DXM is a cough suppressor found in more than 120 over-the-counter (OTC) cold medications, either alone or in combination with other drugs such as analgesics (e.g. acetaminophen), antihistamines (e.g. chlorpheniramine), decongestants (e.g. pseudoephedrine) and/or expectorants (e.g. guaifenesin). The typical adult dose for cough is 15 or 30 mg taken three to four times daily. The cough-suppressing effects of DXM persist for 5 to 6 hours after taken. When taken as directed, side-effects are rarely observed.
DXM when abused in high doses causes euphoria and visual and auditory hallucinations. Some of the many psychoactive effects associated with high-dose DXM include confusion, inappropriate laughter, agitation, paranoia, hallucinations and other sensory changes, including the feeling of floating and changes in hearing and touch.
Abusers take various amounts depending on their body weight and the effect they are attempting to achieve. Some abusers ingest 250 to 1,500 milligrams in a single dosage, far more than the recommended therapeutic dosages described above. Illicit use of DXM is referred to on the street as "Robo-tripping," "skittling” or “dexing." The first two terms are derived from the products that are most commonly abused, Robitussin and Coricidin HBP. DXM abuse has traditionally involved drinking large volumes of the OTC liquid cough preparations. More recently, however, abuse of tablet and gel capsule preparations has increased. These newer, high-dose DXM products have particular appeal for abusers: They are much easier to consume; they eliminate the need to drink large volumes of unpleasant-tasting syrup; and they are easily portable and concealed, allowing an abuser to continue to abuse DXM throughout the day, whether at school or work. DXM powder, sold over the Internet, is also a source of DXM for abuse. (The powdered form of DXM poses additional risks to the abuser due to the uncertainty of composition and dose.) DXM is also distributed in illicitly manufactured tablets containing only DXM or mixed with other drugs such as pseudoephedrine and/or methamphetamine. DXM is abused by individuals of all ages but its abuse by teenagers and young adults is of particular concern. This abuse is fueled by DXM’s OTC availability and extensive "how to" abuse information on various web sites. The 2006 Monitoring the Future (MTF) showed that 4%, 5%, and 7% of 8th, 10th, and 12th grade students, respectively, reported nonmedical use of DXM during the previous year. This was the first year MTF added DXM to the survey for students.
Long-term abuse of DXM is associated with severe psychological dependence. Abusers of DXM describe the following four dose-dependent "plateaus:"
Plateau Dose (mg) Behavioral Effects
1st 100–200 Mild stimulation
2nd 200–400 Euphoria and hallucinations
3rd 300– 600 Distorted visual perceptions Loss of motor coordination
4th 500-1500 Out-of-body sensations.
Most DXM-related deaths are caused by ingesting the drug in combination with other drugs. DXM-related deaths also occur from impairment of the senses, which can lead to accidents.
Teen Drug Treatment for OTC drug abuse and addiction is found in a teen drug rehab that incorporates an individual treatment plan and an educational component for Over The Counter drug abuse, in the teen drug rehabilitation program. The purpose of choosing to send a teen to a teen drug rehab is to address the drug abuse behavior immediately and prevent permanent damage to the teen. In teen rehab, teens will learn the skills necessary to live a fun sober life. Teens will gain an understanding of the cycle of addiction, gain knowledge of the 12 steps to recovery, cultivate individual accountability for daily life responsibilities, and begin to focus on family life and participation in the family, respecting and adhering to family structure, rules, boundaries, and guidelines. Teen rehab also provides numerous therapies to address issues that may have led to a teen “self medicating”. Therapies include individual, group, family, trauma, coping skills, education, music and art therapy, as well as a variety of experiential and holistic therapies.
If you know or suspect a teen is abusing or addicted to Over The Counter drugs, call for help. Inspirations Teen Rehab is a nationally recognized adolescent drug treatment center, designed to meet the needs of teens and their families.
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