What Is Pink Cocaine? The Dark Reality behind a Colorful Name

InfoMetricsFiguresRef. Journal of Medicinal ChemistryASAPArticle This publication is free to access through this site. Learn More CiteCitationCitation and abstractCitation and referencesMore citation options ShareShare onFacebookX (Twitter)WeChatLinkedInRedditEmailJump toExpandCollapse EditorialDecember 3, 2024What Is Pink Cocaine? The Dark Reality behind a Colorful NameClick to copy article linkArticle link copied!Lisa Barbaro*Lisa BarbaroVanderbilt University School of Medicine Basic Sciences, Warren Center for Neuroscience Drug Discovery, Franklin, Tennessee 37067, United States* [email protected]More by Lisa Barbarohttps://orcid.org/0009-0004-0685-4506Jacob L. BouchardJacob L. BouchardVanderbilt University School of Medicine Basic Sciences, Warren Center for Neuroscience Drug Discovery, Franklin, Tennessee 37067, United StatesMore by Jacob L. Bouchardhttps://orcid.org/0000-0002-5936-1244Open PDFJournal of Medicinal ChemistryCite this: J. Med. Chem. 2024, XXXX, XXX, XXX-XXXClick to copy citationCitation copied!https://pubs.acs.org/doi/10.1021/acs.jmedchem.4c02821https://doi.org/10.1021/acs.jmedchem.4c02821Published December 3, 2024 Publication History Received 18 November 2024Published online 3 December 2024editorialPublished 2024 by American Chemical Society. This publication is available under these Terms of Use. Request reuse permissionsThis publication is licensed for personal use by The American Chemical Society. ACS PublicationsPublished 2024 by American Chemical SocietyIn recent months, a synthetic drug commonly referred to as "pink cocaine" has captured headlines, with notable public figures reportedly linked to its hidden dangers. (1,2) Public fascination with what appears to be a new and mysterious "designer" drug has spurred a slew of media attention. The reality is that pink cocaine is neither a new drug nor cocaine; rather, it's an inconsistent and unpredictable formulation of existing drugs and adulterants─primarily ketamine and MDMA─branded with a distinctive rosy hue. This deceptive tactic, designed to lure and entice a new wave of recreational drug users, has little regard for the serious health risks posed by the complex and dangerous interactions among its components.Pink cocaine is an older phenomenon than the recent headlines suggest. It has been circulating in Colombia, where it is more commonly known as "tusi" or "tusibi", since the late 2000s, with the earliest reports dating back to 2012. (3) The nicknames "tusibi" and the shortened "tusi" derive from a phonetic translation of "2C-B", a hallucinogenic phenethylamine first synthesized by Alexander Shulgin in 1974. (4) Known to induce euphoria and hallucinations reportedly similar to a blend of MDMA and LSD, 2C-B belongs to the broader "2C-X family" of drugs (psychedelic phenethylamines containing 2,5-dimethoxy substitution) and was widely popular in the European rave and party scenes in the 1990s. In the late 2000s, 2C-B surfaced in Colombia's vibrant nightlife, where its reputation as a "designer" drug began to solidify. The signature pink hue was introduced as a way to mask the unpleasant and harsh taste of 2C-B when consumed, the food coloring and aromatic additives transforming the drug into a visually enticing and instantly recognizable powder.The drug's evolution to the pink cocaine product of today was driven by the surge in demand for 2C-B in the Colombian market. As supply chains struggled to keep up, dealers began cutting 2C-B with more accessible and cheaper psychoactive substances to mimic its stimulant and hallucinogenic effects. (5) Eventually, 2C-B disappeared from the formulation altogether, giving way to the current iterations of pink cocaine. Recently, law enforcement agencies and drug-checking services have reported an uptick in pink cocaine's presence beyond Latin America, particularly in Europe and North America. (6,7) In the United States, pink cocaine has slowly gained popularity within the club scenes in New York, Miami, and Los Angeles. In 2023, multiple large-scale seizures in the U.S. further underscored its growing popularity.The primary danger of pink cocaine lies in the unknown. Not only is the name itself misleading, giving the illusion of a stimulant akin to cocaine, but the user is completely unaware of the cocktail of substances hidden beneath its appealing pink shade. Aside from the pink food coloring, little about this drug is consistent. Each batch varies widely in composition and potency, exposing users to a risky blend of substances with unpredictable polypharmacology and drug–drug interactions. While the exact amounts and ratios of its ingredients are uncertain, drug-checking studies across the globe have frequently revealed ketamine and MDMA as the primary components, often bulked with caffeine and other adulterants to increase volume. (6) An analysis from the Erowid Center's anonymous drug-testing program, DrugsData.org, shows that of the 68 samples submitted between 2016 and 2024 under labels "pink cocaine", "tusi", or "2C-B", 94% contained ketamine (64 samples) and 81% contained MDMA (52 samples) (Figure 1). (8) Particularly concerning is the wide variety of additional adulterants also detected across these samples, including amphetamines, opioids, and tranquilizers. Given the widespread contamination of other illicit drugs with fentanyl, it may only be a matter of time before it or similarly potent opioids also find their way into batches of pink cocaine.Figure 1Figure 1. Contents of the 68 sample submissions labeled as tusi/2C-B/pink cocaine to DrugsData between 2016 and 2024. (8) Ketamine precursor A = 1-[(2-chlorophenyl)(methylimino)methyl]cyclopentanol; MDMA = 3,4-methylenedioxymethamphetamine; MDA = 3,4-methylenedioxyamphetamine; bk-EBDB = β-keto-1,3-benzodioxolyl-N-ethylbutanamine (eutylone); DMT = N,N-dimethyltryptamine.High Resolution ImageDownload MS PowerPoint SlideFurthermore, in a closer look at 10 samples submitted between 2023 and 2024, ketamine was the dominant component, making up to approximately 40–90% of each sample, followed by MDMA in an approximately 10–45% concentration (Figure 2).Figure 2Figure 2. Percentage of drugs detected within the 10 tusi/2C-B/pink cocaine submissions to DrugsData between 2023 and 2024. (8)High Resolution ImageDownload MS PowerPoint SlideWhen users are not aware of the strength, contents, or potential effects of what they are consuming, they are at significant risk for acute toxicity, misadventure, and overdose. For example, at low recreational doses (∼60 mg), ketamine might produce sensations of lightness, relaxation, and mild intoxication. (9) However, at higher doses, ketamine's effects intensify, often leading to profound psychedelic experiences, pronounced dissociation, and significant loss of motor control. A high enough dose can produce a state known as a "K-hole", where users may feel entirely detached from their body and surroundings. (10) Given this, a person who consumes a batch of pink cocaine that has a particularly high ketamine content can unintentionally find themself in an extremely disorienting and frightening dissociative state which can trigger dangerous levels of anxiety or panic. This state also poses a serious risk of physical harm, as users may lose the ability to protect themselves from falls and other dangerous situations.The complex and often unpredictable interactions between the cocktail of substances found in pink cocaine must be emphasized, as this can lead to amplified and synergistic effects beyond what each drug might cause on its own. Selected components found in pink cocaine and their properties and risks are highlighted in Table 1.Table 1. Selected Components Found in Seized Samples of Pink Cocaine (11−20)This risk is further compounded by the prevalence of poly-drug use in recreational settings, where users often mix other substances including alcohol, potentially leading to larger than expected doses and dangerous combinations. (21) Particularly concerning is the mixing of ketamine with other central nervous system depressants such as opioids, which can cause unintended oversedation and potentially life-threatening respiratory depression, especially in people with pre-existing respiratory conditions. (22) Indeed, a significant number of reported ketamine-related deaths have involved this dangerous combination. (22) On the other hand, the simultaneous use of depressants and stimulants, such as ketamine with MDMA, can create a dangerous physiological state where the stimulant effects of one drug can mask the sedative effects of the other. This can make it difficult for users to gauge their level of intoxication and lead to the consumption of higher than intended doses, increasing the risk of overdose.Given pink cocaine's rising prevalence in the public and the media, swift action is essential to protect people who are unaware of its dangers. Users may mistakenly believe they can predict the drug's effects, despite having little knowledge of what substances and doses they're consuming. While increased education and awareness are critical harm reduction strategies, other measures such as expanding access to reliable drug-testing kits and services could further empower individuals to make safer and more informed choices in this high-risk environment. Although the use of unregulated substances will always carry inherent dangers, these measures can mitigate the risks posed by pink cocaine (and other recreational drugs). Until pink cocaine loses its appeal and fades from popularity, prioritizing education and awareness remains key to safeguarding the public from its allure and hazards.Author InformationClick to copy section linkSection link copied!Corresponding AuthorLisa Barbaro, Vanderbilt University School of Medicine Basic Sciences, Warren Center for Neuroscience Drug Discovery, Franklin, Tennessee 37067, United States, https://orcid.org/0009-0004-0685-4506, Email: [email protected]AuthorJacob L. Bouchard, Vanderbilt University School of Medicine Basic Sciences, Warren Center for Neuroscience Drug Discovery, Franklin, Tennessee 37067, United States, https://orcid.org/0000-0002-5936-1244NotesViews expressed in this editorial are those of the authors and not necessarily the views of the ACS.AcknowledgmentsClick to copy section linkSection link copied!We thank Paige Poppe for the design of the main graphic.ReferencesClick to copy section linkSection link copied! This article references 22 other publications. 1Peart, H. Liam Payne reportedly had 'pink cocaine' in his system when he died. NBC News, October 22, 2024. https://www.nbcnews.com/news/world/liam-payne-death-one-direction-pink-cocaine-toxicology-report-rcna176532 (accessed Nov 15, 2024).Google ScholarThere is no corresponding record for this reference.2Marino, J.; Celona, L.; Troutman, M. Mystery 'pink cocaine' allegedly enjoyed by Diddy sees bump across NYC's drug scene. New York Post, July 2, 2024. https://nypost.com/2024/07/04/us-news/mystery-pink-cocaine-linked-to-diddy-sees-bump-across-nycs-drug-scene/ (accessed Nov 15, 2024).Google ScholarThere is no corresponding record for this reference.3Pachico, E. 2CB Now Drug of Choice for Colombia Elite. Insight Crime, November 1, 2012. https://insightcrime.org/news/analysis/2c-b-now-drug-of-choice-for-colombia-elite/ (accessed Nov 15, 2024).Google ScholarThere is no corresponding record for this reference.4Shulgin, A. T.; Carter, M. F. Centrally active phenethylamines. Psychopharmacol. Commun. 1975, 1 (1), 93– 98Google ScholarThere is no corresponding record for this reference.5Ford, A. Tusi: The Pink Drug Cocktail That Tricked Latin America. Insight Crime, July 6, 2022. https://insightcrime.org/news/tusi-the-pink-drug-cocktail-that-tricked-latin-america/ (accessed Nov 15, 2024).Google ScholarThere is no corresponding record for this reference.6 Tuci", "happy water", "k-powdered milk" – is the illicit market for ketamine expanding? . United Nations Office on Drugs and Crime, December 2022. https://www.unodc.org/documents/scientific/Global_SMART_Update_2022_Vol.27.pdf (accessed Nov 15, 2024).Google ScholarThere is no corresponding record for this reference.7Ovalle, D. It's hot pink and smells sweet. But the party drug tusi can prove deadly. Washington Post, October 22, 2024. https://www.washingtonpost.com/health/2024/10/22/pink-cocaine-tusi-liam-payne-diddy/ (accessed Nov 15, 2024).Google ScholarThere is no corresponding record for this reference.8DrugsData.org: Test Results. Erowid Center, https://drugsdata.org/results.php?sort=DatePublishedU+desc&start=0&a=&s=tusi&m1=-1&m2=-1&sold_as_ecstasy=both&datefield=tested&max=2000 (accessed Nov 15, 2024).Google ScholarThere is no corresponding record for this reference.9Gable, R. S. Acute Toxic Effects of Club Drugs. Journal of Psychoactive Drugs 2004, 36 (3), 303– 313, DOI: 10.1080/02791072.2004.10400031 Google ScholarThere is no corresponding record for this reference.10Corazza, O.; Assi, S.; Schifano, F. From "Special K" to "Special M": The Evolution of the Recreational Use of Ketamine and Methoxetamine. CNS Neuroscience & Therapeutics 2013, 19 (6), 454– 460, DOI: 10.1111/cns.12063 Google ScholarThere is no corresponding record for this reference.11Quibell, R.; Prommer, E. E.; Mihalyo, M.; Twycross, R.; Wilcock, A. Ketamine. Journal of Pain and Symptom Management 2011, 41 (3), 640– 649, DOI: 10.1016/j.jpainsymman.2011.01.001 Google ScholarThere is no corresponding record for this reference.12Morgan, C. J. A.; Curran, H. V. Ketamine use: a review. Addiction 2012, 107 (1), 27– 38, DOI: 10.1111/j.1360-0443.2011.03576.x Google Scholar12Ketamine use: a reviewMorgan Celia J A; Curran H ValerieAddiction (Abingdon, England) (2012), 107 (1), 27-38 ISSN:. AIMS: Ketamine remains an important medicine in both specialist anaesthesia and aspects of pain management. At the same time, its use as a recreational drug has spread in many parts of the world during the past few years. There are now increasing concerns about the harmful physical and psychological consequences of repeated misuse of this drug. The aim of this review was to survey and integrate the research literature on physical, psychological and social harms of both acute and chronic ketamine use. METHOD: The literature on ketamine was systematically searched and findings were classified into the matrix of Nutt et al.'s (2007) rational scale for assessing the harms of psychoactive substances. RESULTS: A major physical harm is ketamine induced ulcerative cystitis which, although its aetiology is unclear, seems particularly associated with chronic, frequent use of the drug. Frequent, daily use is also associated with neurocognitive impairment and, most robustly, deficits in working and episodic memory. Recent studies suggest certain neurological abnormalities which may underpin these cognitive effects. Many frequent users are concerned about addiction and report trying but failing to stop using ketamine. CONCLUSIONS: The implications of these findings are drawn out for treatment of ketamine-induced ulcerative cystitis in which interventions from urologists and from addiction specialists should be coordinated. Neurocognitive impairment in frequent users can impact negatively upon achievement in education and at work, and also compound addiction problems. Prevention and harm minimization campaigns are needed to alert young people to these harmful and potentially chronic effects of ketamine. >> More from SciFinder ®https://chemport.cas.org/services/resolver?origin=ACS&resolution=options&coi=1%3ACAS%3A280%3ADC%252BC387ltFSisA%253D%253D&md5=1b0c67d0319ca372f2284dfa1ba19cf713Freye, E. Pharmacological Effects of MDMA in Man. In Pharmacology and Abuse of Cocaine, Amphetamines, Ecstasy and Related Designer Drugs: A comprehensive review on their mode of action, treatment of abuse and intoxication; Freye, E., Ed.; Springer Netherlands, 2010; pp 151– 160.Google ScholarThere is no corresponding record for this reference.14Kupferschmidt, K. All clear for the decisive trial of ecstasy in PTSD patients. Science, August 26, 2017. https://www.science.org/content/article/all-clear-decisive-trial-ecstasy-ptsd-patients (accessed 2024 November 25).Google ScholarThere is no corresponding record for this reference.15Cohen, S. P. Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Chronic Pain From the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists. Reg. Anesth. Pain Med. 2018, 43 (5), 521– 546, DOI: 10.1097/AAP.0000000000000808 Google ScholarThere is no corresponding record for this reference.16Research Topics: Cocaine. National Institute on Drug Abuse, March 2024. https://nida.nih.gov/research-topics/cocaine#long-term (accessed Nov 15, 2024).Google ScholarThere is no corresponding record for this reference.17Heedes, G.; Ailakis, J. Amphetamine. World Health Organization, June 1998. https://www.inchem.org/documents/pims/pharm/pim934.htm (accessed Nov 15, 2024).Google ScholarThere is no corresponding record for this reference.18Riley, J.; Eisenberg, E.; Müller-Schwefe, G.; Drewes, A. M.; Arendt-Nielsen, L. Oxycodone: a review of its use in the management of pain. Current Medical Research and Opinion 2008, 24 (1), 175– 192, DOI: 10.1185/030079908X253708 Google ScholarThere is no corresponding record for this reference.19Sande, M. Characteristics of the use of 3-MMC and other new psychoactive drugs in Slovenia, and the perceived problems experienced by users. International Journal of Drug Policy 2016, 27, 65– 73, DOI: 10.1016/j.drugpo.2015.03.005 Google ScholarThere is no corresponding record for this reference.20Ferreira, B.; Dias da Silva, D.; Carvalho, F.; de Lourdes Bastos, M.; Carmo, H. The novel psychoactive substance 3-methylmethcathinone (3-MMC or metaphedrone): A review. Forensic Science International 2019, 295, 54– 63, DOI: 10.1016/j.forsciint.2018.11.024 Google ScholarThere is no corresponding record for this reference.21Díaz Moreno, M.; Alarcón Ayala, N.; Estrada, Y.; Morris, V.; Quintero, J. Échele Cabeza as a harm reduction project and activist movement in Colombia. Drugs, habits and social policy 2022, 23 (3), 263– 276, DOI: 10.1108/DHS-07-2022-0026 Google ScholarThere is no corresponding record for this reference.22Corkery, J. M.; Hung, W.-C.; Claridge, H.; Goodair, C.; Copeland, C. S.; Schifano, F. Recreational ketamine-related deaths notified to the National Programme on Substance Abuse Deaths, England, 1997–2019. Journal of Psychopharmacology 2021, 35 (11), 1324– 1348, DOI: 10.1177/02698811211021588 Google ScholarThere is no corresponding record for this reference.Cited By Click to copy section linkSection link copied!This article has not yet been cited by other publications.Download PDFFiguresReferences Get e-AlertsGet e-AlertsJournal of Medicinal ChemistryCite this: J. Med. Chem. 2024, XXXX, XXX, XXX-XXXClick to copy citationCitation copied!https://doi.org/10.1021/acs.jmedchem.4c02821Published December 3, 2024 Publication History Received 18 November 2024Published online 3 December 2024Published 2024 by American Chemical Society. This publication is available under these Terms of Use. Request reuse permissionsArticle Views-Altmetric-Citations-Learn about these metrics closeArticle Views are the COUNTER-compliant sum of full text article downloads since November 2008 (both PDF and HTML) across all institutions and individuals. These metrics are regularly updated to reflect usage leading up to the last few days.Citations are the number of other articles citing this article, calculated by Crossref and updated daily. Find more information about Crossref citation counts.The Altmetric Attention Score is a quantitative measure of the attention that a research article has received online. Clicking on the donut icon will load a page at altmetric.com with additional details about the score and the social media presence for the given article. Find more information on the Altmetric Attention Score and how the score is calculated.Recommended Articles FiguresReferencesFigure 1Figure 1. Contents of the 68 sample submissions labeled as tusi/2C-B/pink cocaine to DrugsData between 2016 and 2024. (8) Ketamine precursor A = 1-[(2-chlorophenyl)(methylimino)methyl]cyclopentanol; MDMA = 3,4-methylenedioxymethamphetamine; MDA = 3,4-methylenedioxyamphetamine; bk-EBDB = β-keto-1,3-benzodioxolyl-N-ethylbutanamine (eutylone); DMT = N,N-dimethyltryptamine.High Resolution ImageDownload MS PowerPoint SlideFigure 2Figure 2. Percentage of drugs detected within the 10 tusi/2C-B/pink cocaine submissions to DrugsData between 2023 and 2024. (8)High Resolution ImageDownload MS PowerPoint SlideReferences This article references 22 other publications. 1Peart, H. Liam Payne reportedly had 'pink cocaine' in his system when he died. NBC News, October 22, 2024. https://www.nbcnews.com/news/world/liam-payne-death-one-direction-pink-cocaine-toxicology-report-rcna176532 (accessed Nov 15, 2024).There is no corresponding record for this reference.2Marino, J.; Celona, L.; Troutman, M. Mystery 'pink cocaine' allegedly enjoyed by Diddy sees bump across NYC's drug scene. New York Post, July 2, 2024. https://nypost.com/2024/07/04/us-news/mystery-pink-cocaine-linked-to-diddy-sees-bump-across-nycs-drug-scene/ (accessed Nov 15, 2024).There is no corresponding record for this reference.3Pachico, E. 2CB Now Drug of Choice for Colombia Elite. Insight Crime, November 1, 2012. https://insightcrime.org/news/analysis/2c-b-now-drug-of-choice-for-colombia-elite/ (accessed Nov 15, 2024).There is no corresponding record for this reference.4Shulgin, A. T.; Carter, M. F. Centrally active phenethylamines. Psychopharmacol. Commun. 1975, 1 (1), 93– 98There is no corresponding record for this reference.5Ford, A. Tusi: The Pink Drug Cocktail That Tricked Latin America. Insight Crime, July 6, 2022. https://insightcrime.org/news/tusi-the-pink-drug-cocktail-that-tricked-latin-america/ (accessed Nov 15, 2024).There is no corresponding record for this reference.6 Tuci", "happy water", "k-powdered milk" – is the illicit market for ketamine expanding? . United Nations Office on Drugs and Crime, December 2022. https://www.unodc.org/documents/scientific/Global_SMART_Update_2022_Vol.27.pdf (accessed Nov 15, 2024).There is no corresponding record for this reference.7Ovalle, D. It's hot pink and smells sweet. But the party drug tusi can prove deadly. Washington Post, October 22, 2024. https://www.washingtonpost.com/health/2024/10/22/pink-cocaine-tusi-liam-payne-diddy/ (accessed Nov 15, 2024).There is no corresponding record for this reference.8DrugsData.org: Test Results. Erowid Center, https://drugsdata.org/results.php?sort=DatePublishedU+desc&start=0&a=&s=tusi&m1=-1&m2=-1&sold_as_ecstasy=both&datefield=tested&max=2000 (accessed Nov 15, 2024).There is no corresponding record for this reference.9Gable, R. S. Acute Toxic Effects of Club Drugs. Journal of Psychoactive Drugs 2004, 36 (3), 303– 313, DOI: 10.1080/02791072.2004.10400031 There is no corresponding record for this reference.10Corazza, O.; Assi, S.; Schifano, F. From "Special K" to "Special M": The Evolution of the Recreational Use of Ketamine and Methoxetamine. CNS Neuroscience & Therapeutics 2013, 19 (6), 454– 460, DOI: 10.1111/cns.12063 There is no corresponding record for this reference.11Quibell, R.; Prommer, E. E.; Mihalyo, M.; Twycross, R.; Wilcock, A. Ketamine. Journal of Pain and Symptom Management 2011, 41 (3), 640– 649, DOI: 10.1016/j.jpainsymman.2011.01.001 There is no corresponding record for this reference.12Morgan, C. J. A.; Curran, H. V. Ketamine use: a review. Addiction 2012, 107 (1), 27– 38, DOI: 10.1111/j.1360-0443.2011.03576.x 12Ketamine use: a reviewMorgan Celia J A; Curran H ValerieAddiction (Abingdon, England) (2012), 107 (1), 27-38 ISSN:. AIMS: Ketamine remains an important medicine in both specialist anaesthesia and aspects of pain management. At the same time, its use as a recreational drug has spread in many parts of the world during the past few years. There are now increasing concerns about the harmful physical and psychological consequences of repeated misuse of this drug. The aim of this review was to survey and integrate the research literature on physical, psychological and social harms of both acute and chronic ketamine use. METHOD: The literature on ketamine was systematically searched and findings were classified into the matrix of Nutt et al.'s (2007) rational scale for assessing the harms of psychoactive substances. RESULTS: A major physical harm is ketamine induced ulcerative cystitis which, although its aetiology is unclear, seems particularly associated with chronic, frequent use of the drug. Frequent, daily use is also associated with neurocognitive impairment and, most robustly, deficits in working and episodic memory. Recent studies suggest certain neurological abnormalities which may underpin these cognitive effects. Many frequent users are concerned about addiction and report trying but failing to stop using ketamine. CONCLUSIONS: The implications of these findings are drawn out for treatment of ketamine-induced ulcerative cystitis in which interventions from urologists and from addiction specialists should be coordinated. Neurocognitive impairment in frequent users can impact negatively upon achievement in education and at work, and also compound addiction problems. Prevention and harm minimization campaigns are needed to alert young people to these harmful and potentially chronic effects of ketamine. >> More from SciFinder ®https://chemport.cas.org/services/resolver?origin=ACS&resolution=options&coi=1%3ACAS%3A280%3ADC%252BC387ltFSisA%253D%253D&md5=1b0c67d0319ca372f2284dfa1ba19cf713Freye, E. Pharmacological Effects of MDMA in Man. In Pharmacology and Abuse of Cocaine, Amphetamines, Ecstasy and Related Designer Drugs: A comprehensive review on their mode of action, treatment of abuse and intoxication; Freye, E., Ed.; Springer Netherlands, 2010; pp 151– 160.There is no corresponding record for this reference.14Kupferschmidt, K. All clear for the decisive trial of ecstasy in PTSD patients. Science, August 26, 2017. https://www.science.org/content/article/all-clear-decisive-trial-ecstasy-ptsd-patients (accessed 2024 November 25).There is no corresponding record for this reference.15Cohen, S. P. Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Chronic Pain From the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists. Reg. Anesth. Pain Med. 2018, 43 (5), 521– 546, DOI: 10.1097/AAP.0000000000000808 There is no corresponding record for this reference.16Research Topics: Cocaine. National Institute on Drug Abuse, March 2024. https://nida.nih.gov/research-topics/cocaine#long-term (accessed Nov 15, 2024).There is no corresponding record for this reference.17Heedes, G.; Ailakis, J. Amphetamine. World Health Organization, June 1998. https://www.inchem.org/documents/pims/pharm/pim934.htm (accessed Nov 15, 2024).There is no corresponding record for this reference.18Riley, J.; Eisenberg, E.; Müller-Schwefe, G.; Drewes, A. M.; Arendt-Nielsen, L. Oxycodone: a review of its use in the management of pain. Current Medical Research and Opinion 2008, 24 (1), 175– 192, DOI: 10.1185/030079908X253708 There is no corresponding record for this reference.19Sande, M. Characteristics of the use of 3-MMC and other new psychoactive drugs in Slovenia, and the perceived problems experienced by users. International Journal of Drug Policy 2016, 27, 65– 73, DOI: 10.1016/j.drugpo.2015.03.005 There is no corresponding record for this reference.20Ferreira, B.; Dias da Silva, D.; Carvalho, F.; de Lourdes Bastos, M.; Carmo, H. The novel psychoactive substance 3-methylmethcathinone (3-MMC or metaphedrone): A review. Forensic Science International 2019, 295, 54– 63, DOI: 10.1016/j.forsciint.2018.11.024 There is no corresponding record for this reference.21Díaz Moreno, M.; Alarcón Ayala, N.; Estrada, Y.; Morris, V.; Quintero, J. Échele Cabeza as a harm reduction project and activist movement in Colombia. Drugs, habits and social policy 2022, 23 (3), 263– 276, DOI: 10.1108/DHS-07-2022-0026 There is no corresponding record for this reference.22Corkery, J. M.; Hung, W.-C.; Claridge, H.; Goodair, C.; Copeland, C. S.; Schifano, F. Recreational ketamine-related deaths notified to the National Programme on Substance Abuse Deaths, England, 1997–2019. Journal of Psychopharmacology 2021, 35 (11), 1324– 1348, DOI: 10.1177/02698811211021588 There is no corresponding record for this reference.