to the editorial, these beverages are sold online as well as in dispensaries, large alcohol retailers, and some bars and restaurants. Containing a variety of active compounds, including delta-9 THC, delta-8 THC, tetrahydrocannabivarin (THCV), cannabidiol (CBD), cannabinol (CBN), melatonin, and caffeine, they are also more rapidly absorbed than THC-infused food, resulting in a quicker onset but shorter duration.

Read more here. 

Photo credit: Elsa Olofsson/Pexels.com

The Tox Chat Box vodcast series, presented by the Center for Forensic Research and Education, features leading experts in the field of forensic toxicology. In the video linked below, Pierre Negri and Alex Krotulski explore novel psychoactive substances (NPS) characterization and identification with accurate mass spectrometry.

To view the video, click on the thumbnail below. 

While CDC data show a national decline in overdose deaths by about 10% between April 2023 and April 2024, a recent Salon article featuring NIDA Director Dr. Nora Volkow and NDEWS SAG Member Dr. Daniel Ciccarone highlights that overdose deaths continue to rise among Native American, Black, and Hispanic communities.

Read more here.

Photo credit: Stockcake.com

Date: Friday, October 11, 2024

Time: 11:00 a.m. – 12:30 p.m. ET

Location: Virtual

Learn more and register here

Webinar presenters include:

Alex Krotulski - Director of Forensic Toxicology and Chemistry at the Center for Forensic Science Research and Education (CFSRE)

Michael Evans-Brown - Principal Programme Manager for Risk Assessment and Risk Communication at the European Union Drugs Agency (EUDA)

Conor Crean - Scientific Affairs Officer in Laboratory and Scientific Services of the Division of Policy Analysis and Public Affairs at the United Nations Office on Drugs and Crime (UNODC)

Svante Vikingsson - Senior Research Forensic Scientist at RTI International and is the Chair of the NPS Committee for The International Association of Forensic Toxicologists (TIAFT)

Date: Wednesday, October 16, 2024

Time: 1:00 p.m. – 2:30 p.m. ET

Location: Virtual — Register here.

Learn more here. 

Date: Monday, November 11 – Wednesday, November 13, 2024

Location: Philadelphia, Pennsylvania, USA

Learn more here. 

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