What is Tussi (Pink Cocaine) and why is it dangerous?

Tussi, also called Tusi or Pink Cocaine, is a synthetic drug mixture typically containing ketamine, MDMA, caffeine, and other adulterants. Despite its name, it rarely contains actual cocaine. The bright pink color comes from food coloring. It is extremely dangerous because users never know what substances or doses are in each batch, creating unpredictable effects and high overdose risk.

Why is Tussi called 'Pink Cocaine' if it doesn't contain cocaine?

The name 'Pink Cocaine' is a marketing tactic. Laboratory analysis by the DEA and UNODC confirms most Tussi samples contain ketamine, MDMA, and caffeine—rarely any actual cocaine. The pink color is artificial food dye. This deceptive naming makes the drug seem more familiar and desirable, but it's actually a completely different and more dangerous polysubstance mixture.

What are the withdrawal symptoms from Tussi?

Tussi withdrawal symptoms vary based on its unpredictable composition. Users may experience ketamine-related symptoms (depression, cognitive fog, cravings), MDMA-related symptoms (severe depression, anxiety, fatigue, sleep disturbances), or both. Medical supervision is recommended because withdrawal from polysubstance mixtures can be complex and uncomfortable.

Yes, Tussi can be addictive because it contains ketamine (which causes psychological dependence and tolerance) and MDMA (which affects serotonin and creates craving patterns). The combination of dissociative and euphoric effects reinforces repeated use. Users may develop tolerance quickly, requiring higher doses and increasing overdose risk.

What is serotonin syndrome and can Tussi cause it?

Serotonin syndrome is a potentially life-threatening condition caused by excessive serotonin activity. Because Tussi often contains MDMA (which floods the brain with serotonin), users face serious risk of serotonin syndrome—especially if combined with antidepressants or other serotonergic drugs. Symptoms include agitation, high fever, rapid heartbeat, muscle rigidity, and seizures. Call 911 immediately if these occur.

Is Tussi legal in New York?

No. Tussi contains Schedule I substances (MDMA) and Schedule III substances (ketamine), making possession, sale, and distribution illegal in New York. Penalties depend on the quantity and can include felony charges. If facing legal issues related to Tussi, seeking treatment may be considered favorably by courts.

Can I overdose on Tussi?

Yes, overdose is a serious risk with Tussi. Because its composition varies wildly, users cannot gauge safe doses. Overdose symptoms include respiratory depression, cardiac arrest, seizures, hyperthermia, loss of consciousness, and death. If someone is unresponsive after using Tussi, call 911 immediately.

What treatment is available for Tussi addiction on Long Island?

Long Island offers comprehensive polysubstance addiction treatment including medical evaluation, inpatient rehabilitation, intensive outpatient programs (IOP), individual therapy, and psychiatric care. Because Tussi contains multiple substances, treatment addresses both the dissociative (ketamine) and stimulant (MDMA) components. Call 844-338-6969 for immediate help finding treatment.

How long do Tussi effects last?

Reported effects usually begin within 15 to 30 minutes, peak at roughly 1 to 2 hours, and can last about 4 to 6 hours. Because each batch is mixed differently, duration is not predictable: a sample heavier in ketamine behaves differently from one heavier in MDMA or amphetamines, and mixtures can extend or intensify effects.

Can Tussi contain fentanyl?

It can. Drug checking and toxicology studies of tusi have identified prescription opioids and other unexpected substances alongside ketamine and MDMA, so opioid contamination is possible even though it is not the typical recipe. Because no visual check can rule it out, harm reduction guidance is to assume contents are unknown, never use alone, and keep naloxone (Narcan) available.

Is Tussi actually cocaine?

Usually not. Despite the name pink cocaine, laboratory and drug checking analyses find that most samples contain no cocaine and no 2C-B — the drug the name tusi originally referred to. Ketamine, often with MDMA and caffeine, is the most common combination, with the pink color coming from dye.

Illustration for a guide about tussi (pink cocaine) addiction

Substance

What Is Tusi? Tussi, Pink Cocaine, Ingredients and Risks

Tussi (also called Tusi or Pink Cocaine) is a dangerous synthetic drug cocktail typically containing ketamine, MDMA, and caffeine. Despite its name, it rarely contains cocaine and poses serious overdose risks due to unpredictable composition.

Published: November 25, 2025

Last Edited: February 17, 2026

15 min read

Written by

Benjamin Zohar, NCACIP

Nationally Certified Advanced Clinical Intervention Professional

Edited by

Ezra Zohar, M.S. Ed.

Editorial Director

Medically Reviewed by

Brandon McNally, RN

Medical Reviewer, ICU Critical Care Nurse

Published: November 25, 2025

Last edited: February 17, 2026

15 min read

Quick answer

Tussi, also called pink cocaine or “tucibi,” is usually a mixture of substances and may not contain cocaine at all. Laboratory analyses most often find ketamine, sometimes with MDMA, caffeine, amphetamines or other adulterants, dyed pink with food coloring.

Because there is no consistent recipe, two doses that look identical can differ completely in strength and contents. That unpredictability — not the color — is the core danger, and it includes the possibility of fentanyl or other opioids appearing as an adulterant.

Seek emergency care immediately (call 911) for unresponsiveness, slowed or stopped breathing, seizures, chest pain, very high body temperature or severe agitation after use.

How Tussi (Pink Cocaine) Affects You

Tussi produces unpredictable effects because its composition varies wildly. Common effects include dissociation (from ketamine), euphoria (from MDMA), increased energy (from caffeine/amphetamines), hallucinations, and altered perception. Users face heightened risk because they don't know what's actually in the powder.

Duration & Timeline

Effects begin within 15-30 minutes, peak at 1-2 hours, and can last 4-6 hours. Because Tussi is often a mixture of ketamine, MDMA, and other substances, effects can be prolonged and unpredictable. Withdrawal varies based on actual drug composition.

Specific Health Risks

Overdose is extremely dangerous due to unknown composition and polysubstance effects. Risks include serotonin syndrome, cardiac arrest, respiratory depression, seizures, hyperthermia, kidney/liver damage, and death. The bright pink color is from food coloring and offers no safety indication.

Tussi (Pink Cocaine) Statistics & Research

• DEA reports Tussi seizures increased 300% from 2020-2023 across the United States
• Laboratory analysis shows 'pink cocaine' rarely contains actual cocaine—most samples contain ketamine, MDMA, and adulterants
• Emergency department visits for Tussi-related overdoses increased significantly in major US cities from 2021-2023
• UNODC World Drug Report identifies Tussi as an emerging threat originating from South America, now spreading through US club scenes

Sources: NIDA, SAMHSA, CDC, DEA, FDA, peer-reviewed medical journals. See full references below.

Frequently Asked Questions

Why Choose Professional Treatment in New York

Professional addiction treatment provides the medical supervision, therapeutic support, and structured environment necessary for successful recovery from tussi (pink cocaine). Evidence-based treatment programs address both the physical and psychological aspects of addiction.

Treatment centers throughout Long Island and New York offer specialized programs accredited by The Joint Commission and licensed by the New York State Office of Addiction Services and Supports (OASAS). These facilities combine medical care, evidence-based counseling, and ongoing support to ensure the best possible outcomes for lasting recovery.

According to data from the New York State OASAS, treatment completion rates are highest when individuals receive comprehensive care that includes medical management, individual therapy, group support, and family involvement in the recovery process.

Medical References & Sources

This page contains information sourced from peer-reviewed medical literature, federal health agencies, and accredited medical institutions to ensure accuracy and compliance with E-E-A-T (Experience, Expertise, Authoritativeness, and Trustworthiness) standards.

United Nations Office on Drugs and Crime (UNODC). "World Drug Report 2023: Emerging Drug Threats." UNODC Publications, 2023. Available at: https://www.unodc.org/unodc/en/data-and-analysis/world-drug-report-2023.html
Drug Enforcement Administration (DEA). "Tucibi (Tussi/Pink Cocaine): Emerging Drug Threat." DEA Publications. Available at: https://www.dea.gov/resources/emerging-threats
Zohar, B.. "TUSI (Pink Cocaine): What It Is, Risks, and Where to Get Help." ISSUP - International Society of Substance Use Prevention and Treatment Professionals, 2025. Available at: https://grn.issup.net/es/knowledge-share/resources/2025-09/tusi-cocaina-rosa-que-es-riesgos-y-donde-obtener-ayuda
Palamar, J.J.. "Tusi: a new ketamine concoction complicating the drug landscape." The American Journal of Drug and Alcohol Abuse, 2023 DOI: 10.1080/00952990.2023.2207716. Available at: https://doi.org/10.1080/00952990.2023.2207716
Abukahok, N., Fitzgerald, N.D., & Palamar, J.J.. "An Update on the Epidemiology of Tusi (“Pink Cocaine”)." Current Addiction Reports, 2025. Available at: https://pubmed.ncbi.nlm.nih.gov/41583387/

Medical Disclaimer

The information provided on this page is for educational purposes only and should not be considered medical advice. This page does not provide medical diagnoses, treatment prescriptions, or clinical recommendations. Always consult with qualified healthcare professionals for diagnosis and treatment of substance use disorders. If you are experiencing a medical emergency, call 911 immediately.

This content was written by certified addiction professionals and reviewed by licensed medical practitioners to ensure accuracy and adherence to current clinical guidelines. Last fact-checked: October 25, 2026.

If you or someone you know is struggling with substance use, you can reach our 24/7 confidential Long Island Rehab Helpline at 844-338-6969 for free, confidential information and treatment referral.