Pink cocaine has been showing up in headlines, on social media, and in the conversations of parents, partners, and friends who are worried about someone they love. The name sounds like a single, identifiable drug. It isn't. According to the U.S. Drug Enforcement Administration (DEA), pink cocaine is a powdered mixture of substances, dyed pink, that may have a sweet smell and typically produces mind-altering, hallucinogenic effects. What's actually in any given batch is unknown until a sample is tested in a lab, and it likely contains no cocaine at all.
At MATClinics, we operate eight outpatient addiction treatment locations across Maryland and treat the substance use disorders most often tied to pink cocaine use: stimulant use disorder, opioid use disorder, and the broader risks of polysubstance use. If you or someone you love has used pink cocaine and is struggling, you are not alone, and same-day appointments are available.
This post explains what pink cocaine is, why it's so dangerous, and what to do if it's affecting your life.
What Is Pink Cocaine?
Pink cocaine is also called tusi. The name comes from the original active compound in the drug, 2C-B, a psychedelic phenylethylamine. Once 2C-B became harder to get, drug organizations shifted to selling a drug cocktail dyed pink and marketed under the same name. Today, pink cocaine rarely contains 2C-B anymore.
According to DEA laboratory testing, pink powders sold as pink cocaine have been identified containing combinations such as:
- Ketamine and MDMA
- Methamphetamine, ketamine, and MDMA
- Cocaine and fentanyl
- Fentanyl and xylazine
The pink color comes from food dye or colored baking powder. It's used to distinguish pink cocaine from other substances such as cocaine and methamphetamine, not to indicate anything about what's inside.
Why Pink Cocaine Is So Dangerous
The danger of pink cocaine isn't tied to a single ingredient. It's tied to the fact that no two batches are the same. According to the DEA, the only commonality of pink cocaine is its bright pink coloring. Beyond the dye, every dose can contain a different mix of substances at different concentrations, and the person taking it has no way of knowing how their body will react.
A few of the specific risks:
- Unknown stimulant load: When the mix contains methamphetamine, cocaine, or both, users can experience the cardiac and neurological effects of high-dose stimulant use without knowing they took stimulants at all.
- Hallucinogenic effects: Much like MDMA or ecstasy, pink cocaine is a mind-altering psychedelic drug, per the DEA. Effects can be unpredictable, intense, and difficult to manage without medical support.
- Fentanyl contamination: Some pink cocaine samples seized by the DEA contained fentanyl, often combined with xylazine. Fentanyl now contaminates much of the broader drug supply, including cocaine, counterfeit pills, and MDMA, which means a person using pink cocaine may be exposed to a potent opioid they did not knowingly take, and have no opioid tolerance.
- Polydrug marketing: Dealers are marketing pink cocaine as a "new" drug and catering to the polydrug user population, according to the DEA. This framing can make it feel safer or more novel than the substances it actually contains.
The combined message is simple: ingesting an unknown substance or drug cocktail is dangerous and can be deadly.
What's Actually in Pink Cocaine?
Because there is no standard recipe for pink cocaine, the only honest answer is: it depends on the batch. What is sold as pink cocaine may contain different combinations of drugs, and those combinations can change from one supply to another.
According to the DEA, common ingredient combinations may include:
- Ketamine + MDMA: This combination can create both dissociative and stimulant-like effects. It may increase the risk of confusion, dissociation, dangerous drug interactions, and breathing problems.
- Methamphetamine + ketamine + MDMA: This mix combines stimulant effects with dissociation, which can place serious strain on the body. Key risks may include cardiovascular stress, overheating, severe agitation, and unpredictable behavior.
- Cocaine + fentanyl: This combination is especially dangerous because it mixes a stimulant with a powerful opioid. It can increase the risk of overdose, respiratory depression, and loss of consciousness.
- Fentanyl + xylazine: This mix combines an opioid with a veterinary sedative. It may cause prolonged sedation, slowed breathing, overdose, and a more complicated overdose response.
The effects of pink cocaine can vary greatly, but the underlying risk is consistent: a person cannot know exactly what they are taking or how their body will react each time they use it.
How Widespread Is Pink Cocaine?
Per the DEA, pink cocaine is currently not a commonly trafficked substance, and state and local law enforcement are more likely to encounter it at the retail level. Since 2020, DEA has seized a total of 960 pink powders. Of those, only 4 exhibits contained 2C-B, while 956 contained "other" substances. To put that in perspective, in the same time frame, DEA has seized 180 million fentanyl pills.
Pink cocaine has been most commonly identified in urban areas with active night club scenes, such as Miami, New York, and Los Angeles, according to the DEA. As polydrug use grows, awareness in other regions, including Maryland and the broader Mid-Atlantic, matters too.
Pink Cocaine and the People We Treat
At MATClinics, pink cocaine isn't a separate diagnosis. It's a window into a bigger pattern: polysubstance use that often blurs the lines between stimulant use, hallucinogen use, and unintended opioid exposure. People we see in our clinics are dealing with one or more of the following:
- Stimulant use disorder: Often from cocaine, methamphetamine, or amphetamines. Pink cocaine commonly contains these substances. Stimulant use disorder is a medical condition where repeated stimulant use causes significant harm and stopping feels impossible.
- Opioid use disorder: Including fentanyl exposure. Because fentanyl is increasingly mixed into non-opioid drug supplies, including powders sold as pink cocaine, some patients develop opioid dependence without ever intending to take an opioid.
- Co-occurring mental health concerns: Including anxiety, depression, and the after-effects of hallucinogen use. Our team is trained in trauma-informed dual-diagnosis therapy.
If pink cocaine is part of someone's story, the treatment plan is built around what they're actually using and what their body and mind are actually doing, not the marketing on the bag.
How MATClinics Can Help
MATClinics provides outpatient addiction treatment tailored to each patient. Care can include:
- Medication-assisted treatment for opioid use disorder using Suboxone®, Sublocade®, Brixadi®, Vivitrol®, or Zubsolv®.
- Medication support for stimulant use disorder. While no FDA-approved medications exist specifically for stimulant use disorder, several have shown clinical benefit and are used at MATClinics based on each patient's needs, like topiramate.
- Substance use counseling, including individual, group, and Intensive Outpatient.
- Mental health therapy, including trauma-informed dual-diagnosis care.
- Psychiatry, available in person and via telemedicine.
- 24/7 patient support through a dedicated case manager you can reach between appointments.
We operate eight locations across Maryland, offer evening and Saturday office hours, schedule appointments 24/7, and patients are often seen the same day. We accept all Maryland Medicaid plans, Medicare Part B, and CareFirst BlueCross BlueShield.
Learn more about our outpatient treatment for stimulant use, opioid and fentanyl use, and medication-assisted treatment.
If You're Worried About Someone Using Pink Cocaine
A few things worth knowing:
- Because pink cocaine may contain fentanyl, having naloxone (Narcan) available is a meaningful safety step for anyone in the user's circle.
- Polysubstance use, including using pink cocaine alongside alcohol or other drugs, increases the risk of dangerous interactions.
- A person does not need to have stopped using before their first appointment at MATClinics. The first visit is a medical evaluation, not a test anyone can fail.
If you or a loved one is ready to talk to someone, schedule an appointment or call 410-907-7509.
Frequently Asked Questions
What is pink cocaine?
Pink cocaine is a powdered mixture of substances, dyed pink, that typically produces mind-altering, hallucinogenic effects. According to the DEA, what's actually inside any given batch is not known until a sample is tested, and pink cocaine likely contains no cocaine.
What is tusi?
Tusi is another name for pink cocaine. The name comes from the original active compound, 2C-B, a psychedelic phenylethylamine. As 2C-B became harder to get, drug organizations shifted to selling a drug cocktail under the same name, which today rarely contains 2C-B.
Is pink cocaine dangerous?
Yes. Pink cocaine is a mixture of several different substances, every batch is different, and a person does not know how their body will react each time. The DEA states clearly that ingesting an unknown substance or drug cocktail is dangerous and can be deadly. Some samples have also contained fentanyl.
Does pink cocaine contain fentanyl?
It can. DEA laboratory testing has identified pink powders containing combinations including cocaine and fentanyl, and fentanyl and xylazine. Because fentanyl now contaminates much of the broader drug supply, exposure can happen even when a person did not knowingly use an opioid.
Can MATClinics treat someone who has used pink cocaine?
Yes. MATClinics provides outpatient addiction treatment for the substance use disorders most often tied to pink cocaine use, including stimulant use disorder and opioid use disorder. Treatment can include medication, counseling, mental health therapy, psychiatry, and 24/7 patient support.
How do I start treatment at MATClinics?
Call 410-907-7509 or schedule an appointment online. Same-day appointments are often available. The first visit is a medical evaluation. You do not need to have stopped using before your first appointment.