Teens and adults often abuse DXM for its purported benefits; irresponsible Web sites even provide tips for abusing and dosing DXM and recipes to increase its palatability. Furthermore, the issue of its safety in infants has resurfaced. Both the FDA and the U. The FDA also revealed the growing practice of purchasing pure DXM powder, with the aim of encapsulating it and selling it to others.
With just a few clicks on a popular search engine, one can find two laboratories seemingly prepared to sell pure DXM to anyone with a credit card. The quantity abused can range from to 1, mg per episode vs. Abusers try to titrate the amount in order to move to the desired plateau. At the first plateau, a mild inebriation begins. The second plateau resembles alcohol intoxication, with slurring of speech and impaired short-term memory.
Mild hallucinations may begin. At the third plateau, the abuser undergoes an altered state of consciousness with sensory impairment, especially visual. The list is revealing, compared to the plateau symptoms sought by abusers. Adverse effects include blurred vision, pruritus, rash, sweating, fever, tachycardia, hypertension, shallow respirations, diarrhea, toxic psychosis, violence, and coma; long-term abuse may lead to learning and memory impairments.
More problems arise with abuse because DXM is usually available as hydrobromide salt. While reports seldom mention it, bromide intoxication is possible. DOJ focused on three ingredients: Overdoses of acetaminophen can cause hepatic damage and death; chlorpheniramine can cause tachycardia, incoordination, seizures, and coma; and guaifenesin can cause emesis.
One multiadditive cough product, Buckley's Mixture, includes such odd ingredients as camphor, ammonium carbonate, Canada balsam, menthol, pine needle oil, and tincture of capsicum. Many of these products have no FDA-approved oral use, and the effects of oral ingestion could be devastating.
Abusers who choose a medication with this mix of unapproved ingredients risk unknown and potentially deadly sequelae. Apparently, some abusers are aware of the dangers of the additional ingredients, engaging in a practice known as the "robo shake. When the recommended dose is exceeded, side effects of DXM may include: confusion, nausea and vomiting, sweating, dizziness, accelerated heartbeat, stomach pain, hyperexcitability, paranoia, slurred speech, seizures and vivid auditory and visual hallucinations.
The use of high doses of DXM in combination with alcohol or other drugs is particularly dangerous and deaths have been reported. Chronic abuse of the drug has also been associated with psychosis. Related posts. Nonbinary Gender Affirming Care July 15, It helps stop a cough. Used as directed, DXM products are safe and effective. But DXM has become popular among teens who want a cheap, easy high. You can find it in at least 70 common over-the-counter OTC cough and cold medicines.
DXM has no serious side effects when used in small doses. When taken in larger amounts, it can distort awareness and alter time perception. It can also cause hallucinations. Cold medicines with DXM also have other ingredients that can be harmful in large amounts. These include acetaminophen or decongestants. Combining high doses of DXM with alcohol is very unsafe, too.
Addresses are provided at the end of the page. Outlook Sources List of Figures Figure 1. Cough medications with DXM may contain other active ingredients. Figure 2. Figure 3. Cough syrup with DXM. Table 1. The abuse of DXM dextromethorphan --a common ingredient contained in over-the-counter cough and cold medicines--is an increasing concern for law enforcement officers in the United States. Adolescents are the primary abusers of the drug, most likely because it is inexpensive and relatively easy to obtain.
Additionally, because DXM is a common ingredient in many cough and cold medicines, many adolescents do not perceive any risk in abusing the drug.
Compounding the problem is that few parents know about the potential for abuse of the drug. DXM is a synthetically produced substance that is chemically related to codeine, though it is not an opiate. DXM is an ingredient in more than over-the-counter cough and cold remedies and since the s has gradually replaced codeine as the most widely used cough suppressant in the United States. It is available in capsule, liquid, liquid gelatin capsule, lozenge, and tablet forms. It also is available in powdered form on the Internet--typically for sale to laboratories conducting research on DXM.
When ingested at recommended dosage levels, DXM generally is a safe and highly effective cough suppressant; however, when ingested in larger amounts, DXM produces negative physiological effects.
The proposed legislation did not pass in either state. A similar bill introduced in California this year was also defeated. Slang terms for DXM intoxication include robo tripping, skittling, and dexing.
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