Dextromethorphan (DXM) is a synthetic drug used as a cough suppressant in many over-the-counter medications. When used at recommended dosage levels, DXM has few adverse effects. DXM is subject to abuse, however, and causes a variety of severe side effects at higher doses. DXM abuse carries a high risk of potential health consequences to both the body and brain. Dextromethorphan abuse is not uncommon. According to the National Institute of Health, “Data collected between 2000–2010 on rates of abuse for cough and cold medication containing DXM describe a peak in DXM abuse in 2006 with 34,755 single substance exposures reported by the National Poison Data System.” The effects of DXM abuse vary based on dose. At low doses, a user experiences mild motor and cognitive impairment. At higher doses, according to the NIH, a user may experience “PCP-like para-psychotic symptoms such as delusions, dissociative states, paranoia, and visual hallucinations. This combination of symptoms can lead to impulsive or violent acts, such as assault, suicide, or homicide.” The Drug Enforcement Agency points out that DXM abuse is particularly common among teenagers and young adults because it is easy to acquire. Cough syrup is often abused because it contains dextromethorphan, but these medications are mixed with a combination of other ingredients that can be dangerous in high doses. The DEA explains, “Abuse of combination DXM products also results in health complications from the other active ingredient(s), which include increased blood pressure from pseudoephedrine, potential delayed liver damage from acetaminophen, and central nervous system toxicity, cardiovascular toxicity and anticholinergic toxicity from antihistamines. The use of high doses of DXM in combination with alcohol or other drugs is particularly dangerous and deaths have been reported.” Dextromethorphan is addictive and causes physical dependence. Withdrawal from DXM can be severe and consist of vomiting, muscle aches, and diarrhea during the first week of detoxification, then night sweats, insomnia, anxiety, and intolerance to cold for three weeks, according to the NIH. Early abuse of dextromethorphan is a good indicator that an individual will progress into more harmful forms of drug abuse. Early intervention may be necessary to treat the addiction before it progresses.
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