In this week’s report, NDEWS highlights observations from biospatial.io detailing the EMS encounters in the US for nonfatal tusi-related overdoses from 2022 to 2025. The data shows that all counties with the highest rates of nonfatal tusi-related overdose encounters over 38 months were on the east coast and west coast—especially the southeast and southwest of the US. Among states with at least 75% coverage,* there were 105 nonfatal tusi-related overdose encounters.

To view the entire Special Report from our Weekly Briefing, click here.

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What was found? Tucibi had a steady increase from early 2020 to September 2024. There was a sharp increase from September to November, likely due to discussion about the death of Liam Payne that occurred October 16, 2024. This was followed by a sharp drop from November to January and activity has remained steady since then.

Past Reports:
October 11, 2024
July 19, 2024
February 2, 2023

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.

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 risk of 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.

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

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A recently published case report in the Journal of Forensic Sciences by Moore et al. examines eight fatalities in Miami-Dade County associated with the ingestion of “tusi,” also known as “pink cocaine.” The report highlights the variable composition of these colored powders, which were found within ketamine-positive cases, frequently in combination with MDMA, and occasionally with other stimulants (cocaine, methamphetamine, MDA), opioids (oxycodone), benzodiazepines (alprazolam), and synthetic cathinones (eutylone). Notably, none of the powders contained 2C-B, despite the name's phonetic association with the 2C-class of hallucinogens.

Read more here.

Media Coverage
 - 'Pink cocaine' identified in South Florida overdose deaths - USA Today

A recently published editorial in the Journal of Medicinal Chemistry by Barbaro and Bouchard explores the growing prevalence of “pink cocaine” (also known as “tusi” or “tucibi”) and its deceptive marketing as a stimulant similar to cocaine. The authors clarify that pink cocaine is not a new drug, but an inconsistent mixture primarily composed of ketamine and MDMA, often laced with additional psychoactive substances, including amphetamines, opioids, and tranquilizers. Analysis of 68 samples submitted to drug-checking programs between 2016 and 2024 found ketamine in 94% of cases and MDMA in 81%, with wide variability in composition and potency.

Read more here.

A recent news report from KDVR Denver highlights the emergence of "tusi," or pink cocaine, in Colorado, as identified by the U.S. Drug Enforcement Administration Rocky Mountain Division during recent raids. DEA officials note that the drug, which has been circulating in Miami and other U.S. cities, is now appearing "quite a bit" in Colorado’s party and club scene. Given its inconsistent composition and unknown potency, authorities warn of its serious risks, particularly in overdose potential and dangerous drug interactions. Law enforcement is monitoring the drug’s presence and its potential connections to organized crime networks.

Read more here.

Submit any information concerning the use of tusi in your area here.

Is there any other information NDEWS should know about related to substance use, overdoses (fatal or nonfatal) or other drug-related trends in your area, including trends associated with polysubstance or co-use? Share it via our submission form here!

A recently published study in Journal of Community Health by Abukahok et al., co-authored by NDEWS Co-Director Dr. Palamar, examined naloxone acceptance among nightclub attendees in New York City. Of 991 adults surveyed, 62.1% agreed to receive a naloxone kit, but only 49.6% were recorded as accepting a kit. Higher acceptance was linked to NYC residency (aPR = 1.41), naloxone familiarity (aPR = 1.27), and greater readiness to intervene in overdoses (aPR = 1.18). Misconceptions were common—35.4% mistakenly believed naloxone reverses cocaine or any drug effects.

Read more here.

📅 Date: Wednesday, April 9, 2025

🕑 Time: 3:00 pm ET

📍 Location: Online

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📅 Date: Thursday, April 10, 2025

🕑 Time: 11:00 am to 12:30 pm ET

📍 Location: Online

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📅 Date: Thursday, April 10, 2025

🕑 Time: 3:30 pm to 5:00 pm ET

📍 Location: Online

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📅 Dates: May 29 - May 30, 2025

📍Location: UF Academic and Research Center at Lake Nona, Orlando, FL

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📅 Dates: June 2 - 4, 2025

📍 Location: University of Puget Sound, Tacoma, WA

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📅 Date: Friday, June 20, 2025

📍 Location: New Orleans

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If you miss or want to learn more about NDEWS Original Content, you can find our archived content on the NDEWS website:

     • NDEWS Hotspot Alerts using substance-related EMS data
     • NDEWS Rapid Street Reporting (RSR) survey data reports
     • NDEWS Web Monitoring Team Reddit Alerts
     • NDEWS Sentinel Site Reports
     • Previous issues of the NDEWS Weekly Briefings

The Weekly Briefing is a newsletter published each week by the National Drug Early Warning System (NDEWS) Coordinating Center, which is funded by the National Institute on Drug Abuse (U01DA051126) to the University of Florida (MPI: Cottler (contact), Co-Is: Goldberger, Nixon, Striley), New York University (MPI: Palamar), and Florida Atlantic University (Co-I: Barenholtz). Any item may be reproduced provided the source is acknowledged.