When was dxm discovered

When surveying total OTC medication sales by AAFES at various Pacific locations for the previous 2 years, we discovered that the generic variety of cough and cold medication containing DXM was the 1 selling medication in Okinawa stores compared with being only 25 in Hawaii.

The corresponding name brand product, Coricidin, was ranked 27 in Okinawa and in Hawaii. When comparing total sales adjusted for population between Okinawa and Hawaii, sales were 3. These numbers are likely conservative, as the product was frequently stolen from stores, and stolen products were not included in the report. Also, the product was frequently unavailable sold-out because of its popularity, further limiting its sales.

In addition, DeCA sales from four large grocery stores in Okinawa were also not included in the reports. Potential contributing factors explaining why DXM sales were higher in Okinawa are likely because of a number of factors, though two factors seem most probable: One, illicit recreational drugs are more prominent in Hawaii, which has one of the highest rates of illicit drug use in the U.

However, DXM may be particularly attractive to military service members as it is not considered as an illicit substance in random drug testing. A second plausible factor contributing to excessive sales of DXM in Okinawa may be related to numerous social stressors such as isolation from family, home, and culture, all of which are more pervasive in Okinawa compared with Hawaii. An interesting counterpoint to consider is how DXM abuse was not notable in bases located in other areas of Japan.

In , as aforesaid, our medical records showed that 34 known cases of DXM intoxication were confirmed as reasons for visits to the ED in Okinawa. Since coding for DXM intoxication is not consistently performed, this number is likely underrepresentative.

When we interviewed physicians in the ED, numbers were reported as high as 1 to 3 patients per week who were suspected of abusing DXM. There were 9 confirmed intensive care unit admissions, and at least 10 additional suspected, but unconfirmed, cases. There were also 14 patients admitted to or consulted with inpatient mental health because of suspected suicide attempts using DXM-containing products, all by those who had been abusing the medication recreationally prior.

These numbers include both military personnel and their dependents ie, spouses and children. Since DXM abuse is prominent among high-school students, 10 we also attempted to investigate DXM abuse from high-school students, specifically. We interviewed a local high-school substance abuse counselor who reported 45 confirmed students abusing DXM among a population of around Among these students, at least 9 were sent to the ED.

An additional 6 students from the other high school on the island were also sent to the ED. The reports from this survey motivated rapid intervention as an attempt to reduce or eliminate DXM abuse by military personnel and their dependents in Okinawa. Normalized total weekly sales of DXM per location. Data have been normalized to sales from Hawaii. In , a similar problem of DXM abuse was observed in Korea. DXM was then moved behind the counter so that one had to directly request it in order to make a purchase.

This made theft difficult in addition to instilling a fear of being caught by frequently asking for it.

DXM was previously available at 23 stores across the island, but now DXM has been removed from smaller stores, or with limited products available only at the register. DXM was also moved behind the register at medium-sized stores. At the two largest stores, DXM was tagged with electronic theft protector sensors and placed under hour camera surveillance. In order to assess whether the policy changes meant to limit access to DXM were impactful, the DXM problem in Okinawa was reassessed a year after these changes took effect.

First, we compared sales records to assess if sales of DXM-containing medications were decreasing. During this 3-month period, sales of DXM-containing products went down between Furthermore, we performed a query of the U. Additionally, no minors of military personnel were sent to the ED for intoxication in , and after April of , none were seen by the substance abuse counselor.

The second plateau resembles alcohol intoxication, with slurring of speech and impaired short-term memory. Mild hallucinations may begin.

At the third plateau, the abuser undergoes an altered state of consciousness with sensory impairment, especially visual. The list is revealing, compared to the plateau symptoms sought by abusers. Adverse effects include blurred vision, pruritus, rash, sweating, fever, tachycardia, hypertension, shallow respirations, diarrhea, toxic psychosis, violence, and coma; long-term abuse may lead to learning and memory impairments.

More problems arise with abuse because DXM is usually available as hydrobromide salt. While reports seldom mention it, bromide intoxication is possible. DOJ focused on three ingredients: Overdoses of acetaminophen can cause hepatic damage and death; chlorpheniramine can cause tachycardia, incoordination, seizures, and coma; and guaifenesin can cause emesis.

One multiadditive cough product, Buckley's Mixture, includes such odd ingredients as camphor, ammonium carbonate, Canada balsam, menthol, pine needle oil, and tincture of capsicum. Many of these products have no FDA-approved oral use, and the effects of oral ingestion could be devastating. Abusers who choose a medication with this mix of unapproved ingredients risk unknown and potentially deadly sequelae.

Apparently, some abusers are aware of the dangers of the additional ingredients, engaging in a practice known as the "robo shake. The fallacy in this strange practice is that absorption of all ingredients occurs simultaneously.

Thus, the user still risks toxicity from the other active ingredients. Some abusers, however, have discovered and shared chemical methods to extract DXM from cough syrups. It is referred to as "triple C," in reference to the three C 's imprinted on the tablets. Other names include "skittles," "dex," "candy," "red hots," and "red devils. In one case, a year-old Colorado boy tried to cross a highway under the influence of DXM.

Investigators hypothesized that visual problems caused him to misjudge the time he would have to cross the road. Abuse of DXM powder caused two deaths--a suicide and an unintentional overdose. At these levels, in addition to its cough suppressant properties, DXM can cause nausea, vomiting, drowsiness, sedation, and confusion, among other things.

Some even report closed-eye hallucinations at this dosage. In these amounts, DXM can cause euphoria and feelings of increased confidence and strength, and people will often speak very fast, so behaving rather like a stimulant.

The negatives of this can include insomnia and nausea. The next plateau begins at roughly milligrams, though this varies from person to person based on body weight, body chemistry, and tolerance. At this level, for which people sometimes take milligrams or even more, Dextromethorphan causes strong dissociation and many report vivid hallucinations and confusion, including a lost or distorted sense of time.

At this and higher doses, DXM has a range of side effects that include blackouts, the inability to focus visually, and serious confusion that can cause paranoia. In my research for this drug of the month segment, I even came across many reports of people consuming up to 2 grams — meaning 2, milligrams, which is times the medical dose — although they almost universally reported terrible experiences, and this dosage is certainly an outlier and not recommended by anyone.

Dextromethorphan does come with a small risk of overdose, but only in giant doses like the ones I just described. There is no set number for humans, but there are some reports of people dying from high doses of DXM alone. However, much more common is dying from a mix of DXM and other substances — one thing prospective recreational users should be aware of is that many over-the-counter formulations of cough syrup that have DXM also contain acetaminophen, which can be very toxic at high doses and cause serious liver damage.

So if someone is choosing to use DXM, they should not only calculate the dosage of the Dextromethorphan, but everything in the formulation and make sure that they are all well within the safety range.

While it does certainly carry risks, DXM is not considered to be physically addictive. Active robo-trippers tend not to use it more than once a month, but of course, like any drug it can also be psychologically addictive, particularly if someone is having other problems that they are seeking to disassociate from. It is particularly dangerous when used along with MDMA, which could happen if someone consumes drugs from two sources and one of them was from an honest dealer while the other was not.

In order to help mitigate this risk, the testing kits sold by DanceSafe are able to identify pills which contain DXM. As I mentioned in the Intro episode, DXM was first synthesized in a lab in , as part of government-funded research to replace codeine with a less addictive alternative. It was approved in by the FDA as a cough suppressant and made available for over-the-counter sales.

Initially, DXM was sold in tablets under the brand name Romilar. As early as , recreational use of DXM was reported in pop cultural writings, and was apparently particularly popular among Beat writers, such as Allen Ginsberg, Jack Kerouac, and Peter Orlovsky.

The Beats were so well-known for their use of Romilar during their time in Ibiza that they were known among locals as the Romilar army. This was characterized by hyperactive behavior, extreme pressure of thought, marked visual and auditory hallucinations, and association of sounds with colours synaesthesia.

This experience was likened to that experienced when he was under the influence of L. By the late s, recreational use or abuse of DXM had reached such levels that manufacturers began including ingredients in their cough medicines solely designed to induce nausea, in order to discourage over-consumption. However, DXM continued to be available in cough syrups, with manufacturers developing more formulations designed to deter abuse by ensuring the syrups were unpleasant to consume in large quantities due their foul, medicinal taste.

While the potential for abuse of DXM was already well-established in , when the Controlled Substances Act was originally passed by Congress and signed into law by Nixon, dextromethorphan was specifically excluded from being scheduled, under Section g 2. That puts it a cut above a lot of other medicines out there.

So, hey, thanks Central Intelligence Agency. Anyone with experience what to describe what a Dextromethorphan high is like? The A. By Esther Inglis-Arkell.