Date of Presentation

5-6-2021 12:00 AM

College

School of Osteopathic Medicine

Poster Abstract

Dextromethorphan (3-methoxy-N-methylmorphinan), also known as “DXM,” is a synthetically produced drug available in many over-the- counter (OTC) cough and cold medications as a centrally acting cough suppressant that binds to NMDA receptors. In a 2006 national survey of 50,000 students, 4, 5, and 7% of 8, 10, and 12th graders reported DXM abuse in the past year. In high doses, DXM can cause euphoria, hallucinations, dissociations, and distortion of cognition and perception. DXM abuse is also known as “Robotripping,” “Robodosing,” “Dexing,” “Tussin,” or “Triple Cs” because Robitussin® and Coricidin® Cough and Cold are most frequently abused. DXM has replaced codeine and promethazine in many cough syrup preparations, yet it is still known as “Purple drank,” “Lean,” “Sizzurp,” “Orange Crush,” or “Skittles” when mixed with alcohol or soda for flavor. Co-toxicity can occur since DXM is usually combined with acetaminophen, antihistamines, or decongestants like pseudoephedrine. DXM reaches its peak effects at 30-60 minutes, and lasts 2-4 hours. Abusers often use throughout the day to maintain a consistent high. At doses of >500mg, users can experience hallucinations, violent behaviors, and even trance- like states. Poison control recommends ED evaluation for ingestions of more than 7.5 mg/kg. We report an interesting case of DXM abuse whose symptoms present as acute psychosis.

Keywords

case reports, dextromethorphan, substance abuse

Disciplines

Emergency Medicine | Medicine and Health Sciences | Pathological Conditions, Signs and Symptoms | Pharmaceutical Preparations | Substance Abuse and Addiction

Document Type

Poster

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May 6th, 12:00 AM

Robotripping: The Dangers of Abusing Dextromethorphan

Dextromethorphan (3-methoxy-N-methylmorphinan), also known as “DXM,” is a synthetically produced drug available in many over-the- counter (OTC) cough and cold medications as a centrally acting cough suppressant that binds to NMDA receptors. In a 2006 national survey of 50,000 students, 4, 5, and 7% of 8, 10, and 12th graders reported DXM abuse in the past year. In high doses, DXM can cause euphoria, hallucinations, dissociations, and distortion of cognition and perception. DXM abuse is also known as “Robotripping,” “Robodosing,” “Dexing,” “Tussin,” or “Triple Cs” because Robitussin® and Coricidin® Cough and Cold are most frequently abused. DXM has replaced codeine and promethazine in many cough syrup preparations, yet it is still known as “Purple drank,” “Lean,” “Sizzurp,” “Orange Crush,” or “Skittles” when mixed with alcohol or soda for flavor. Co-toxicity can occur since DXM is usually combined with acetaminophen, antihistamines, or decongestants like pseudoephedrine. DXM reaches its peak effects at 30-60 minutes, and lasts 2-4 hours. Abusers often use throughout the day to maintain a consistent high. At doses of >500mg, users can experience hallucinations, violent behaviors, and even trance- like states. Poison control recommends ED evaluation for ingestions of more than 7.5 mg/kg. We report an interesting case of DXM abuse whose symptoms present as acute psychosis.

 

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