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DXM – Dextromethorphan
Most schedule I and II drugs began as non-controlled substances that were readily available to the general public. Methamphetamine was used by soldiers in World War II, cocaine was an additive to popular drinks, and people have been chewing coca leaves and khat for centuries. These drugs, in small doses, do have some beneficial effects that can be used to enhance productivity, ease relaxation or act as a stimulant similar to caffeine. Dextromethorphan, also knows as DXM, has some properties similar to other psychedelic drugs, but it is commonly used in many cough suppressants. Thus, more than the other substances mentioned, it is a helpful additive that is concentrated and abused when not used in proper proportions.
Dextromethorphan is a cough suppressant that is an additive in more than 100 over-the-counter (OTC) cough medications. It can be found in the most popular brand cough medications such as Mucinex, Robitussin, Theraflu, and Nyquil. Since it has sedative properties it is also used in other medications that help patients manage pain and opioid addiction among other things. It is a white powder in its base form.
The substance was originally developed by researchers within the United States military because they wanted to find an alternative to codeine which had been used as a cough suppressant, but was found to be both addictive and have powerful sedative properties. DXM also has sedative properties, but they are much less than codeine. DXM was concocted because it was thought to have no addictive properties. Unfortunately, users soon found that pure dextromethorphan, when extracted from the cough medicine, would provide effects similar to those of codeine and other opiates and opioids (such as heroin and morphine).
In fact, when DXM was first introduced as a cough suppressant to the public, it was as a tablet in its pure form. The government quickly found that this had been a mistake when people began buying the drug in large individual quantities. After is reintroduction in a cough syrup form, it was not until the 1990s and 2000s, with the increased popularity of the internet, that people found a more efficient means of extracting the drug. It was at this time that abuse began to increase markedly.
Dextromethorphan has not been scheduled by the United States because it is not seen as a significant worry. The chemical has effects somewhat similar to other substances that began life as alternatives to more highly addictive drugs such as phencyclidine and ketamine, but the actual effect is magnitudes lower. The low dosage amount found in even a bottle of cough suppressant is thought to be low enough that it is not harmful to the general public. Only one nation, Indonesia, has in any way controlled the sale of DXM. California does not allow minors to purchase products containing DXM.
Although the drug is largely harmless unless ingested in very large quantities, there are reports of abuse and addiction. The internet provides many different methods by which the chemical can be extracted from different OTC cough suppressants, usually those in capsule form. There are even videos which provide step-by-step instructions on how to do this. The rise of the internet and the increase in DXM correspond because it is much easier now to tell potential drug users how to produce this high.
The substance has also become a trendy teen drug. Because of its popularity on the internet and its seemingly harmless high (since it is sold in OTC cough medicines), people believe that it is not as dangerous as other drugs. However, research has shown that DXM can cause many of the same short and long-term effects as other psychoactive substances.
On the street, it has been named Skittles, Robo (from Robitussin) and CCC (from Coricidin). Dextromethorphan has been said to cause a euphoric effect, and can produce visual and auditory hallucinations. Some people will experience side effects even when they take the recommended dose of DXM, but these symptoms (such as vomiting, headache, confusion, sleepiness and constipation) increase when the substance is abused. Other short-term effects include hyperactivity (in some), lethargy, sweating and an increase in blood pressure. Even in the short-term, the effects of DXM in high dosages has led to hospitalizations and reports of more serious medical complications.
As with other substances, the short-term effects are magnified when DXM is abused over a long period of time. For example, first time uses often report that they have trouble walking or completing manual tasks associated with gross muscle movement after they have taken a large dose of DXM. Over time this issue can worsen meaning that those who abuse DXM over a long period can permanently lose some muscle control. It has also been reported that since DXM increases blood pressure and heart rate that extended use can lead to heart attack and stroke.
Possibly the most dangerous effect is that since DXM has sedative properties it can result in a suppression of respirations. This means that not enough oxygen is getting to the brain and brain damage may occur. The loss of oxygen, though it does not often cause permanent damage to other tissues can significantly harm lung tissue.
It is also not advised that DXM be mixed with alcohol. Most hospitalizations from DXM abuse occur because the user has been both drinking alcohol and taking concentrated DXM. The two taken together cause an adverse synergistic effect. According to drugs.com synergism is defined as “coordinated or correlated action of two or more structures, agents, or physiologic processes so that the combined action is greater than the sum of each acting separately.” Basically, when two substances are taken together, the resultant action is much greater than it would be if the two were taken separately. The body uses the liver to metabolize drugs and alcohol and this utility is decreased greatly when two competing substances are introduced together. Thus, the impairment from the two drugs is longer and it takes a lot longer for them to leave your system. Emergency rooms have reported deaths as a result of individuals using alcohol and DXM together.
Some people, notably, some Caucasians have a difficult time metabolizing DXM. Research indicates that from 5% to 10% of Caucasians are poor DXM metabolizers and will retain the drug up to five times as long as good metabolizers. This means that the drug can cause effects up to three times as strong for poor metabolizers of the drug.
As an over-the-counter drug, DXM is thought to be harmless, but teens and young adults are proving that to be false. By taking capsules and tablets and extracting the pure DXM, they are able to produce a high that has been found to be very harmful in some cases. DXM can cause drowsiness, increased heart rate and blood pressure, awkward muscle movements and other problems. If taken for a long period of time it can be linked to stroke, brain damage due to hypoxia and permanent muscle damage. When taken with alcohol it is especially dangerous and has caused some deaths according to emergency room data. It is also not easily metabolized by up to ten percent of the Caucasian population and can cause more serious issues for these individuals.
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