Understanding the Implications of Pink Cocaine in Substance Use

Makeba Royall, LCSW Senior Practice Associate, Behavioral Health

December 2025

The impact of substance use on communities continues to exist. As social workers continue to raise awareness for well-known drugs, new drugs are being formulated making it exceedingly difficult to stand in front of the current substance use crisis that saturates communities at alarming rates. Tusi, also referred to as “Pink Cocaine,” has become increasingly popular. What precisely is Tusi, and what effects is it having on communities? The purpose of this practice tool is to raise awareness about a more recent substance use trend and to educate social workers on how we can help.

What is Tusi - Pink Cocaine

Tusi which is the phonetic spelling for 2C is a category of drugs within the phenylethylamine family, which includes 2C-B and is known to provide euphoria and hallucinations. When Tusi first appeared within the drug market it was a drug that contained synthetic stimulants 2C or 2C-B. 2C-B is currently classified as a Schedule I controlled substance, which means the substance is not accepted for medical use and has a high potential for misuse, abuse or addiction and may not be prescribed, dispensed or administered. (Lopez et al., 2023).

2C-B was first created by Alexander Shulgin, a biochemist, in 1974 for use in psychotherapy. Since 1974 the drug has evolved and has been found in urban areas and club scenes in Miami, New York and Los Angeles. In the 1990’s Tusi had been circulating in the European rave and party scene and later became popular in Columbia in the 2000’s. Eventually, due to the demand, the drug market changed to meet the needs which began the creation of pink cocaine. In more recent times it rarely contains 2C-B and is now an Illicitly manufactured mixture of drugs dyed pink with food coloring or colored baking powder, which is why it is called, pink cocaine. While at times it may contain cocaine it does not always contain cocaine.

Every batch that is made in powder or pill form can be different and may contain a mixture of stimulants, hallucinogens, opioids, and other psychoactive substances. Any combination of ketamine, ecstasy, methamphetamine, cocaine, fentanyl, oxycodone and tramadol may be mixed to create pink cocaine. Due to the mixture of stimulants and depressant drugs one can easily overdose when using it.

Effects on the Community

Although there has been little data to date due to the most recent trend in use of pink cocaine there have been clear signs the drug deserves more attention. Miller (n.d.) reports in January 2023, there was a seizure of 10 pounds of pink cocaine in New York City. Six months later, there was a seizure of 140 pounds of Tusi off the coast of California. Furthermore, the Society for the Study of Addiction, reports 2.7% of electronic dance music-nightclub attending adults in New York City used Tusi in the past year with higher use among Hispanic individuals and people exposed (sometimes unintentionally) to other drugs. (Palamar et al., 2025).

With its misleading name, it can be confused as containing only cocaine, however the drug has caused great concern because it can be unpredictable and lethal due to its mixture of stimulants and depressant drugs. In December 2024, Drug Enforcement Agency (DEA) warned of pink cocaine presence in Los Angeles indicating it was being found at a retail level within the night life and club scene. In January 2025, a South Florida medical examiner linked several overdose deaths due to the use of pink cocaine. Later in May 2025, the state of Louisiana issued a deadly pink cocaine warning after an increase in overdoses due to the drug. The ever-changing concoction of how the drug is made has had an impact on people who use pink cocaine. As a result, when people are not aware of the strength, contents or potential effects of what they are consuming, they are at risk for acute toxicity, misadventure, or overdose. (Barbaro & Bouchard, 2024).

Treatment-Related Concerns

According to the United States Drug Enforcement Administration pink cocaine has had an emergence because it is being marketed as a “new drug” and caters to the polydrug use population (Pink Cocaine, n.d.). CDC reported in 2022, nearly half of drug overdose deaths involved multiple drugs (SUDORS Dashboard: Fatal Drug Overdose Data, 2025). Much like fentanyl, pink cocaine is being mixed with multiple illicit drugs which increases the risk of use. Polysubstance dependence may result from this, and because of the potential for overlapping withdrawal symptoms, treatment may be challenging. It may also be challenging to refrain from use.

As a result of mixing, treatment can be complex when multiple substances are involved and may include an approach that is specific to each substance to help address withdrawal symptoms, which may include but are not limited to low energy, irritability, restlessness, muscle aches, nausea, anxiety, mood swings, and depression. Polysubstance use impacts treatment, harm reduction efforts and the approach to detoxification

How Can Social Workers Help

Because of unintentional polysubstance use the illegal drug market is changing and evolving quickly. As a result, social workers must become familiar with symptoms from use, which may include but are not limited to oversedation, respiratory depression, shallow breathing, low blood pressure, vomiting, seizures, and high levels of anxiety or panic. When we familiarize ourselves with potential effects related to drug use, we can engage in well-informed discussions with the people we serve and with multidisciplinary teams regarding treatment and harm reduction initiatives.

We should be prepared to have conversations around the potential for overdosing. This can be done by offering early intervention and treatment services to individuals who could be at risk of substance use or misuse by using the Drug Abuse Screening Test (DAST). By using the DAST screening tool we can assess the severity of use, discuss harm reduction interventions, and identify appropriate levels of care when necessary

Because co-occurring disorders are frequently seen we may utilize motivational therapy, psychoeducation and group therapy to provide services for individuals who may be experiencing both substance use and mental health conditions.

Lastly, we can help individuals build community by making referrals to support groups which can be a helpful way to assist with treatment and recovery. We can encourage individuals, children and families to use support groups to help with managing the ebbs and flows related to use, misuse and recovery.

Resources

Barbaro, L., & Bouchard, J. L. (2024). What Is Pink Cocaine? The Dark Reality behind a Colorful Name. Journal of Medicinal Chemistry, 67(23), 20733–20736. https://doi.org/10.1021/acs.jmedchem.4c02821

Centers for Disease Control and Prevention. State Unintentional Drug Overdose Reporting System (SUDORS). Final Data. Atlanta, GA: US Department of Health and Human Services, CDC; 2024, March, 8. Access at: https://www.cdc.gov/overdose-prevention/data-research/facts-stats/sudors-dashboard-fatal-overdose-data.html

Drug Abuse Screening Test. (n.d.). Drug abuse screening test. https://oasas.ny.gov/system/files/documents/2022/11/dast-10.pdf

Lopez, M. J., Preuss, C. V., & Tadi, P. (2023, July 30). Drug Enforcement Administration Drug scheduling. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK557426/

Miller, J. R. (n.d.). ‘Pink Cocaine’ Emerging as New Threat in Drug Market, Experts Warn. Newsweek. https://www.newsweek.com/pink-cocaine-drugs-narcotics-tusi-dea-coastguard-1923902

Palamar, J. J., Abukahok, N., Acosta, P., Krotulski, A. J., Walton, S. E., Stang, B., & Cleland, C. M. (2025). Tusi use among the New York City nightclub‐attending population. Addiction, 120(8), 1646–1654. https://doi.org/10.1111/add.70069 Pink Cocaine. (n.d.). DEA. https://www.dea.gov/pink-cocaine

Salmassi, M. (2025, April 17). What is Pink Cocaine (Tusi), and Why is it Dangerous? Partnership to End Addiction. https://drugfree.org/article/what-is-pink-cocaine-tusi-and-why-is-it-dangerous/

Team, F. 1. D. (2024, December 12). DEA warns of “pink cocaine” in Los Angeles. FOX 11 Los Angeles. https://www.foxla.com/news/dea-warns-pink-cocaine-los-angeles

Walker, D., & Goñi-Lessan, A. (2025, January 30). What is pink cocaine? It’s not always cocaine and has caused Florida deaths. What’s in it. The Palm Beach Post. https://www.palmbeachpost.com/story/news/2025/01/30/pink-cocaine-florida-drug-overdose/78016783007/