Report: The synthetic drug market in the Americas became unpredictable

(AFP) The synthetic drug market across the Americas is unpredictable and adaptive, because of mixtures to lower costs, according to a report by the Inter-American Observatory on Drugs released Wednesday.

Sixty-seven percent of health alerts issued between 2019 and 2025 in the Americas described products with two or more substances, for example, combinations known as "tusi" or "pink cocaine," which include ketamine or MDMA, or mixtures such as fentanyl with xylazine, a veterinary sedative.

The Observatory began using a regional early warning system in 2019 to share information on potentially highly problematic trends for health systems in the region.

In seven years, the system went from being used by four countries to 19 today, allowing for a much more in-depth study of trends, Marya Haynes, head of the Observatory, told AFP in a video interview.

"We have seen a movement from one synthetic drug like synthetic cannabis or MDMA to multiple combinations of drugs that are increasingly difficult to forecast," she explained.

"The market is defined by unpredictable mixtures rather than a single substance. Unstable mixtures, not new molecules, define the risk," the observatory added in its report.

One of the most dramatic cases of these lethal combinations of substances occurred in 2022 in Argentina, where a batch of cocaine adulterated with carfentanil caused 24 deaths and 80 hospitalizations in just 48 hours.

Known as "tusi" or "pink cocaine," originally associated with the synthetic phenethylamine 2C-B, has evolved into a multi-substance mixture, typically ketamine, MDMA and caffeine.

"Tusi" is known on the streets of numerous Latin American cities, but it does not carry the same ingredients everywhere.

"That creates a kind of risk for consumers," the expert added.

The mixtures are not requested by consumers, but tested by vendors according to their stocks of substances.

"There is very little pricing information, and when we do get that information, it goes in many directions," Haynes said.