DXM

Dextromethorphan (DXM) Use in Members of an !
Online DXM Community!
!
!
Michael P. McDonald, George Pringle, Kara I. Gabriel!
Dept of Psychology, Central Washington University, Ellensburg, WA !
Number of respondents ranking specific DXM-containing products as their 1st, 2nd, and 3rd
INTRODUCTION!
METHODS!
Participants!
!Sixty individuals were recruited from an online community dedicated to
DXM issues, Dextroverse.org, via discussion threads on that
community’s forums. Fifty-two indicated it was their first time taking the
survey, of whom nine (17.3%) were women and 43 (82.7%) were men.
The mean reported participant age was 23.6 ± 7.3 years old (range: 18
– 63; median: 21.5). !
!
Materials!
!The survey included sections on demographics, illegal and prescription
drug use, perceptions of DXM, perceived effects of DXM, and specifics
on DXM use and preferences. Response options varied by item, and
included yes/no, multiple choice, free response, and Likert-style scale
options. !
!!
!The content of the open response questions was analyzed for the
presence of specific themes by two coders. Disagreement triggered a
review by both coders until agreement reached 100%.
!!
choice for most preferred and most used!
Powder DXM
DXM−only cough syrup
DXM−only cough syrup
Cough gelcaps
Cough gelcaps
Delsym cough syrup
Zicam
Powder DXM
Delsym cough syrup
Preferred
First
Second
Third
Other
DXM and guaifenesin pills
Product
Product
Dextromethorphan (DXM) is used as a cough suppressant in more than 125
over-the-counter medications, and may also be useful as a neuroprotective
agent or in the treatment of opiate withdrawal. At high doses, DXM acts as a
nonselective serotonin reuptake inhibitor and a N-methyl-D-aspartate
(NMDA) receptor antagonist, with effects similar to those of phencyclidine
(PCP) and ketamine.!
!
Unfortunately, recreational intake of high-doses of DXM has been
documented in case reports of adolescents and young adults in the United
States, Germany, Thailand, and Iran, and may be facilitated by legal access
to the drug as well as by information available on the Internet. !
!
Despite growing awareness of the prevalence of DXM use, little systematic
information is available on use patterns and preferences among recreational
DXM users, on such users’ perceptions and attitudes toward DXM use, or
on the impact of the Internet on DXM use. Given DXM’s legal availability,
better understanding of DXM users’ intake patterns could aid in developing
targeted intervention or treatment approaches, particularly online. Lastly,
because DXM and illicit drug use co-occur, and drug use alters the
perceived danger of drugs, knowledge of DXM users’ behavior and
perceptions of DXM may contribute to a better understanding of illicit and
polysubstance drug use in general. !
!
The purpose of the current research was to seek information on DXM intake
patterns, preferences, and perceptions of DXM from a sample of adult DXM
users participating in a DXM-focused online community. !
RESULTS AND DISCUSSION!
Other
Zicam
Coriciden Cough and Cold
Concentrated DXM hydrocitrate
DXM and guaifenesin syrup
Other cough syrup
Other cough syrup
DXM and guaifenesin syrup
Concentrated DXM hydrocitrate
10
20
Count
30
Themes present in!
open-response questions:!
“What are the main reasons you use DXM?”!
“Is there anything else you would like to say
about DXM?”!
First
Second
Third
DXM and guaifenesin pills
Coriciden Cough and Cold
0
Used
0
10
20
Count
Substances used concurrently with DXM
to modify or enhance its effects!
30
40
!
Informed, Sophisticated, Polysubstance Use Patterns!
!
•  Majority of users (82.7%) reported using other substances to modify or
enhance the effects of DXM.!
•  79% of those listed more than one substance!
•  In addition to drugs such as cannabis, alcohol, and other psychotropics,
users frequently consumed non-psychoactive substances solely to
amplify or modulate the effects of DXM (e.g. grapefruit juice, magnesium,
cimetidine).!
•  Participants displayed proficiency with biological properties of DXM as well as
substances used to modify its effects – one user cited DXM as motivation to
pursue graduate studies in biochemistry!!
•  Preferred using DXM alone (84.3%) rather than socially (15.7%).!
!
Early Age of First Drug Use!
!
•  First Illegal Drug: 15.7 ± 3.1, Range = 7-27.!
•  First Prescription Drug w/o Prescription: 16.6 ± 2.3, Range = 11-22.!
•  First use of Recreational DXM: 17.1 ± 3.2, Range = 12-30.!
!
Perception of DXM as Safe and Beneficial!
!
•  Users saw their DXM use as having been more beneficial than harmful.
across a variety of life areas, finding DXM especially beneficial for their
mental health. Responses across the areas were highly consistent
(Cronbach’s α = 0.83).!
!
Goal Oriented Drug Use!
!
•  Majority of respondents (79%) reported using DXM to explore their
consciousness or alter their state of mind.!
•  While many respondents mentioned DXM’s accessibility (legal, readily
available, cheap) as a reason or benefit of using DXM, the focus was on
specific effects, such as dissociation and visual hallucinations.!
•  Users tended to avoid products containing non-DXM ingredients (such
as Coricidin® Cough & Cold, or CCC). These products have been more
frequently reported in prior studies of DXM abuse, potentially due to the
increased likelihood of hospitalization.!
•  Few respondents had ever been arrested (7.7%) or visited an emergency
room (17.3%) as a result of DXM use.!
!
ACKNOWLEDGEMENTS!
!
The authors would like to thank the administrative staff, moderators, and
members of the online community Dextroverse.org for their support and
participation in this study.!