Dextromethorphan - Overview

Overview

In 1949, American chemists applied for a patent on dextromethorphan, after having isolated it from its parent drug, levomethorphan, a synthetic opioidA substance created in a laboratory to mimic the effects of naturally occurring opiates such as heroin and morphine.. During the 1950s, abuse of cough syrups containing codeine was a serious problem for adults and teenagers. This led manufacturers of cough and cold remedies to search for a product that would suppress coughs without causing drowsiness or promoting addiction. Dextromethorphan seemed to be the answer. By 1959, it had won approval by the U.S. Food and Drug Administration (FDA) for use as a cough remedy. In the 1960s, a dextromethorphan-only pill, Romilar, was introduced as an over-the-counter medication. However, it was pulled from the market when its potential for abuse became known.

The World Health Organization (WHO) classified dextromethorphan as a non-analgesic, non-addictive substance in the late 1960s. (An analgesic is a drug that relieves pain.) Yet, pharmaceutical companies decided to use the drug in combination form with other agents. The era of multi-symptom cough, cold, and flu remedies was born, with a variety of products for adults and children.

Cough syrup abuse can lead to many side effects, including double vision. The side effects get worse when dextromethorphan is taken in combination with other drugs. Lauren Shear/Photo Researchers, Inc.
Cough syrup abuse can lead to many side effects, including double vision. The side effects get worse when dextromethorphan is taken in combination with other drugs. Lauren Shear/Photo Researchers, Inc.

So Easy to Get

Modern pharmacies, grocery stores, and even convenience stores stock cough remedies with dextromethorphan. The drug can be found in brand-name products such as Coricidin, Robitussin, Vicks NyQuil, Dimetapp DM, Alka-Seltzer Plus Cold and Cough, Sudafed cough products, Tylenol cold products, and Vicks Formula 44. The street names "triple-C" and "skittles" have been coined to describe Coricidin. "Robo-tripping" is slang for abuse of liquid cough syrups such as Robitussin.

According to the Cleveland Plain Dealer, reported cases of teen dextromethorphan abuse more than doubled nationwide between 2000 and 2003. An increase of dextromethorphan abuse among teenagers sparked parent groups, legislators, and pharmacies to take action. Drug Topics magazine noted that some national chain pharmacies, such as CVS and Wal-Mart, have programmed their computer scanners to ask for an age identification before selling DXM products. Others, including Walgreens, restrict the number of packages a customer can buy. Some drugstores have even moved these medications from the main aisles into the pharmacy area, so the sale of these drugs can be monitored. By September of 2004, several states were considering legislation that would prohibit anyone under the age of eighteen from buying products containing dextromethorphan.

The easy availability of dextromethorphan sometimes makes it the first choice for abuse among teens who might feel uncomfortable buying illegal drugs. However, in high doses it is as dangerous and unpredictable in its effects as PCP and ketamine. (An entry on ketamine is also available in this encyclopedia.)

In the Palm Beach Post, Carolyn Susman detailed the "laundry list" of side effects from dextromethorphan abuse, including "dissociationA psychological syndrome in which the mind seems detached from the body; sometimes referred to as an out of body experience. … confusion, dizziness, double or blurred vision, slurred speech, impaired physical coordination, abdominal pain, nausea and vomiting, rapid heart beat, drowsiness, numbness of fingers and toes, and disorientation." This list does not include the even more dangerous symptoms associated with use of dextromethorphan in combination with other drugs.