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Cough Preparations
Many cough preparations, especially
cough suppressants, contain codeine or DXM (Dextromethorphan).
Codeine and other opiates are very effective cough suppressants,
but they are addictive. DXM, a powerful psychoactive
drug, is particularly addictive. Cough syrup abusers
can obtain the drug from their doctors by complaining
about coughs and other cold symptoms. Ingredients in
many cough preparations are considered to be dangerous
in combination with other drugs, particularly antidepressants
(including SSRI medications and MAO Inhibitors), antihistamine
allergy medications, and Yohimbe.
Addicts commonly point to three reasons
for using cough syrup: 1) It's legal (and therefore
more acceptable); 2) It's low-cost or free; and 3) It's
seen as being safer than other drugs of abuse.
Methods of Use
Some addicts drink cough syrup undiluted or mixed with
sodas. Others soak marijuana joints with the syrup.
In some cities, an underground black market has developed
for selling syrup. DXM can also be extracted from cough
preparations and taken orally, injected, and occasionally
freebased.
Types
Examples of cough preparations include
Drixoral Cough Liquid Caps, Robitussin AC, Dectuss,
Phenergan with Codeine, Phensedyl, and Pherazine with
Codeine.
Effects on the Central Nervous System
DXM exhibits cough-suppressant functions by activating
specific opioid receptors (sigma opioid receptors) in
the central nervous system. In this sense, DXM functions
like Ketamine or PCP. The sigma opioid receptor has
been implicated in many of the symptoms of schizophrenia.
DXM also affects receptors in the part of the brain
called the cerebellum, which plays a role in coordinating
movement. The involvement of cerebellum receptors may
account for reports of peculiar reactions to movement
among persons abusing cough syrup.
Intoxication
Cough syrup abusers use the drug to
obtain a marijuana-like high with occasional auditory
hallucinations and pleasurable reactions to movement.
Other less desirable effects depend on the dose taken:
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Depression
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Dilated pupils
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Dissociation
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Dizziness
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Fever
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Hallucinations
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High blood pressure
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Hot and cold flashes
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Impaired judgment
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Memory disturbances
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Nausea and other gastric disturbances
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Panic attacks
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Psychotic episodes
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Rash
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Sexual dysfunction
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Sweating
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Tachycardia (increased heart rate)
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Life Risks
Aside from the risk of addiction, cough
syrup use is associated with increased fatigue, poor
coordination, constipation, urinary retention, and other
problems. Overdose deaths have been reported. As mentioned
above, DXM may be particularly dangerous in combination
with other medications or substances, including:
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"Non-drowsy" antihistamines (allergy medications) such as Claritin, Seldane, or Hismina
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MAO inhibitors (a certain class of anti-depressant)
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SSRI antidepressants, such as Desyrel or Serzone
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The herb Yohimbe / yohimbine
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Any of these substances in the system
at the same time as DXM can be fatal!
Withdrawal
Withdrawal from cough syrups can cause
a range of unpleasant and dangerous symptoms, depending
on the content dosage of the preparation. DXM withdrawal
is characterized by depression and difficulties with
thinking and memory.
Warning Signs
A person who is addicted to cough preparations may:
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Frequently purchase over-the-counter cough preparations
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Buy cough preparations at different stores
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