Dextromethorphan HBr: An Era of Cough Syrup Kids

As society changes so does the recreational drugs used by many of today’s teenagers. Dextromethorphan Hybromide is a drug that can be found in the most common of places. A mother’s medicine cabinets, shelves at a department store, or the internet are just a few places that this drug can be found. Yet, as common as this drug may be, it is still a potentially deadly threat to today’s young people. If used for the proper purpose this drug has the ability to help soothe and suppress a cough. Used recreationally this drug has the ability to produce “euphoria, dream-like state and mind-body dissociation reportedly caused by DXM…”, but with a side effects that could kill.

The National Drug Intelligence Center has been researching the abuse of dextromethorphan hybromide for a number of years.

“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.”

With the lack of knowledge about the abuse of this drug many parents are completely unaware that their teen may be using this product to get high. The side effects can be deadly based on the dosage consumed.

“Permanent or serious brain damage can occur from DXM including: impaired memory, control of your behavior, learning, visual perception, and multi-sensory thinking as well as other permanent damage including: psychosis, limbic seizures, temporal lability and depression.”

These are extreme prices to pay just to get a cheap, legal high. Many parents are not even aware how to recognize the signs of abuse, and sometimes it is too late to get help. Pearcesuggests that there are signs to be aware of to spot an abuser. An abuser may appear to be drunk with characteristics such as slurred speech, and being unable to walk properly. Parents need to learn how to recognize these signs in order to save their children’s lives.

Ubelacker  states that abusing such a drug can lead to irreversible damage to the mind, and body. Organs, such as the liver, can be affected by guzzling down huge doses of this medication. Though it may seem like a cheap, and legal way to get high it is deadly and may even lead to coma or death .

There are different levels of “high” as the N.D.I.C. explains.

“Abusers describe the DXM experience as occurring on four different plateaus. Abusers ingest increasing amounts of DXM (based on their weight) to reach each succeeding plateau. Abusers report the following effects occurring in each plateau: First Plateau: Mild inebriation. Second Plateau: An effect similar to alcohol intoxication and, occasionally, mild hallucinations. The abuser’s speech can become slurred, and short-term memory may be temporarily impaired. Third Plateau: An altered state of consciousness. The abuser’s senses, particularly vision, can become impaired. Fourth Plateau: Mind and body dissociation or an “out-of-body” experience. The abuser can lose some or all contact with his or her senses. The effects at this plateau are comparable to the effects caused by ketamine or PCP (phencyclidine).”

Some adolescents who ingest this drug never reach these plateaus. When mixed with other drugs DXM can produce a deadly effect 

Dextromethorphan may seem like a legal way to get high and experience the effects that most illicit drugs provide without the fear of jail time. Parents need to learn the warning signs, and side effects of such drugs while monitoring their drug cabinets for potential abuse. Since dextromethorphan can not be forcefully removed from the shelves we as parents have to monitor the supply kept in our homes in order to keep our children safe.

As you can see from the chart above some cough suppressants kept in the home can contain large amounts of dextromethorphan. Suppressants such as Coricidin Cough & Cold can also contain other medications that can be fatal and induce a coma. One of these medications can be found in virtually every medicine cabinet in America.

The dangers of taking such medications can prove lethal. Some of the irreversible damage can include Olney’s lesions. “In theory Olney’s lesions are small holes in specific areas of the brain due to extensive use of dissociative drugs like, DXM, PCP, Ketamine, Nitrous Oxide, and others.” 

Psychosis is another possible side effect of taking dextromethorphan in large doses, or for long periods of time. Dextroverse Inc. suggests that when dissociative drugs are taken daily, rather than recreationally the reactions in the brain can become intense. There are many chemical reactions that come with taking drugs such as DXM and sometime a user’s brain just can not take anymore of the abuse thus, causing temporary or permanent psychosis.

There are other side effects to consider when using this drug on a regular basis. Teens do not realize the dangers involved with swallowing cough suppressants every day. Some of the risks associated with taking regular doses of dextromethorphan every day can consist of the following items:

“Cerebral hemorrhage, stroke, mania, depression, violent ideations, antisocial behavior, paranoia, memory impairment, language impairment, weight loss, loss of muscle control, habituation, psychological addiction, tolerance, physical addiction, liver damage, kidney damage, damage of the pancreas, and bromide poisoning.”

Such damages can be reversed at times, but sometimes they cannot be reversed. Parents should educate themselves on the risks, and side-effects associated with the use of simple cough suppressants.

Pharmacies and retail stores do not have regulations that restrict the sale of cough syrup to minors. In these types of stores over-the-counter medications, such as, cough syrup is displayed on shelving and is not kept behind the counter. In September of 2006 Virginia legislature made it mandatory for drugs such as pseudoephedrine to be sold behind the counter. This was required at all pharmacies and retail outlets. This drug was regulated because it was used is the production of methamphetamine. 

The National Association of Chain Drug Stores states that drugs like psuedoephedrine are to have strict guidelines that regulate the sales, records, and placement of such products. 

“Retail sales limited to three individual packages with no more than nine grams of active ingredient per transaction. Product must be kept within thirty feet and direct line of sight a cash register or store counter staffed by one ore more store employees. Reliable anti-theft devices are used on packages. Product is kept under constant surveillance.”

Such mandatory regulations help prevent the creation of methamphetamines. These statutes are also keeping teenagers from abusing such products containing psuedoephedrine. Without rules and regulations on over-the-counter medications there is not a limit to who can buy them, who can take them, and how much can be sold. This gives teenagers full access dangerous over-the-counter medications containing dextromethorphan.

As you will see in photo one cough syrups, such as, Vicks 44 will be displayed on shelving with out any regulation behind the sale or distribution of the product.

A child could walk into a store and purchase the product without having to show any form of identification, or proof of age. Unlike psuedoephedrine there are not any laws regulating the sale of cough syrups containing dextromethorphan. This leaves society’s teenagers vulnerable to the easy accessibility of this product.

“In the early 1960’s dextromethorphan (DXM) replaced codeine as the primary active ingredient of cough suppressants on the market, in an attempt to bring down codeine dependency. Abuse of DXM became apparent as early as 1973. The over-the-counter cough medicines using DXM began making their medicines taste unpleasant as a way to discourage abuse.”

In forty-seven years the only thing society has done to discourage abuse of dextromethorphan is make the cough syrups taste disgusting. Changing the taste of medication will not keep an abuser from abusing the medicine. The only thing that changing the taste of the medications did was allow abusers to find new ways to ingest the medication and avoid the nasty taste.

Teens have been known to mix cough syrup with some other type of liquid in order to avoid the unpleasant taste. There are methods to extracting the active ingredient, dextromethorphan, from liquid cough syrups. This method allows teens to make pills also known as lemon drops which are a pure form of DXM created from the extraction method. The extraction method can take anywhere from thirty to ninety minutes to complete.

The internet has made understanding these methods even easier for teenagers access. Pure forms of dextromethorphan can be purchased through the internet at a whim, and that adds to the potential abuse of such medications. There is not a frontline of protection that prevents society’s youth from ingesting these dangerous over-the-counter medications.

Some of the over-the-counter medications also include other active ingredients that when taken in large doses can cause the user to be hospitalized.

“Sold legally over-the-counter, Coricidin HPB Cough and Cold, is used by individuals with high blood pressure to relieve cold symptoms. The small red tablets contain thirty milligrams of dextromethorphan (cough medicine). When taken in numbers greater that directed on package labels, dextromethorphan can lead to hallucinations, loss of motor control and out-of-body sensations.”

Drugs, such as, Coricidin are used primarily for the dosage of DXM that they contain. The danger of ingesting such large amounts of dextromethorphan is immeasurable.

“Abuse of dextromethorphan can cause, increased body temperature, nausea, abdominal pain, vomiting, irregular heartbeat, high blood pressure, headache, numbing of the fingers and toes, loss of consciousness, slurred speech, blurred vision, paranoia, excessive sweating, redness of face, dry and itchy skin, hypothermia, high fever, brain damage and possible death.”

These side effects are a big price to pay just to get high. Society’s youth face the potential risks of dying when abusing the medications found in the average cough suppressant. Coricidin HBP has other names that all parents should listen out for. “The small red pills are also known by several street names such as, Triple C, DXM, Candy, Skittles, Red Devils, DM, Drex, Robo, Rojo, Velvet, and Vitamin D.”

“The act of abusing dextromethorphan is often called dexing, robotripping, or robodosing.” These are the things that parents need to know. Knowing about what types of medications are involved in this epidemic will help parents be aware to what they are actually keeping in their homes. Learning about the side effects of this drug may also help prevent a possible overdose, and could give parents a way to discuss the subject with their children. Knowing the different terms for dextromethorphan can help parents spot if their child is abusing such drugs.

Educating parents and teens of the risks of abusing dextromethorphan could be the only weapon available in the fight against this type of recreational drug use. The legal system provides no statutes of law against the abuse of over-the-counter medications. Until the United States recognizes the continuing abuse of over-the-counter medications and creates a set of rules and regulations regarding the sale of such drugs then we have to do the best with the knowledge given to us. Education, at the moment, will be the primary key element in fighting against the abuse of cough syrup amongst teens.