METHORPHAN
Dextromethorphan
is the main constituent of many over thecountercough remedies. At appropriate doses (a teaspoon or two), this
drug decreases coughing and doesn't do much else.
However, it is a cousin of the hallucinogenic
anesthetics PCP and ketamine, and some resourceful drug users—usually teenagers—have discovered that
if they take exces‑ sive doses (equivalent to drinking an entire
bottle of cough syrup—about 300
milligrams—or taking anywhere from ten to sixty DXM-containing pills), they can
experience a dissociative state that is dose-related. While the
lower end of the abused range (10 pills) leads to a mild state, very high numbers
of pills (60 pills) can lead to an intense dissociated, hallucinatory
state, and there are case reports of psychotic behavior in people taking
extremely high doses. Recent research shows that it indeed acts much like ketamine.
Dextromethorphan also shows up in the guise of fake Ecstasy pills—it is a common substitute for MDMA.
Toxic doses cause confusion,
disorientation, elevated body temperature, high blood pressure, and vomiting or nausea. Some users develop
patterns of repeated chronic use, although
there is not much in the scientific literature about dextromethorphan tolerance, dependence, or
addiction. Although it can cause toxicities,
the lethal dose is still considerably above (roughly double or more) the highest doses the recreational users
typically employ However, the other
constituents in cough syrups can add to the toxicities. Cough syrups with decongestants in them can raise
blood pressure markedly, and the
combination of DXM and the antihistamine (chlorpheniramble ma leate) in some preparations can cause a
serotonin syndrome-like toxicity in
rare cases. Ingestion of high doses (thirty to sixty pills) of formulations with acetaminophen can deliver enough of
this analgesic drug to damage the liver. While DXM is not illegal, most
states have laws that prevent sales
to anyone under the age of18.
