Tusi: a new ketamine concoction complicating the drug landscape.
The American Journal of Drug and Alcohol Abuse September 3, 2023 DOI: 10.1080/00952990.2023.2207716 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | Ketamine Esketamine |
| Keywords | Tusi Club drugs New psychoactive substances Pink cocaine Emerging street drug Drug mislabeling Drug adulteration Misrepresented substances Deceptive drugs Nps Designer drugs Emerging drugs Recreational drugs Party drugs Nightlife drugs Drug safety Public safety Harm reduction User risks |
| Citations | 29 |
| Key findings | Tusi rarely contains 2C series drugs; most samples contain ketamine, often combined with MDMA, methamphetamine, cocaine, opioids, or new psychoactive substances. |
Abstract
A drug concoction called tusi has emerged in Latin America and in Europe and is now beginning to acquire popularity in the United States. "Tusi" is a phonetic translation of "2C," a series of psychedelic phenethylamines. The concoction is also sometimes referred to as "pink cocaine" as it typically comes in the form of pink powder. However, despite its name, the concoction rarely contains 2C series drugs. Multiple drug checking studies have found that the majority of tusi samples contain ketamine, often combined with 3,4-methylenedioxymethamphetamine (MDMA), methamphetamine, cocaine, opioids, and/or new psychoactive substances. The tusi phenomenon complicates the drug landscape because it has the potential to confuse both people who use it and researchers alike. People using may think the drug is 2C/2C-B, and they may also be unaware that the concoction tends to consist of ketamine and a wide variety of other drugs. Unintentional exposure to its contents can lead to increased risk of adverse effects. The tusi phenomenon also has the potential to complicate drug research as unknown exposure to drugs like ketamine and MDMA will lead to underreporting of use. A combination of self-report and toxicological testing may be needed to inform the most accurate estimates of use. Both researchers and people at risk for use need to be informed about this new concoction. Drug researchers need to be cognizant about the way they query use, and people at risk for using need to be educated about the possible contents of tusi and associated dangers.
Comparable studies
Other narrative reviews on ketamine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Ketamine and Ketamine Metabolite Pharmacology: Insights into Therapeutic Mechanisms | 2018 | Review | |
| Mechanisms of Ketamine Action as an Antidepressant | 2018 | Review | |
| Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation Adults with treatment-resistant depression | 2021 | Review | |
| Ketamine Pharmacology: An Update (Pharmacodynamics and Molecular Aspects, Recent Findings) | 2013 | Review | |
| A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders | 2017 | Review and consensus statement |
Citations in the library
Cited by 13
- Trends in poisonings involving ketamine in the United States, 2019-2023. Drug and Alcohol Dependence March 1, 2025
- Trends in ketamine use among nightclub attendees in New York City, 2017-2024. International Journal of Drug Policy June 1, 2025
- Tusi use among the New York City nightclub-attending population. Addiction April 20, 2025
- Monstrous substance: 'Tuci', pharmacopolitical assemblages and spectral materialities. International Journal of Drug Policy November 1, 2025
- Deaths following illicit ketamine use in England, Wales and Northern Ireland 1999–2024: An update report to inform the reclassification debate Journal of Psychopharmacology September 29, 2025
and 8 more in the library
Cites 7
- 4-Bromo-2,5-dimethoxyphenethylamine (2C-B): presence in the recreational drug market in Spain, pattern of use and subjective effects. Journal of Psychopharmacology July 1, 2012
- A qualitative descriptive analysis of effects of psychedelic phenethylamines and tryptamines Human Psychopharmacology: Clinical and Experimental 2020
- Acute Effects of the Novel Psychoactive Drug 2C-B on Emotions BioMed Research International 2015
- Trends in drug use among nightclub and festival attendees in New York City, 2017-2022. International Journal of Drug Policy May 1, 2023
- Consumption of new psychoactive substances in a Spanish sample of research chemical users. Human Psychopharmacology: Clinical and Experimental July 1, 2013
and 2 more in the library