An initial toxicology report revealed that former One Direction singer Liam Payne had multiple drugs in his system, including “pink cocaine,” when he fell to his death from a hotel balcony in Argentina’s capital, Buenos Aires.

Here’s what to know about the drug cocktail.

What is pink cocaine?

Pink cocaine is typically a powdery mix of ketamine and illegal substances such as methamphetamine, MDMA (also called molly or ecstasy), opioids or new psychoactive substances, according to a study published last year in the American Journal of Drug and Alcohol Abuse. The drug cocktail may also contain caffeine, according to the National Capital Poison Center (NCPC).

Despite its name, the recreational drug may not contain cocaine at all and gets its color from food coloring. And although it is also referred to as tusi, tusibi, tuci or tucibi, experts say it rarely contains the psychedelic drug 2C-B developed by California chemist Alexander “Sasha” Shulgin and his wife, Ann, in 1974, part of a 2C family of drugs related to methamphetamine.

The anesthetic ketamine appears to be the active ingredient most commonly found in “pink cocaine.”

The United Nations Office on Drugs and Crime says a ketamine-led concoction of drugs is also appearing in liquid doses known as “happy water” and “k-powdered milk.” Those and other “pink cocaine”-related drugs are popular in Latin America and Thailand, it said in a 2022 update paper on synthetic drug use.

The U.N. update paper warned, “High doses of ketamine used outside a medical context can cause cardiovascular and respiratory toxicity effects as well as other adverse effects such as bladder problems, anxiety, panic attacks, palpitations, tachycardia, chest pains, depression, aggravated symptoms of existing mental health issues, slurred speech and the inability to speak.”

How does pink cocaine affect someone?

It can be hard to determine how the drug cocktail may affect someone after ingesting it. Bridget Brennan, the special narcotics prosecutor for New York, said this is because pink cocaine is mixed with illegal narcotics, and how a person reacts to street drugs often varies.

“To begin with, you don’t know what the substance is, but secondly, people don’t all react the same way to any drugs,” she said. “This stuff is not manufactured under pharmaceutical conditions, there’s no certainty to it. It’s a crapshoot any time you take any street drugs.”

Potential side effects can vary but may include anxiety, hallucination, nausea and vomiting, increased heart rate and blood pressure and elevated body temperature, the NCPC said. Physical and sexual assaults, as well as traumatic injuries, have occurred when people are impaired by the drug, according to the NCPC.

Shortly before Payne’s death, a hotel receptionist called 911 to report that a distressed guest who was intoxicated with alcohol and drugs was “breaking the whole room.” According to audio obtained from local media by Telemundo, the caller said that the guest was “in a room that has a balcony, and, well, we are a little afraid that he might do something life-threatening.”

Argentina’s emergency health service, Sistema de Atencion Medica de Emergencia, or SAME, confirmed to Telemundo that Payne fell from the balcony of his third-floor room at the CasaSur Palermo Hotel. Payne, 31, was found dead a few minutes after the 911 call, SAME director Alberto Crescenti told the Argentine TV station Todo Noticias TV.

An autopsy found that the singer had 25 injuries “compatible with those produced by a fall from height” and that his cause of death was “polytraumatism, internal and external hemorrhage,” according to the Argentina National Prosecutor’s Office.

Is pink cocaine dangerous?

Yes.

Brennan said pink cocaine can be “very dangerous” because it is typically a mix of depressants and stimulants.

“I think the most dangerous aspect of it, is that you typically see stimulants, which might be methamphetamine or cocaine, mixed with other substances like ketamine that are sedating, meaning they have the opposite effect on the body,” she said. “If you have a drug that’s telling your heart to speed up and another drug that’s telling your heart to slow down, that’s a problem.”

The synopsis of the American Journal of Drug and Alcohol Abuse study on pink cocaine said the drug cocktail is “complicating” the recreational drug landscape.

“It has the potential to confuse both people who use it and researchers alike,” it said. “People using may think the drug is 2C/2C-B, and they may also be unaware that the concoction tends to consist of ketamine and a wide variety of other drugs.”

In an interview with NBC News in August, Brennan warned that people “absolutely cannot trust that your dealer is selling you a product that you asked for.”

“The drug market now is more dangerous than I’ve ever seen it,” she said after pink cocaine — commonly used in the club and party scenes — was mentioned in a lawsuit against music mogul Sean “Diddy” Combs.