Dextromethorphan DXM

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Dextromethorphan (DXM)

• By Kevin Johnson and Edmund Fernandez

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What Is DXM?

• DXM is Dextromethorphan, a legal over the counter
  cough suppressant
• C18H25NO
• Found in many cough medicines
• Can be in pill, powder or syrup (solid or liquid)

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What Does DXM Look Like?

• DXM can be formed in a similar shape to ecstasy
• Green triangle
• Clover
• Power form
• Pills
• Syrup

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Who Uses DXM?

• Teens
• Young adults
• Anyone who desires its recreational effects
• Accidental or overdose users

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Whats In DXM?

• Dextromethorphan
• Carbon
• Hydrogen
• Nitrogen
• Oxygen
• Hydrobromide
• Dextrophan

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Original Use of Dextromethorphan

• About 40 years used in the USA to replace codeine
  as an OTC cough suppressant
• Robitussin
• Delsym
• Pertussin
• Drixoral
• Vicks 44
• Romilar

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Cost of DXM
Legal
Illegal

• Cost to make-Unknown
• Cost to purchase-5.99

• Cost to make-cheaper than 10 cents
• Cost to purchase-25-35 (usually sold off as
  ecstasy)

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How Do People Misuse DXM?

• Some people use DXM recreationally. (usually at
  home, in bed, or on the couch)
• DXM is not a dance/club drug
• High doses produce similar ketamine/PCP effect
• Taking a DXM pill thinking it is an ecstasy pill

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Mode of Administration

• Usually orally through liquid or solid form
• Rarely through nasal ingestion in powder form
• Possible through IV injection in liquid form
• Smokable, but rare

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What Are the Dissociative Effects?

• Four main plateaus of euphoria
• Sensory plateau
• Cognitive/Emotion-al plateau
• Motor plateau
• Memory plateau
• Sigma plateau and beyond

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What are the bad side effects?

• Nausea, spacey/ out of it
• Lose motor control
• Audio and visual hallucinations
• Itchy skin
• Taking DXM and MDMA together can be potentially
  fatal
• Feelings of floating and euphoria

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More Damaging Side Effects

• Impaired memory
• Trouble understanding metaphors
• Uncontrolled behavior
• Paranoia
• Disorientation
• Altered time perception
• Increased perceptual awareness
• Theoretical NMDA Antagonist Neurotoxicity

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Withdrawal Symptoms

• Insomnia
• Dysphoria
• Depression
• Possible addiction (mostly psychological)

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DXM A Dissociative

• Dissociative anesthetic
• No response to stimuli because of dissociation of
  a variety of elements in the brain
• Effects seem to occur at Theta rhythm which are
  in sync with the hippocampus that passes through
  the cingulate cortex
• Activate neurons in the posterior cingulate
  cortex (PC) and retrosplenial cortex (RC)

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The Route of DXM

• DXM is converted into DXO (dextrophan), the
  metabolite of DXM, naturally by an enzyme called
  P450-2D6 or CYP2D6 (also called debrisoquine
  4-hydroxylase).
• Blocks the N-methyl-D-aspartate (NMDA)
  neuroreceptor
• The PC and RC increases output because it is less
  affected by the NMDA blockade creating
  overactivity

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The Route of DXM (cont..)

• Overactivity seems to cause intracellular
  organelles (most vivid, the mitochondria and
  endoplasmic reticulum) to break down
• Malfunction of these intracellular organelles
  from free radicals causing cells to be damaged
• Cells respond to damaged by use of a protein,
  HSP70, which heats up the cell
• If the cells are continually overexcited, they
  burn out and die

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DXM Review

• What does DXM stand for?
• What is DXM legally used for?
• How long has DXM been in use in the USA?
• How is DXM usually taken?
• What can result from taking DXM and MDMA?

• Dextromethorphan Hydrobromide
• Used as a cough suppressant
• About 40 years
• Orally
• Potential death

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The End