Some OTC medicines have active ingredients with the potential for misuse at higher-than-recommended dosages. Pseudoephedrine, a nasal decongestant found in many OTC cold medicines, can be used to make methamphetamine. For this reason, products containing pseudoephedrine are sold "behind the counter" nationwide. A prescription is not needed in most states, but in states that do require a prescription, there are limits on how much a person can buy each month. In some states, only people 18 years of age or older can buy pseudoephedrine.
The most common sources of abused DXM are "extra-strength" cough syrup, tablets and gel capsules. DXM may be swallowed in its original form or may be mixed with soda for flavor, called "robo-tripping" or "skittling. These medicines are often misused in combination with other drugs, such as alcohol and marijuana.
Loperamide is an anti-diarrheal that is available in tablet, capsule, or liquid form. When misusing loperamide, people swallow large quantities of the medicine. It is unclear how often this drug is misused. DXM is an opioid without effects on pain reduction and does not act on the opioid receptors.
When taken in large doses, DXM causes a depressant effect and sometimes a hallucinogenic effect, similar to PCP and ketamine. Repeatedly seeking to experience that feeling can lead to addiction-a chronic relapsing brain condition characterized by inability to stop using a drug despite damaging consequences to a person's life and health. Loperamide is an opioid designed not to enter the brain. However, when taken in large amounts and combined with other substances, it may cause the drug to act in a similar way to other opioids.
Other opioids, such as certain prescription pain relievers and heroin, bind to and activate opioid receptors in many areas of the brain, especially those involved in feelings of pain and pleasure. Opioid receptors are also located in the brain stem, which controls important processes, such as blood pressure, arousal, and breathing. At high doses, a person may have hallucinations or feelings of physical distortion, extreme panic, paranoia, anxiety, and aggression. Loperamide In the short-term, loperamide is sometimes misused to lessen cravings and withdrawal symptoms; however, it can cause euphoria, similar to other opioids.
Loperamide misuse can also lead to fainting, stomach pain, constipation, eye changes, and loss of consciousness. Dextromethorphan-containing products — tablets, capsules, gel caps, lozenges, and syrups — are labeled DM, cough suppressant, or Tuss or contain "tuss" in the title. When people take too much DXM, they might have hallucinations and "out-of-body" sensations. DXM also depresses brain function, particularly the parts of the brain that control breathing and heart function.
Taking a lot of DXM causes hallucinations and out-of-body sensations similar to the ones caused by drugs like ketamine and PCP. These effects can last as long as 6 hours. DXM also can make users have trouble controlling their limbs and cause blurred vision, slurred speech, dizziness, and impaired judgment.
It can also cause hallucinations. Cold medicines with DXM also have other ingredients that can be harmful in large amounts. These include acetaminophen or decongestants. Combining high doses of DXM with alcohol is very unsafe, too. It can lead to death. Cough syrup abuse has been a problem for decades. But the concern in the past had been about the alcohol and codeine in cough and cold products. Because of that, the alcohol has been removed from most OTC cough and cold remedies.
State laws also restrict the sale of products that have codeine. DXM seemed a good substitute to codeine and alcohol. It had few, if any, side effects, when used as directed. And a larger amount of DXM such as drinking several bottles of cough syrup at one time would cause vomiting. But today, teens have options to drinking the syrup. DXM is available in powder, capsule, and pill forms. You can find it online. These forms can be swallowed or snorted.
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