Not So Pretty Pink Cocaine

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There’s a new-ish drug in town, highly dangerous and unpredictable, and causing effects from euphoria to seizures, anxiety, hallucinations, heart rate changes, and even cardiac arrest. Pink cocaine, also known as “tusi” or “tucibi,” is a designer drug containing no (or almost no) cocaine and a mix of psychoactive substances. The composition of the drug varies widely depending on the batch, but common ingredients include pink food coloring, ketamine (a dissociative anesthetic), MDMA (ecstasy), and methamphetamine. Other substances like caffeine, opioids, fentanyl, or novel designer drugs may be present, making it an even more unpredictable and dangerous drug. “Pink cocaine,” name-dropped in the “Diddy” Combs lawsuit, was recently tied to the death of former One Direction singer Liam Payne. This designer drug was found in Liam Payne's autopsy .

Pink cocaine, which originated in Colombia, was also named after the synthetic compound “2C,” though it rarely contains this substance. It has been a party drug in Latin America since about the 2010s, particularly in Colombia and Mexico, but it has spread to Europe and parts of North America. Tusi is particularly linked with reggaeton music scenes and Latin American party culture. This connection is part of its image as a trendy, exotic, and high-status substance. Pink cocaine has also gained popularity in Miami. Miami's vibrant nightlife and party culture make it a hot spot for the drug, particularly at invitation-only VIP events and upscale venues. As in other regions, typical users in Miami tend to be young adults frequenting clubs, festivals, and private events. Miami's close ties to Latin American cultures and its role as a gateway for drug trends from South America have contributed to the drug’s presence in the city.

The drug is pink because of pink food coloring, added during production to give it a distinctive appearance. Both the U.S. Drug Enforcement Administration (DEA) and the National Institute on Drug Abuse (NIDA) are concerned about the growing popularity of pink cocaine and the significant health risks it poses.

Scary Unknowns

According to expert Linda Cottler, PhD, MPH, at the University of Florida, “Tinted with food coloring, this concoction is usually very cheap, which attracts people to use. 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.”

One of the major risks of pink cocaine is the unknown composition of the drug, increasing chances of overdose or dangerous interactions, either alone or amplified when combined with other substances like alcohol. While there's no clear evidence of specific celebrities promoting pink cocaine, its association with Sean "Diddy" Combs and elite nightlife party scenes has played a major role in its allure. The media has portrayed the drug as popular and increasing in use in upper-class circles and at exclusive events. Young adults and adolescents who want to be like their celebrity heroes may emulate their drug behavior.

Sean “Diddy” Combs and Pink Cocaine

New drug crazes are often led by celebrity use rumors and their availability at underground party scenes that are sought-after invitation-only events. News coverage can act as inadvertent endorsements or advertisements. For example, reports of a pink “mystery powder” reportedly favored by mogul Diddy and linked to a dangerous Venezuelan gang are highly visible in New York City’s illicit drug scene, according to law enforcement sources. “It is cheaper than coke,” said Ray Donovan, former chief of operations for the U.S. Drug Enforcement Administration. “It is a cheap club drug.”

Sean “Diddy” Combs has been associated with tusi in many media stories and most recently through court filings and documents surrounding his arrest. Combs was arrested on sex crime and racketeering charges at a Manhattan hotel on September 16. Inside his hotel room, law enforcement allegedly found bags of pink powder.

Users of Pink Cocaine

Typical users of pink cocaine are young adults, often between the ages of 18 and 35 and part of urban, nightlife, or party scenes. These users tend to come from upper-middle-class backgrounds, with the drug especially popular at exclusive events, clubs, and festivals.

New York party scenes reported pink cocaine during 2023. According to NYU professor Joseph Palamar, PhD, “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."

Looking Back

The original psychedelic form of pink cocaine dates to 1974 and American biochemist, psychedelic pop hero, chemist, and pharmacologist Alexander Shulgin. Although he didn't synthesize "pink cocaine,” he is widely credited for its emergence. His past work includes resynthesizing MDMA in 1976, though the drug was first synthesized by Merck in 1912. Shulgin explored its potential for therapeutic use in PTSD and introduced the drug to psychotherapists, leading to its rise in popularity in therapeutic and recreational circles. Shulgin's contributions have made him a key figure in the world of psychedelics, and his work continues to influence both scientific research and underground psychoactive drug culture.

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Russian Roulette With Drugs

The growing popularity of pink cocaine is a stark reminder of the ever-changing landscape of illicit drugs, where entrepreneurship, social media trends, and risk-taking behaviors combine to create drug threats.

Experts compare taking pink cocaine to playing Russian roulette with dangerous unknown drug combinations. My own work shows pink cocaine is being field tested, and with time, we will be able to discover and report on all medical and psychiatric effects by cataloging the deaths and diseases that follow its use. This underscores how vital education, prevention, and harm-reduction services are in the face of the unpredictable and dangerous nature of pink cocaine. Public awareness campaigns and support services are also important in reducing harm.

Harm Reduction

One of the most urgent needs highlighted by the rise of pink cocaine is for emergency rooms, EMTs, and users to know what individuals have ingested by using drug-checking services. Theoretically, drug-checking kits could also be an important harm-reduction tool for people looking to test substances they intend to consume. Some experts believe self-testing could help users of illicit drugs like pink cocaine.

However, according to forensic toxicologist and national drug expert Dr. Bruce Goldberger, “The constitution of pink cocaine is so variable that self-testing has little value in the reduction of harm. Pink cocaine is a significant public health threat. Pink cocaine is a dangerous mix of dissociative, stimulant, and opioid substances. 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.”

The Presence of Fentanyl

In general, when a pink cocaine overdose is reported, experts default to the likelihood of fentanyl having been consumed and consequently treat with naloxone (Narcan) or nalmefene to try to reverse respiratory depression and loss of consciousness.

Summary

Media stories have covered pink cocaine widely since the concoction was noted to be used by Sean "Diddy" Combs at invitation-only parties and over 140 lbs. of tusi were seized off the coast of California in June. The synthetic drug concoction has popped up in a growing number of recent narcotics busts, including of an Upper East Side woman who allegedly openly sold it on a messaging app. Parents need to educate children about this very risky drug, what it looks like, its dangers, and what drugs it may include.