Tusi use among the New York City nightclub-attending population.

About 2.7% of adults attending electronic dance music nightclubs in New York City reported using Tusi (also called pink cocaine or tusibí) in the past year. Tusi is a drug mixture often containing ketamine and other substances, and users may be unaware of its composition. Hispanic individuals had five times higher odds of use compared with white individuals. People who used ecstasy/MDMA, ketamine, or 2C series drugs in the past year were more likely to also use Tusi. Those reporting Tusi use were more likely to test positive for cocaine, ketamine, MDMA, methamphetamine, or synthetic cathinones via saliva testing, and some tested positive for cocaine, ketamine, or methamphetamine even without reporting past-year use of those drugs.

Study at a glance

Abstract

'Tusi', also known as 'tusibí' or 'pink cocaine', is a drug concoction which previously emerged in Latin America and Europe and has recently acquired popularity in the United States (US). Consumers are often unaware that Tusi contains a mixture of ketamine and other drugs, and the concoction can be confused with 2C/2C-B (ring-substituted phenethylamines/4-bromo-2,5-dimethoxyphenethylamine) or cocaine. This study aimed to estimate the prevalence and correlates of past-year Tusi use in the electronic dance music (EDM) nightclub-attending population in New York City (NYC), US. This cross-sectional study included surveys and optional saliva testing of adults entering randomly selected EDM events in NYC in 2024. Adults aged ≥18 years entering EDM events at nightclubs (n = 1465). Exposures were demographic characteristics and past-year use of other drugs. The primary outcome was self-reported past-year use of Tusi, and in a subsample, biologically confirmed exposure to various drugs determined by saliva testing. Based on self-report, an estimated 2.7% [95% confidence interval (CI) = 1.9-3.9] of adults in the NYC EDM nightclub-attending population have used Tusi in the past year. Compared with white individuals, Hispanic individuals were at higher odds for use [adjusted odds ratio (aOR) = 5.10, 95% CI = 1.96-13.25]. Compared with those who did not use, those who used ecstasy/3,4-Methylenedioxymethamphetamine (MDMA) (aOR = 6.59, 95% CI = 1.60-27.16), ketamine (aOR = 3.44, 95% CI = 1.18-10.08) and/or 2C series (aOR = 14.82, 95% CI = 4.77-46.04) in the past year were at higher odds for use. Compared with those not reporting Tusi use, those reporting past-year use were more likely to have saliva test positive for cocaine, ketamine, MDMA, methamphetamine and/or synthetic cathinones (Ps < 0.001). They were also more likely to test positive for cocaine, ketamine or methamphetamine after not reporting past-year use (Ps < 0.01). An estimated 2.7% of electronic dance music-nightclub attending adults in New York City appear to have used Tusi in the past year, with higher use among Hispanic individuals and people exposed (sometimes unintentionally) to other drugs.