Dexter the Meth Orphan
01-18-2007, 01:47 PM
This post is a compilation of everything I have found in both the scientific literature as well as from the experiences of this board. Where it has been possible, I have broken down each problem, restated every 'long word', and tried to be as objective as possible. There were many times that my sources began to overlap, and for this and other issues, there may be some grammatical and organizational issues with the post itself. With the help of member-input, mods, etc., I will work on cleaning up this post until it is 'perfect.' PLEASE feel free to criticize the SHIT out of this; including my logic, my sources, etc. BTW, I have yet to complete the references to many of these quotes, so be gentle.
also, please note that much of this subject is still in the investigational realm. Very little information is known for certain about toxic effects from recreational-doses of DXM... I will attempt to bring together the current theories and facts and each person can decide for him/herself. Suffice it to say that prior to investigating this issue, I personally had no idea how dangerous that DXM actually can be and how dangerous that it "is" even when taken in 'acceptable' trip doses without any other medications thrown into the mix.
Part of my decision to NEVER do recreational DXM after compiling this research is this: There have been several deaths from DXM overdose. The signs and symptoms of those patients who died were IDENTICAL to the presenting signs and symptoms that a "regular" person would experience while taking this drug. In other words, the psycho-active effects of DXM are almost entirely based upon DXM's toxic effects... So, if I were asked the question, "How dangerous is DXM?"; this is very similar to asking "How many times can I take Cyanide until I eventually die?" or "How much arsenic can I swallow but still live to talk about it!?"
But still, it's YOUR BRAIN, it's YOUR BODY. and your life... Choose wisely. Here are my findings. -Dick
Is DXM Dangerous?
YES, DXM use can be dangerous especially if
1.you take too high of a dose.
2.you take DXM too often.
3.take high-doses of DXM AND take it too frequently, aka “Chronic, High Dose Usage”
Important Short-Term Dangers:
Nausea, diarrhea, vomiting, and allergic reactions (often from the cough syrup itself)
Hot flashes, dizziness, and bad trips
Psychotic breaks (generally from high dose use)
Poisoning from Bromide Ions (Bromism)Important Long-Term Dangers:
Psychological addiction and depression (from regular use)
Poisoning from Bromide Ions.
Irreversible brain damage (from chronic use at high doses)Brain damage is fairly rare, occurring in less than 1% of the regular users that William White interviewed. He says, “They all used DXM very frequently. If you do DXM twice a month or less, you'll probably be OK. But remember there's always the risk of something going wrong.” FYI: William White is the ‘famous’ author of the DXM FAQ.
Quote:
Other "Inactive" Ingredients
Cough syrups tend to contain several thickening and sweetening agents. Glucose, sucrose, invert sugar, and fructose are all commonly used as sweetening agents. Obviously, a person with blood sugar problems (diabetes or hypoglycemia) should not take large amounts of these syrups. "Diabetic" syrups are available.
Thickening agents don't generally cause problems other than nausea. Occasionally people will look on cough syrup labels and see propylene glycol or polyethylene glycol, and (thinking about ethylene glycol, i.e., antifreeze) worry about toxicity. Propylene glycol is not toxic, even though ethylene glycol is. The same goes for polyethylene glycol (PEG) - it's also nontoxic. About the worst you will get from any of these is an upset stomach.
One general note - keep in mind that your body does eventually have to use or excrete whatever you eat and drink. Drinking huge amounts of sugars and thickening agents can put a fair amount of load on the pancreas and kidneys and should definitely be avoided if you have kidney problems already. There is anecdotal evidence that regular high-dose use of DXM cough syrups (without eating much) has led to kidney damage due to the glucose load (though I suspect rhabdoymolysis may be the cause) I cannot confirm this but I can't disprove it either. I've also heard of people having blood sugar problems after repeated use of DXM cough syrups, but again I can't verify this. (White)
HISTORY OF DXM.
DXM was first patented with U.S, Patent 2,676,177.
In 1958 the FDA approved DXM as an anti-tussive (cough medicine), in response to the recreational use of codeine cough medicine at that time. There were several advantages of DXM over codeine. DXM was not physically addictive, and a normal dose did not cause any pleasant, "sedative-like" effects.
In 1960, DXM was marketed in the US as a DXM-only pill called Romilar. It was considered "safe cough medicine" compared to codeine. But soon, Romilar users discovered the abuse potential of DXM.
13 years later, Romilar was withdrawn from the shelves.
After Romilar's removal in 1973, it was assumed that DXM would be phased-out in favor of some newer compound less susceptible to abuse. As it turns out, this hypothetically 'newer and better' drug was never discovered. And so DXM and codeine remained the only cough-relievers available.
So, manufacturers re-released DXM in syrup which tasted disgusting. William White, (DXM FAQ) suggests that the reason people "forgot" about DXM's abuse potential was mainly due to the emergence of hallucinogenic studies, and the abundance of better drugs such as LSD and Magic Mushrooms (White, 1997).
The 1980s and early '90's saw very little DXM abuse as the War on Drugs was waged in the U.S. There was very little information around about abusing DXM until the internet took shape in the mid-90's, allowing people to dissiminate information together on various subjects. First, DXM information was spread on Usenet. As internet access increased, DXM became a star, and now there dedicated websites with compiled information that is more accurate, and includes scientific information about DXM. But, even after the dissemination of DXM 'knowledge', the medical community remained relatively unaware of the drug, until several deaths were attributed to DXM.
William White's comprehensive DXM FAQ details DXM's effects, chemistry and dangers as a how-to guide for the interested psychonaut. While he originally presented DXM as benign, White soon began receiving various reports from users who claimed long-term effects like changes in moods, personalities, and memory. After these disturbing reports, and after Dr. Olsney's discovery of DXM-induced brain lesions in rats, he changed his stance on DXM being 'harmless.'
The purpose of THIS compilation is to bring together the presently known and understood information from several fields of science and medicine into the layman arena where the DXM 'epidemic' first began--the internet. Now, DXM users, and potential users of DXM can become better educated on possible side effects, toxicity, issues of concern, potentially deadly combinations, and the internet community can hopefully learn more respect and shed the frivolous stance on DXM's availability as a recreational drug. If this does not occur, then DXM will certainly go the route of all other "famous" psychoactive plants and drugs--into the realm illegality. Remember that as every teenager presents to his/her local ER with advanced DXM toxicity, that more pressure will be placed on the already-advancing search for a newer, kinder, non-psychoactive anti-tussive medication. The search that originally began in 1973.
DXM's EFFECT ON THE LIVER
METABOLISM OF DXM,
HOW YOUR BODY HANDLES DXM, AND
*PROBLEMS* WITH DETOXIFICATION.
DXM is metabolized by the liver (liver secretes bile and functions in metabolism of protein and carbohydrate and fat; synthesizes substances involved in the clotting of the blood; breaks down toxins by the cytochrome P450 oxidase enzyme). Specifically, DXM is broken down by a P450 enzyme called: CYP2D6.
Concerns about Liver Enzyme CYP2D6:
1. Poor Metabolizers.
A significant portion of the population have a functional deficiency in this enzyme called "CYP2D6 Poor Metabolizers". Since CYP2D6 is the primary metabolic pathway in the inactivation of DXM, the duration of action and effects of DXM are significantly increased in "CYP2D6 Poor Metabolizers." Also, Deaths & Hospitalizations have been reported in poor metabolizer recreational users.
2. Inhibitors of CYP2D6. A large number of medications, including antidepressants (SSRI's), are potent inhibitors of CYP2D6. So, there is a HIGH potential for drug interactions between DXM and other medications. There have been reports of fatal consequences arising from such interactions.
DANGERS OF DXM:
Obviously (due to the plateau-type effects), DXM intoxication varies depending on the dose. Many of the expected effects of recreational DXM use are actually signs of DXM toxicity in various organs.
SHORT TERM POISONING
List of Known Acute Toxic Effects
Quote:
DXM is known to cause a variety of acute toxic effects:
ranging from nausea, restlessness, insomnia, ataxia (cerebellar uncoordination/inability to balace while walking), slurred speech and nystagmus (eyeballs shaking), mood changes, perceptual alterations, inattention, disorientation and aggressive behavior (Rammer et al 1988; Katona and Watson 1986; Isbell and Fraser 1953; Devlin et al 1985; McCarthy 1971; Dodds and Revai 1967; Degkwitz 1964; Hildebrand et al 1989).
DIFFERENT "PLATEAU'S" & SHORT TERM TOXIC EFFECTS OF DXM ABUSE
Plateau 1 & 2: In addition to Euphoria & laughing, people on 1st or 2nd plateau often develop Tachycardia (FAST Heart Rates), Blood Pressure spikes, Vomiting, Mydriasis (pupil dilation), Nystagmus (eyeballs shaking), Sweating, Loss of Motor Coordination (cerebellar intoxication / cerebellar shutdown).
Plateau 2&3: In addition to the above findings, persons with moderate intoxication (Plateau 2 & 3) may demonstrate hallucinations and a distinctive, plodding ataxic gait that has been compared with "zombie-like" walking.23
Plateau 2,3, or 4: Severely intoxicated individuals in a dissociated state may be agitated or somnolent.5,6,8,21
Plateau 3&4: Extremely agitated patients may develop hyperthermia and metabolic acidosis. The presence of these signs are largely ominous. They represent a severe shift in the body's natural ion balance: causing or resulting from kidney failure, inadequate oxygenation, and/or a diseased, allergic-type reaction within the neuro-muscular junctions.
Quote:
DXM (and other dissociatives: PCP, ketamine) can also trigger psychosis, limbic seizures, temporal lability, depression, and other neurological and psychological diseases much more frequently than other types of drugs.
Quote:
The differential diagnosis of DXM intoxication includes other potentially serious toxidromes. Patients with ataxia, nystagmus, and mental status changes may suffer from ketamine or phencyclidine abuse, lithium intoxication, phenytoin, or carbamazepine poisoning, Wernicke-Korsakoff syndrome, and sedative-hypnotic, including ethanol, abstinence syndromes.26 (http://gateway.ut.ovid.com.libproxy2.usouthal.edu/gw2/ovidweb.cgi#74)
Quote:
When taken in very large doses, DXM can produce a high. It also can pose a real danger to the user, including:
Impaired judgment and mental functioning
Loss of coordination
Dizziness
Nausea
Hot flashes
Hallucinations
Brain damage
Seizure
Death. http://www.drugs-forum.co.uk/forum/showthread.phpDXM+danger (http://www.drugs-forum.co.uk/forum/showthread.php?t=3828&highlight=DXM+danger)
LONG TERM TOXIC USE OF DXM.
TOXICITY.
Probably the most important effects to consider from long-term abuse is liver or brain damage.
Quote:
"People who have used dissociatives heavily have shown clear evidence of brain damage. This is not necessarily conclusive, since the people who become addicted to them might have underlying conditions (specifically, temporal lobe complex partial seizures) which could be responsible for some of the damage.
Nonetheless, one cannot ignore the fact that most everyone who uses dissociatives both frequently and heavily ends up with some sort of neurological or psychological problem, ranging from impaired memory to a schizophrenia-like syndrome.
Many of the impairments correspond exactly to the areas of the brain damaged in lab animals." (White)
BROMIDE TOXICITY.
Bromide Ions. DXM is usually found as a salt of DXM and hydrobromide ions.
Large amounts of bromide ions can cause sedation and eventually lead to bromism (bromide poisoning), which affects (among other things) the skin andnervous system.It is one more VERY important reason to avoid prolonged high-dose use.
Quote:
Because DXM is produced as the crystalline hydrobromide salt, bromism is a consequence that has been identified in heavy chronic abusers of DXM.31
Quote:
Bromide-poisoning from DXM has been KNOWN to cause IRREVERSIBLE BRAIN DAMAGE (Cerebello-bulbar syndrome), and SHRINKING OF THE CEREBELLUM!
***The Cerebellum is a very important part of the brain! It is the Sensory/Motor Processing and Integration Center of the brain. It is necessary for nearly every coordinated motor activity (using muscles), balancing, touch, feeling, applying your hands and fingers to perform fine motor tasks, and MUCH more!!***
Quote:
There are reported cases of bromide toxicity, especially organic bromide, causing an irreversible cerebello-bulbar syndrome with cerebellar atrophy on CT and EEG changes (Van Balkom et al 1985).
Many Doctors believe that prolonged heavy use of DXM may lead to bromism. There is a case presented in the American Journal of Nephrology that demonstrated “Spurious Hyperchloremia and Decreased Anion Gap” in a DXM user. 1992;12:268-70. Translation: the human body is an aqueous environment—just like the ocean. Like the oceans, our body water is NOT just plain, pure H2O. Instead, it is “salty”—meaning that there are dissolved ions. The most common, and most commonly known are Sodium, Chloride (i.e. NaCl). Also very important to the functioning of our internal environment are other ions: Potassium, Magnesium, Calcium, etc. Bromide is very low on the list of ‘normal’ ions in terms of concentrations.
This brings us nicely into the discussion about our renal system.
DXM'S EFFECTS ON THE KIDNEYS.
ION EXCHANGE, WASTE REMOVAL AND SERUM PH
You might recall an ongoing argument about GHB. Should you make it with KOH (potassium) or NaOH (sodium)? If you make it w/potassium, then you can actually ‘overdose’ on the potassium and… well, look it up yourself if you’re interested.
If you make it w/sodium, then you can ‘overdose’ on sodium, causing a serious depletion in the essential—and short-supplied potassium. This is because the body’s watery environment exists in homeostasis—in other words, your body uses MANY mechanisms to keep its pH normal (~7.2), in other words, your organs make sure that there aren’t too many negative charges (“basic” or “alkaline”) and to make sure there aren’t too many positive charges (“acidic” or “acidosis”). Some positive ions: H+, Na+, Ca++, Mg+. Some negative ions: OH-, Cl-, K-, and more.
“Anion Gap” is simply a measure of your blood pH minus the concentration of “normal” ions—mostly sodium and chloride.
Equation for A.G. = Serum Sodium - Chloride - Bicarbonate
HIGH ANION GAP: Most types of acidosis that are UNNATURAL are a result of strange positive ions (or “acids”) not normally found in the blood.
Causes include: Metabolic acidosis (lactic acid), Methanol poisoning, Uremia (uric acid from kidney failure), Diabetes (ketones), paraldehyde poisoning, Iron, INH (a medicine), Ethylene Glycol, Salicilates (aspirin=”salicylic acid”).
LOW ANION GAP**:**THIS is what you get from DXM!!!
Causes include: Paraproteinemia (too many weird, charged un-natural proteins, e.g. Multiple Myeloma), Hyponatremia (low sodium), Hypermagnesemia (high Mag level), Hypoalbuminemia (too LITTLE albumin—a fancy word for normal blood protein), and…. Lastly: Spurious Hyperchloremia (from Bromide toxicity)
So, essentially, DXM toxicity seems to exhibit TWO contradictory adverse effects upon the body's normal serum pH:
1. Low anion Gap, caused by spurious Hyperchloremia from Bromide toxicity and
2. Metabolic acidosis (higher anion gap)
What do these conflicting messages mean?
Well, for starters, they both practically PROVE that DXM is toxic to your body's aqueous serum environment. At the very minimum, DXM causes heavy glucose and abnormal ion loads on fluid homeostatic mechanisms, meaning stress and damage to the kidneys and pancreas.
Rhabdomyolysis.
In addition to these findings, there has been reported several cases of DXM effecting serum protein levels (increased protein from MUSCULAR CELL DEATH AND BREAKDOWN, aka Rhabdomyolysis). From an unknown mechanism, probably not unlike Dantrolene Poisoning, DXM can apparently cause rhabdomyolysis--a condition that causes permanent, irreversible kidney failure.
Remember, these effects are in addition to the liver issues.
Just to repeat myself ONE more time, it certainly seems that the effect of DXM poisoning is to shift your body's plasma ion balance in both directions, skewing the normal balancing act we measure by serum pH. DXM causes increased anion gap and metabolic acidosis, and hyperchloremia (low Cl-) and low anion gap.
The biggest danger from this is when your kidneys cannot handle the continuous assault--trying to detoxify the blood and return proper balance to pH and ion concentrations.
If you have the time to skim through this, please do as it will make you laugh a bit. This is the same stupid ass tactics that the US gov used on LSD. Fucking SAD! TXT TOO LONG, SKIP TO PART 2 PLEASE
also, please note that much of this subject is still in the investigational realm. Very little information is known for certain about toxic effects from recreational-doses of DXM... I will attempt to bring together the current theories and facts and each person can decide for him/herself. Suffice it to say that prior to investigating this issue, I personally had no idea how dangerous that DXM actually can be and how dangerous that it "is" even when taken in 'acceptable' trip doses without any other medications thrown into the mix.
Part of my decision to NEVER do recreational DXM after compiling this research is this: There have been several deaths from DXM overdose. The signs and symptoms of those patients who died were IDENTICAL to the presenting signs and symptoms that a "regular" person would experience while taking this drug. In other words, the psycho-active effects of DXM are almost entirely based upon DXM's toxic effects... So, if I were asked the question, "How dangerous is DXM?"; this is very similar to asking "How many times can I take Cyanide until I eventually die?" or "How much arsenic can I swallow but still live to talk about it!?"
But still, it's YOUR BRAIN, it's YOUR BODY. and your life... Choose wisely. Here are my findings. -Dick
Is DXM Dangerous?
YES, DXM use can be dangerous especially if
1.you take too high of a dose.
2.you take DXM too often.
3.take high-doses of DXM AND take it too frequently, aka “Chronic, High Dose Usage”
Important Short-Term Dangers:
Nausea, diarrhea, vomiting, and allergic reactions (often from the cough syrup itself)
Hot flashes, dizziness, and bad trips
Psychotic breaks (generally from high dose use)
Poisoning from Bromide Ions (Bromism)Important Long-Term Dangers:
Psychological addiction and depression (from regular use)
Poisoning from Bromide Ions.
Irreversible brain damage (from chronic use at high doses)Brain damage is fairly rare, occurring in less than 1% of the regular users that William White interviewed. He says, “They all used DXM very frequently. If you do DXM twice a month or less, you'll probably be OK. But remember there's always the risk of something going wrong.” FYI: William White is the ‘famous’ author of the DXM FAQ.
Quote:
Other "Inactive" Ingredients
Cough syrups tend to contain several thickening and sweetening agents. Glucose, sucrose, invert sugar, and fructose are all commonly used as sweetening agents. Obviously, a person with blood sugar problems (diabetes or hypoglycemia) should not take large amounts of these syrups. "Diabetic" syrups are available.
Thickening agents don't generally cause problems other than nausea. Occasionally people will look on cough syrup labels and see propylene glycol or polyethylene glycol, and (thinking about ethylene glycol, i.e., antifreeze) worry about toxicity. Propylene glycol is not toxic, even though ethylene glycol is. The same goes for polyethylene glycol (PEG) - it's also nontoxic. About the worst you will get from any of these is an upset stomach.
One general note - keep in mind that your body does eventually have to use or excrete whatever you eat and drink. Drinking huge amounts of sugars and thickening agents can put a fair amount of load on the pancreas and kidneys and should definitely be avoided if you have kidney problems already. There is anecdotal evidence that regular high-dose use of DXM cough syrups (without eating much) has led to kidney damage due to the glucose load (though I suspect rhabdoymolysis may be the cause) I cannot confirm this but I can't disprove it either. I've also heard of people having blood sugar problems after repeated use of DXM cough syrups, but again I can't verify this. (White)
HISTORY OF DXM.
DXM was first patented with U.S, Patent 2,676,177.
In 1958 the FDA approved DXM as an anti-tussive (cough medicine), in response to the recreational use of codeine cough medicine at that time. There were several advantages of DXM over codeine. DXM was not physically addictive, and a normal dose did not cause any pleasant, "sedative-like" effects.
In 1960, DXM was marketed in the US as a DXM-only pill called Romilar. It was considered "safe cough medicine" compared to codeine. But soon, Romilar users discovered the abuse potential of DXM.
13 years later, Romilar was withdrawn from the shelves.
After Romilar's removal in 1973, it was assumed that DXM would be phased-out in favor of some newer compound less susceptible to abuse. As it turns out, this hypothetically 'newer and better' drug was never discovered. And so DXM and codeine remained the only cough-relievers available.
So, manufacturers re-released DXM in syrup which tasted disgusting. William White, (DXM FAQ) suggests that the reason people "forgot" about DXM's abuse potential was mainly due to the emergence of hallucinogenic studies, and the abundance of better drugs such as LSD and Magic Mushrooms (White, 1997).
The 1980s and early '90's saw very little DXM abuse as the War on Drugs was waged in the U.S. There was very little information around about abusing DXM until the internet took shape in the mid-90's, allowing people to dissiminate information together on various subjects. First, DXM information was spread on Usenet. As internet access increased, DXM became a star, and now there dedicated websites with compiled information that is more accurate, and includes scientific information about DXM. But, even after the dissemination of DXM 'knowledge', the medical community remained relatively unaware of the drug, until several deaths were attributed to DXM.
William White's comprehensive DXM FAQ details DXM's effects, chemistry and dangers as a how-to guide for the interested psychonaut. While he originally presented DXM as benign, White soon began receiving various reports from users who claimed long-term effects like changes in moods, personalities, and memory. After these disturbing reports, and after Dr. Olsney's discovery of DXM-induced brain lesions in rats, he changed his stance on DXM being 'harmless.'
The purpose of THIS compilation is to bring together the presently known and understood information from several fields of science and medicine into the layman arena where the DXM 'epidemic' first began--the internet. Now, DXM users, and potential users of DXM can become better educated on possible side effects, toxicity, issues of concern, potentially deadly combinations, and the internet community can hopefully learn more respect and shed the frivolous stance on DXM's availability as a recreational drug. If this does not occur, then DXM will certainly go the route of all other "famous" psychoactive plants and drugs--into the realm illegality. Remember that as every teenager presents to his/her local ER with advanced DXM toxicity, that more pressure will be placed on the already-advancing search for a newer, kinder, non-psychoactive anti-tussive medication. The search that originally began in 1973.
DXM's EFFECT ON THE LIVER
METABOLISM OF DXM,
HOW YOUR BODY HANDLES DXM, AND
*PROBLEMS* WITH DETOXIFICATION.
DXM is metabolized by the liver (liver secretes bile and functions in metabolism of protein and carbohydrate and fat; synthesizes substances involved in the clotting of the blood; breaks down toxins by the cytochrome P450 oxidase enzyme). Specifically, DXM is broken down by a P450 enzyme called: CYP2D6.
Concerns about Liver Enzyme CYP2D6:
1. Poor Metabolizers.
A significant portion of the population have a functional deficiency in this enzyme called "CYP2D6 Poor Metabolizers". Since CYP2D6 is the primary metabolic pathway in the inactivation of DXM, the duration of action and effects of DXM are significantly increased in "CYP2D6 Poor Metabolizers." Also, Deaths & Hospitalizations have been reported in poor metabolizer recreational users.
2. Inhibitors of CYP2D6. A large number of medications, including antidepressants (SSRI's), are potent inhibitors of CYP2D6. So, there is a HIGH potential for drug interactions between DXM and other medications. There have been reports of fatal consequences arising from such interactions.
DANGERS OF DXM:
Obviously (due to the plateau-type effects), DXM intoxication varies depending on the dose. Many of the expected effects of recreational DXM use are actually signs of DXM toxicity in various organs.
SHORT TERM POISONING
List of Known Acute Toxic Effects
Quote:
DXM is known to cause a variety of acute toxic effects:
ranging from nausea, restlessness, insomnia, ataxia (cerebellar uncoordination/inability to balace while walking), slurred speech and nystagmus (eyeballs shaking), mood changes, perceptual alterations, inattention, disorientation and aggressive behavior (Rammer et al 1988; Katona and Watson 1986; Isbell and Fraser 1953; Devlin et al 1985; McCarthy 1971; Dodds and Revai 1967; Degkwitz 1964; Hildebrand et al 1989).
DIFFERENT "PLATEAU'S" & SHORT TERM TOXIC EFFECTS OF DXM ABUSE
Plateau 1 & 2: In addition to Euphoria & laughing, people on 1st or 2nd plateau often develop Tachycardia (FAST Heart Rates), Blood Pressure spikes, Vomiting, Mydriasis (pupil dilation), Nystagmus (eyeballs shaking), Sweating, Loss of Motor Coordination (cerebellar intoxication / cerebellar shutdown).
Plateau 2&3: In addition to the above findings, persons with moderate intoxication (Plateau 2 & 3) may demonstrate hallucinations and a distinctive, plodding ataxic gait that has been compared with "zombie-like" walking.23
Plateau 2,3, or 4: Severely intoxicated individuals in a dissociated state may be agitated or somnolent.5,6,8,21
Plateau 3&4: Extremely agitated patients may develop hyperthermia and metabolic acidosis. The presence of these signs are largely ominous. They represent a severe shift in the body's natural ion balance: causing or resulting from kidney failure, inadequate oxygenation, and/or a diseased, allergic-type reaction within the neuro-muscular junctions.
Quote:
DXM (and other dissociatives: PCP, ketamine) can also trigger psychosis, limbic seizures, temporal lability, depression, and other neurological and psychological diseases much more frequently than other types of drugs.
Quote:
The differential diagnosis of DXM intoxication includes other potentially serious toxidromes. Patients with ataxia, nystagmus, and mental status changes may suffer from ketamine or phencyclidine abuse, lithium intoxication, phenytoin, or carbamazepine poisoning, Wernicke-Korsakoff syndrome, and sedative-hypnotic, including ethanol, abstinence syndromes.26 (http://gateway.ut.ovid.com.libproxy2.usouthal.edu/gw2/ovidweb.cgi#74)
Quote:
When taken in very large doses, DXM can produce a high. It also can pose a real danger to the user, including:
Impaired judgment and mental functioning
Loss of coordination
Dizziness
Nausea
Hot flashes
Hallucinations
Brain damage
Seizure
Death. http://www.drugs-forum.co.uk/forum/showthread.phpDXM+danger (http://www.drugs-forum.co.uk/forum/showthread.php?t=3828&highlight=DXM+danger)
LONG TERM TOXIC USE OF DXM.
TOXICITY.
Probably the most important effects to consider from long-term abuse is liver or brain damage.
Quote:
"People who have used dissociatives heavily have shown clear evidence of brain damage. This is not necessarily conclusive, since the people who become addicted to them might have underlying conditions (specifically, temporal lobe complex partial seizures) which could be responsible for some of the damage.
Nonetheless, one cannot ignore the fact that most everyone who uses dissociatives both frequently and heavily ends up with some sort of neurological or psychological problem, ranging from impaired memory to a schizophrenia-like syndrome.
Many of the impairments correspond exactly to the areas of the brain damaged in lab animals." (White)
BROMIDE TOXICITY.
Bromide Ions. DXM is usually found as a salt of DXM and hydrobromide ions.
Large amounts of bromide ions can cause sedation and eventually lead to bromism (bromide poisoning), which affects (among other things) the skin andnervous system.It is one more VERY important reason to avoid prolonged high-dose use.
Quote:
Because DXM is produced as the crystalline hydrobromide salt, bromism is a consequence that has been identified in heavy chronic abusers of DXM.31
Quote:
Bromide-poisoning from DXM has been KNOWN to cause IRREVERSIBLE BRAIN DAMAGE (Cerebello-bulbar syndrome), and SHRINKING OF THE CEREBELLUM!
***The Cerebellum is a very important part of the brain! It is the Sensory/Motor Processing and Integration Center of the brain. It is necessary for nearly every coordinated motor activity (using muscles), balancing, touch, feeling, applying your hands and fingers to perform fine motor tasks, and MUCH more!!***
Quote:
There are reported cases of bromide toxicity, especially organic bromide, causing an irreversible cerebello-bulbar syndrome with cerebellar atrophy on CT and EEG changes (Van Balkom et al 1985).
Many Doctors believe that prolonged heavy use of DXM may lead to bromism. There is a case presented in the American Journal of Nephrology that demonstrated “Spurious Hyperchloremia and Decreased Anion Gap” in a DXM user. 1992;12:268-70. Translation: the human body is an aqueous environment—just like the ocean. Like the oceans, our body water is NOT just plain, pure H2O. Instead, it is “salty”—meaning that there are dissolved ions. The most common, and most commonly known are Sodium, Chloride (i.e. NaCl). Also very important to the functioning of our internal environment are other ions: Potassium, Magnesium, Calcium, etc. Bromide is very low on the list of ‘normal’ ions in terms of concentrations.
This brings us nicely into the discussion about our renal system.
DXM'S EFFECTS ON THE KIDNEYS.
ION EXCHANGE, WASTE REMOVAL AND SERUM PH
You might recall an ongoing argument about GHB. Should you make it with KOH (potassium) or NaOH (sodium)? If you make it w/potassium, then you can actually ‘overdose’ on the potassium and… well, look it up yourself if you’re interested.
If you make it w/sodium, then you can ‘overdose’ on sodium, causing a serious depletion in the essential—and short-supplied potassium. This is because the body’s watery environment exists in homeostasis—in other words, your body uses MANY mechanisms to keep its pH normal (~7.2), in other words, your organs make sure that there aren’t too many negative charges (“basic” or “alkaline”) and to make sure there aren’t too many positive charges (“acidic” or “acidosis”). Some positive ions: H+, Na+, Ca++, Mg+. Some negative ions: OH-, Cl-, K-, and more.
“Anion Gap” is simply a measure of your blood pH minus the concentration of “normal” ions—mostly sodium and chloride.
Equation for A.G. = Serum Sodium - Chloride - Bicarbonate
HIGH ANION GAP: Most types of acidosis that are UNNATURAL are a result of strange positive ions (or “acids”) not normally found in the blood.
Causes include: Metabolic acidosis (lactic acid), Methanol poisoning, Uremia (uric acid from kidney failure), Diabetes (ketones), paraldehyde poisoning, Iron, INH (a medicine), Ethylene Glycol, Salicilates (aspirin=”salicylic acid”).
LOW ANION GAP**:**THIS is what you get from DXM!!!
Causes include: Paraproteinemia (too many weird, charged un-natural proteins, e.g. Multiple Myeloma), Hyponatremia (low sodium), Hypermagnesemia (high Mag level), Hypoalbuminemia (too LITTLE albumin—a fancy word for normal blood protein), and…. Lastly: Spurious Hyperchloremia (from Bromide toxicity)
So, essentially, DXM toxicity seems to exhibit TWO contradictory adverse effects upon the body's normal serum pH:
1. Low anion Gap, caused by spurious Hyperchloremia from Bromide toxicity and
2. Metabolic acidosis (higher anion gap)
What do these conflicting messages mean?
Well, for starters, they both practically PROVE that DXM is toxic to your body's aqueous serum environment. At the very minimum, DXM causes heavy glucose and abnormal ion loads on fluid homeostatic mechanisms, meaning stress and damage to the kidneys and pancreas.
Rhabdomyolysis.
In addition to these findings, there has been reported several cases of DXM effecting serum protein levels (increased protein from MUSCULAR CELL DEATH AND BREAKDOWN, aka Rhabdomyolysis). From an unknown mechanism, probably not unlike Dantrolene Poisoning, DXM can apparently cause rhabdomyolysis--a condition that causes permanent, irreversible kidney failure.
Remember, these effects are in addition to the liver issues.
Just to repeat myself ONE more time, it certainly seems that the effect of DXM poisoning is to shift your body's plasma ion balance in both directions, skewing the normal balancing act we measure by serum pH. DXM causes increased anion gap and metabolic acidosis, and hyperchloremia (low Cl-) and low anion gap.
The biggest danger from this is when your kidneys cannot handle the continuous assault--trying to detoxify the blood and return proper balance to pH and ion concentrations.
If you have the time to skim through this, please do as it will make you laugh a bit. This is the same stupid ass tactics that the US gov used on LSD. Fucking SAD! TXT TOO LONG, SKIP TO PART 2 PLEASE