The boys had previously experimented with DXM for recreational use many times. There are many tablet products that contain DXM along with other drugs that could be dangerous in overdose.Д¬ase 1: Two boys, aged 17 and 19 years, found a way to purchase dextromethorphan powder over the internet.

Dextromethorphan is NOT just in cough syrups.

Watch for symptoms that could be related to DXM poisoning such as loss of coordination, slurred speech, dizziness, hallucinations, and agitation.

Watch for warning signs of DXM abuse such as loss of interest in activities or hobbies, empty cough and cold medication containers, declining grades, and medicinal smells.

Warn teens and young adults that mixing dextromethorphan (DXM) with alcohol or other drugs is extremely dangerous.

Talk to children and teenagers about the dangers of cough medicine abuse.

If you suspect someone has taken too much dextromethorphan, immediately check the web POISONCONTROL В® online tool for guidance or call Poison Control at 1-80.Д¬ertified Specialist in Poison Information Calls to Poison Control regarding DXM have increased dramatically since 2006. Data on patterns of drug abuse usually come from reports from Poison Control and emergency physicians. Recreational DXM use might not be widely appreciated because DXM has legitimate uses and is not thought of as a drug of abuse, making it difficult to assess the public health impact. There are websites that claim to offer DXM powder for sale, provide instructions on the extraction of DXM from OTC products, and abusers' descriptions of their 'trips'. Many manufacturers of cough and cold products containing DXM have included warnings and information on their product websites to increase awareness about the dangers of DXM abuse. DXM abuse leads to approximately 6000 emergency room visits each year with half due to abuse by those aged 12 to 25 years. In 2009, the National Institute on Drug Abuse's Monitoring the Future Survey found that 6% of high school seniors had abused DXM.

This warning was in response to reports of deaths of teens that were related to the use of raw DXM purchased over the Internet. In 2005, the FDA issued a warning regarding DXM abuse to increase awareness of this growing trend. Recreational abuse of DXM-containing products began shortly thereafter. How did dextromethorphan become so readily available? DXM was approved by the Food and Drug Administration (FDA) in 1958 and was deemed a safe and effective cough suppressant.

The interaction between DXM and drugs such as alcohol, acetaminophen, and other OTC cough and cold medicines can be highly toxic. DXM abuse goes by many slang names including 'dexing,' 'robodosing,' 'robofizzing,' 'robotripping,'and 'skittling'.ДЄdding to the danger is that DXM is often taken in combination with other drugs.

When DXM is abused regularly it can actually cause symptoms that are the opposite of the userвЂ™s intent such as insomnia and dysphoria (unease, unhappiness). Dextromethorphan poisoning can also cause slow breathing, fast heart rate, increased blood pressure, psychosis (losing contact with reality), seizures, coma, and death. At high doses, DXM can produce psychedelic symptoms including mania, panic, extreme agitation, and hallucinations. Although there is controversy about its effectiveness as a cough suppressant, the effects of DXM at high doses are well documented. When used at the dosage printed on the product label, dextromethorphan (DXM) is a fairly safe drug intended to reduce coughing.

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