Talk:Dextromethorphan/Archive 1

Archive 1

Grammatical error?

What is this sentence supposed to mean? -> "In addition to having a methoxy group that water (at 20 degrees Celsius, Sodium D-line) with a specific rotation of +27.6 degrees." -anonymous 2

It seems a big chunk of that paragraph was accidentally deleted at some point. I just fixed it. Thanks for pointing that out. Equazcion 10:09, 8 June 2007 (UTC)

Typo edits

I fixed some typos and the headline text. -anonymous

Dextromethorphan Deaths

"Deaths and hospitalizations have been reported in recreational use by poor CYP2D6 metabolizers." Considering there are very few DXM deaths at all. I doubt that the few that have happened were caused by poor CYP2D6 metabolizers. But I am willing to believe it if I see a some report even one of this being true. So please, if we are going to make a claim like that lets provide a source.

Foolishben 20:50, 24 August 2006 (UTC)

You're right, and the statement was removed. Equazcion 06:34, 21 February 2007 (UTC)

Terminology: "Recreational Use" or "Abuse"

Shenanigans! The Term "Recreational use" is used in virtually all common Wikipedia articles on medicinal drugs used recreationaly. This term has precedence dating back years, there is absolutely no reason this compound's entry should be any different! In fact, I suggest that whomever started this controversy read the wikipedia article on Recreational_drug_use. In the Wikipedia article for Cannabis "Religious and "spiritual use" along with "medicinal use" are used. In the Wikipedia article for ketamine "Recreational use" is used. In the Wikipedia article for MDMA "Recreational use" is used. In the Wikipedia article for Effects_of_nitrous_oxide_on_the_body "Recreational use" is used. In the Wikipedia article for Vallium the term "Recreational use" is used. In the Wikipedia article for oxycontin "Recreational use" is used. I could go on and on. This is fact, I and the rest of Wikipedia don't care if you vehemently object or not, Wikipedia is here to present facts, not to persuade or dissuade according to your own personal morals or beliefs on a topic. If you have a fact, post it. If not, keep your morals away from our facts and quit passing judgement onto people. In the very post here where you whine about a user correctly changing the term "abuse" to "recreational use" you make unproven claims as to DXM being "psychologically addictive", it's clear you've done little research, have no facts, and nothing positive to contribute to this article. We thank you for kindly refraining from editing FACTS in our encyclopedia.

Just because a term is used elsewhere doesn't make it right or prove its accuracy. MDMA, ketamine and PCP don't have a prescribed or over-the-counter indicated use, so "recreational use" seems to accurately cover what people do with it. DXM, though, is taken via an over-the-counter cough suppressant. It's clearly indicted that this is a pharmaceutical medicine meant for people who are sick, and what the usage and dosage is supposed to be. Buying cold medicine and taking 7 to 50 times what the directions say when you're not even sick is something that can be accurately referred to as "abuse" by definition. People are taking advantage of the fact that a cough medicine happens to contain a psychoactive drug, and are, quite literally, abusing it. Abuse has negative connotations, while "recreational use" is more comfy and happy-sounding, but that doesn't make it any more accurate. That having been said, I'm fine with using the more comfy terminology, as long as it's made clear what the dangers of such usage are. But to reiterate, complaining about the term "abuse" as part of some kind of quest for political correctness to make yourself feel better about taking 15 times the intended dose of cold medicine just means you're too easily offended. I've abused DXM before and I'm fine with calling it exactly what it is. The moment they come out with a "Robitussin Multi-Purpose DXM Capsules, for General Use" then 'recreational use' will be 100% accurate and abuse will be wrong, but til then, it really is abuse. Look it up. PS, many of the article's references show the "psychologically addictive" properties of DXM.

Equazcion 07:00, 21 February 2007 (UTC)

"ketamine and PCP don't have a prescribed or over-the-counter indicated use".

I think you should check your facts buddy. While they may not be over the counter both Ketamine and PCP have valid unrecreational uses. Ketamine is schedule III and PCP is schedule II, this means both have medicaly accepted uses and using your logic they to then should be considered as "abuse". The first post is correct in saying that calling it abuse is a moral bias.

I haven't checked the non-recreational uses of those drugs. However even if they do have such uses, the point still stands. If you have the ability to acquire a drug only because the government and the drug company recognizes its usefulness to, say, treat common cold symptoms, and you decide to take advantage of the resulting availability to acquire and consume large quantities of the drug for a purpose that both the government and the drug company would probably not condone, then you are abusing a number of things. You're abusing the privilege of being able to acquire the drug (whether over-the-counter or by prescription), since the government and drug companies only sought to make it easier for people to treat their colds, not let people get high. You are also abusing the specific preparation, since you're exceeding the maximum dosage indicated on the labeling. The first post is incorrect in saying that calling it abuse is a moral bias.Equazcion 02:10, 20 April 2007 (UTC)

---

A user decided to change the Dextromethorphan terminology from "abuse" to "recreational use," stating that the term "abuse" did not have a neutral point-of-view. I must vehemently object to this for several reasons. First of all, the term "Abuse" covers more ground: People may use DXM for reasons other than recreation: They may be depressed, and find it to be something that helps them escape reality, they may be psychologically addicted and implusively take the drug, they may even take 10 times the indicated dosage due to a horrible cough thinking it will help more, only to find themselves intoxicated. ...or they may be bored and just trying to get "high". The term "abuse" covers ALL of those situations. "Recreational use" only covers the latter.

Here's another problem: The scientific community does not generally use the term "recreational use." Doctors do not generally use that term. The FDA doesn't use that term. International governments do not usually use that term. Schools don't use that term. BUT -- erowid.org does, and high-school/college kids like it better.

Yes, I know "recreational use" sounds better if you're young. And it may well be an accurate term in many instances. I know you all probably like Erowid. Erowid was launched my junior year of college and, being college students, we all liked to read about ways to get f***ed up as I'm sure you all do too. But when you leave college and all that behind, you look back in retrospect and feel just a little silly.

But here's the bottom line: Dextromethorphan was designed with ONE purpose in mind. Its patent has ONE function listed at the patent office. It's job it to control your cough. Therefore, using it for any other purpose that its indicated is, by definition, abusing it (See dictionary.com, definition 2: "Improper use or handling; misuse"). This is not POV, it's simple fact. It doesn't necessarily imply that it's good, or that it's bad. Hell, I abuse my car by redlining the engine. That's not good or bad -- I know she can take it -- but it's using the engine in a method other than that specified by the manufacture.

Chances are (but not necessarily), if you object to the term "abuse," it's because you're a DXM user and you don't want to think of it as abuse. Reverting it to "recreational use" betrays your biased point-of-view as you are using a less inclusive, less official term than makes DXM's usage for fun sound better. But abuse is more inclusive, more mature, more official, used by more legitimate institutions, and makes Wikipedia look better and relate to a wider audience.

The implication of "abuse" is that something about this sort of use is inherently wrong or immoral, which is most definitely not a neutral point of view. "Recreational use" is the correct term when referring to non-medical use.

You comment that one "may even take 10 times the indicated dosage due to a horrible cough thinking it will help more, only to find themselves intoxicated". This is not abuse. It is misuse, and certainly would not be considered recreational use. Please see the drug abuse article. ‣ᓛᖁᑐ 17:50, 12 July 2005 (UTC)

The phrase "drug abuse" is usually POV.. it implies that using drugs recreationally is necessarily harmful. The term "recreational use" is preferred over "abuse". Rhobite 19:58, July 12, 2005 (UTC)

I agree that we should avoid moral judgements, even about drug use. And really, if this were an article on LSD, mushrooms or the like, I think "recreational use" is the best term. However, DXM is -- for most people, the government, the companies that produce and patent it -- a cough suppressent. So therefore any use inconsistent with its labelling (not just the accidental overdose) is by definition misuse. And according to The American Heritage® Dictionary of the English Language, abuse and misuse are synonymous in this case. ("Abuse: (n)Improper use or handling; misuse: abuse of authority; drug abuse.") So whether it's immoral or not, using cough syrup to get high is improper use. Abuse definitely has a moral tone, but only with other definitions (spousal abuse, etc) that are separate from the context in which it is used here. This is according to the Dictionary, a source more authoritative than a Wikipedia article to which you referred me.

But seeing as you did refer me to said article, several official definitions contained therein support the case for "abuse." Among them:

The US National Institute on Drug Abuse defines drug abuse as "The use of illegal drugs or the inappropriate use of legal drugs. The repeated use of drugs to produce pleasure, to alleviate stress, or to alter or avoid reality (or all three)." In place of this definition, WHO uses the term drug misuse, defined as the "use of a substance for a purpose not consistent with legal or medical guidelines, as in the non-medical use of prescription medications."

So "abuse" is an appropriate term according to NIDA. Granted, the WHO prefers "misuse," because -- like you -- they feel that there exists a negative connotation there (even though none technically does, according to the dictionary). And of course, we have definition from the executive level of government that states,

"the use, usually by self-administration, of any drug in a manner that deviates from the approved medical or social patterns within a given culture".

Now I agree that deviation from social patterns is something that can be debated. But again, the term "abuse" fits perfectly here in that it "deviates from the approved medical" usage.

Here's the thing: You don't like "abuse" because you feel like it reflects a POV. And I see your point -- it sounds like it does. "Abuse" is usually a bad word ("domestic abuse"). But that's a totally separate definition. Some people get sensitive over words that SOUND bad, but in actuality, are not in and of themselves. There is no case for the term "abuse" carrying moral weight when used as the dictionary, NIDA, and the executive branch define it.

Calling recreational use of cough syrup or cough pills "abuse" is really just like calling your dog a bitch. Yes, it sounds bad, but in reality, that's the technical term -- it's just that many prefer not to use it; they'll say female dog. But institutions interested in being as technically correct as possible, say, the American Kennel Club, will always use the term "bitch."

I really do think there's a strong case for calling this "Abuse." I don't think there's a strong case for calling "abuse" a POV word besides the fact it may sound wrong. Furthermore, I think there's a strong case against "recreational use" for DXM, or there's at least as strong a case for considering "recreational use" a POV word as there is for "abuse." One could argue that the term presents the impression that the activity in question should be assigned no more scrutiny than other recreational activities like golf or painting pictures. Some might say that it presents a careless image, that -- while "abuse" might sound overly negative -- "recreational use" sounds overly positive.

I dispute that "recreational use" lacks NPOV. Between one or the other, I believe we should stick with the dictionary, the government, and medical industry and produces and regulates the drug. Remember, this is a drug that's being MISUSED. LSD and Mushrooms have no collectively accepted use anywhere other than in the drug community, so a stronger case could be made for such a drug. Ultimately, I do not feel like you have made a strong enough case for reverting "abuse." You simply state it's POV, though nothing official (only other people's opinions) backs it up. I am going to revert it to the medical term, but I will not get into a reverting war. Perhaps we could agree on "misuse" or another such word.

I would really like to hear a debate on this issue from others as well, and I'm glad you have engaged in this one with me. Civil discourse like this only helps increase both our knowledge, better inform our positions, and is a nice exercise in logic as well. Does anyone else have anything to add? Anyone? Anyone? Bueller? (..ah that joke's not funny anymore)

PS -- Rhobite just added his 2 cents, and now being in the minority for the time being, I will not revert it back. I'd like to challenge you, Rhobite, to explain why "abuse" implies that such drug use is "necessarily" harmful, or at least to the extent that we should ditch the medically accepted term in favor of a new-age PC term.

RJSampson 20:05, 12 July 2005 (UTC)

I think you're using odd criteria to determine which drugs can be "used recreationally" and which drugs necessarily constitute "abuse". You're saying that since LSD and mushrooms have no legitimate medical purpose (according to modern western doctors), they can be used recreationally? But as soon as a drug has an approved purpose, it is "abuse" to use it to get high? Cocaine is approved as an anaesthetic.. marijuana is approved for medical use in many countries and some U.S. states. Does that mean that getting high off marijuana is necessarily "abuse"? I use the word "necessarily" because that's the logical conclusion you make: By moving the article to "dextromethorphan abuse", you are saying "if you get high off cough syrup, then you are abusing it". You are the one claiming that there is no possible way to get high off of dextromethorphan without it constituting abuse. Please correct me if I'm misreading your statements.

I'm not convinced that the word "abuse" is preferred by doctors over "recreational use". Would you please cite this? About your dictionary definition, you're mistaken: dictionaries are not authoritative sources. They are descriptive guides to the use of language - not to be used for settling disputes such as this one. Dictionary definitions are vague and completely useless in settling disputes over the connotation of a word. "Drug abuse" certainly does have a negative connotation, even though it is used by certain official groups. The government has an incentive for using loaded terms such as "drug abuse", of course, and I don't place much value on publications from groups such as NIDA. They have a vested interest in keeping people from openly discussing drugs using neutral terminology. I think you're relying too heavily on sources you claim are official. As I said, dictionaries say nothing about connotation. And the idea that the POV of the US government should trump anyone else's POV is simply wrong. The medical community is a better source than either a dictionary or US government propaganda, but I'm not convinced you've done your homework there - I'm not convinced that medical practitioners like the term "drug abuse" any more than I do. Rhobite 20:22, July 12, 2005 (UTC)

Some quick searching of the JAMA archives confirms that while the term "drug abuse" is used, medical researchers seem to prefer "drug use" or a specific, e.g. "cannabis use", "cocaine use", etc. Rhobite 20:32, July 12, 2005 (UTC)

Rhobite,

Thanks for your response. I think you make a strong argument that we shouldn't trust NIDA to lack POV. And I agree with you 100%, I think that they're suppressing honest argument about drug use in America. The only reason I cite them is because they're the ones who ciminalize this sort of thing, so without other standard references, I think it makes at least some sense to defer to their syntax. But I am impressed and convinced by your argument that the government should not be used to defend my argument. As for the medical industry, I could certainly tell you, that none, if any of my medical school textbooks make reference to the term "recreational use," except when defining "abuse." (I did not go to medical school, but have many doctors in my family -- used their books to get through undergrad Bio courses) But what's THE authoritative book on all legal drugs? The Physicians Desk Reference. For each drug described, there is a section that evaluates both its abuse and addiction liability. The PDR never once uses the term "recreational use." DXM is cited as having a low addiction potential but likelihood of abuse. I can't cite anything, of course, that says "the term is 'abuse' and not 'recreational use'", but I could theoretically cite the hundreds of PDR entries that use the term "abuse" in various capacities. The only other thing that I take issue with is that you say we can't use the dictionary as a source. Why not? The American Heritage dictionary and Webster's dictionary (that is, the major comprehensive English language tomes) are cited in court cases all the time, and if you'll allow some time to pull them up, I can cite some of them

I think you have a good point in mentioning my inconsistent criteria for identifying drugs of abuse. I think what I was trying to say was simply this: A drug that is designated for medical purposes is being abused if it's used for any other purpose, one that has no accepted use by society or industry outside of recreational use is simply being used. But then, my argument already has a hole in it -- abuse is also almost unanimously used to refer to addictive drug use, which can be the case with Scedule I drug as much as a legal drug. So yeah, I should stick with all or nothing, so we'll just use "drug abuse" for my argument.

Rhobite has definitely made strong arguments that have given me reason to abandon some of my premises. The only one I'm truly left with, the one one which I actually have done my homework, is the medical community. Because the PDR, medical textbooks, and my friend who is an endocrinologist (who I just called) said that abuse is the term the industry uses for such behavior, I still stick with my argument. He agreed with my appraisal of "abuse" as the correct term (but, of course, that's hearsay unless I can convince him to join Wikipedia).

My concern is simply that Wikipedia will get a reputation among professionals for being juvenile, and worse, unreliable. Rhobite makes a strong case, though. I definitely won't be doing any reverts as my only sources are medical books and the dictionary. But I do believe that those are very strong sources, and I would like to hear a medical authority say that "recreational use" is preferable to "drug use" before we abandon this argument. And I still think "recreational use" has POV in much the same way that "abuse" can be said to have POV. Furthermore, "recreational use" can't really refer to addiction or compulsive use as that falls more along the lines of a mental condition rather than doing it for recreation.

Suggestion: What do you guys think of "Dextromethorphan Abuse/Recreational Use" ?

Thanks for indulging me Rhobite, and well done on your arguments.

PS again -- I hope anyone else who is reading this understands that all this is in the spirit of intelligent debate and search for truth. As Rhobite and I can attest to, nothing is more annoying than a.. well, abusive user (:P) taking the level of argument down to juvenile levels. Future posters would do well to use Eequor and Rhobite as examples of presenting mature arguments.

RJSampson 21:05, 12 July 2005 (UTC)

In most contexts, medical doctors have no strong preference for recreational use versus abuse and all would understand the terms as synonymous in nearly all context and regardless of one's political views. I suppose as a child of the 60s I use the term recreational use at least as often as abuse. Drug abuse is not my field, but I talk to adolescents every day and when the topic comes up I especially favor recreational use rather than abuse because it is a more explicit way of reassuring someone that you don't consider him or her a bad person if they should do that. Obviously, the same term can be used to a different audience, in a different tone of voice, with the clear message that you consider the person who does that a waste of protoplasm. It's the attitude and context, not the word. I tend to favor the term most likely to be used by readers unless it is actually and clearly erroneous, and I would mention both terms early in the article, noting why some might prefer one or the other exactly as you have explained above. alteripse 23:59, 12 July 2005 (UTC)

"Recreational use" sounds more NPOV, but "abuse" is not necessarily POV depending on what definition one uses. Nonproprietary use of substances such as dextromethorphan can be classified as "abuse", IMO. The healthcare system is having enough trouble with really ill people, and nobody is waiting for perfectly well people who poison themselves just for a kick. So abuse it is. JFW | T@lk 00:39, 13 July 2005 (UTC)

Well, there's definitely a spectrum of opinions developing. I think that, as Jfdwolff pointed out, some non-medicinal uses of cough syrup can be unarguably bad -- ie, overdosing and taking medical resources, or maybe DUI on DXM. We'd all probably agree that this constitutes abuse. I remain unconvinced that the medical industry prefers or even recognizes the term "recreational use" over "abuse," and I still believe in the risk of looking "drug-friendly" to certain individuals who may consider "recreational use" just as POV as many of you consider "abuse." Having said that, I'd like to bring up an earlier suggestion for a new title: Dextromethorphan Abuse/Recreational Use. What do you think? That should appeal to everyone, no?

RJSampson 22:37, 13 July 2005 (UTC)

I also agree that drinking a bottle of cough syrup and taking a trip to the hospital constitutes abuse.. but this is still a value judgment, it's my personal opinion. Even if an act is unarguably bad as you say, describing it as bad is an NPOV violation. Rhobite 22:26, July 14, 2005 (UTC)

"Off-label use" would probably be better, I suppose. This captures the facts that recreational use is not medically approved, and the results are intentional. It also avoids an implied point of view that all "illicit" use is recreational. ‣ᓛᖁᑐ 22:51, 15 July 2005 (UTC)

Except that doctors often prescribe drugs "off label." 66.57.225.195 21:50, 19 July 2006 (UTC) DEL

I think that's a perfect title! Even better than abuse. Good thinking! RJSampson 04:03, 16 July 2005 (UTC)

No.Neither "Abuse" or "Recreational" are neutral as they should be. I Belive the best title is the Current one, "Non-Medical use".-MeDP.

Strongly Agree. -- ×××jijin+machina | Chat Me!××× -- 20:39, 2 September 2006 (UTC)

Merge the DXM articles

Both articles need to be merged together again. We don't have 2 pages for medical use and abuse of methamphetamine or oxycodone do we? Most of the information on the recreational use page was just copied straight from the DXM Faq. Heres a better idea. Keep the information on Dextromethorphan recreational use brief, make a warning saying that Wikipedia does not condone drug abuse and advise anyone who wants to try out DXM to read the DXM Faq. Then put a link for it. --Arm

I'm indifferent about merging the articles, but I am strongly against any warnings. Wikipedia already has a general disclaimer which is linked at the bottom of every page. Additional warnings (especially ones about Wikipedia "not condoning" certain acts) are POV. Wikipedia does not condone any acts, beneficial or harmful. Of course, the article should neutrally describe the harmful effects of DXM, deaths, etc. I am not saying we should hide any information - just let the information speak for itself. Rhobite 18:50, July 16, 2005 (UTC)

I think a warning on the part of recreational use of Dextromethorphan would be useful. At the very least there should be one saying Wikipedia does not give medical advice. --Arm

There is a medical disclaimer saying exactly that. Wikipedia:Medical disclaimer is linked from the general disclaimer. Additional warnings are POV and unnecessary. If we're into individual disclaimers we might as well have a king crab fishing warning, or an astronaut warning. Rhobite 19:02, July 16, 2005 (UTC)

I guess the idea of telling someone unfamilar with dex who want to try DXM recreationally to read the DXM faq, then say Wikipedia does not give medical advice is POV. Though thats still the best idea. Would work for a harm reduction site but no Wikipedia, the land of the neutral point of view. --Arm

As I said, there's nothing wrong with noting how dangerous DXM is in the article. Rhobite 20:46, July 16, 2005 (UTC)

I am strongly against merging the articles. I agree that, if done, the rec. info should be brief but that's very unlikely to happen. There SHOULD be separate articles on rec/abuse for meth and oxy. Maybe we can do that here. But if 90% of the article on DXM is about the "plateaus" of getting high -- well then, the article is more about recreational use of DXM than DXM itself. As I've said before, it makes wikipedia look like erowid. An in-depth article on the off-label experience should not be the majority of the general article about a medication. RJSampson 21:09, 16 July 2005 (UTC)

The plateau system is a farce. It's just Whites version of the 5 levels of the psychedelic experience. The plateaus should be briefly menctioned but not dwelled on as William White said himself that the levels shouldnt be taken too seriously. I do admit that the recreational use of DXM articles a mess but we should clean up and merge. --Arm

I agree with RJSampson and Rhobite here. The off-label use article is large enough that it should stay separate, and there is a link to a disclaimer on every page. ‣ᓛᖁᑐ 01:58, 17 July 2005 (UTC)

Off-label use of dextromethorphan, what a stupid and misleading name. That sounds like someone taking dex for medical use, not abusing it to get high. But I'm sure it will get changed again. Ive been trying to clean up the "Off-label use of dextromethorphan" page. Mostly by removing useless, sourceless or outdated information. If you feel I removed something that I shouldnt of have, ask yourself if the sentence/paragraph conforms to Wikipedia standards and as to wether or not it conveys any useful and factual information. --Arm

• "Non-medical use" would probably be better. --Tarnas 06:00, 30 July 2005 (UTC)

I agree with Arm and Tarnas. While I still think "Abuse" is the most appropriate term, it seems to not have consensus support (yet)... I think Tarnas' suggestion ("Non-medical use") is the best alternative. You should go ahead and make the change. I would myself, but doing so is a bitch and I'm lazy :) RJSampson 08:51, 30 July 2005 (UTC)

i agree with arm's original statement. even if the dxm article ends up being about the non-medical usage more than dxm, i don't see how that is a problem, or much different from some of the other drug pages. i'm not sure of the usefullness of this seperation. i also am unsure of the need for such an extensive account of non-medical usage (especially as it seems to have been mostly copied from an faq.) imho this section should be shortened and merged with the main article. I'd also like to encourage everyone to check out the fairly new WikiProject on Psychedelics, Dissociatives and Deliriants, which theoretically should be dealing with issues like this and how the articles within the project should be organized. i just put up the template at the top of the talk page, i thought it was here already. --Heah (talk) 17:54, 31 July 2005 (UTC)

• The only reason to keep them split at this point is so that the non-medical use text can be cleaned up and condensed before being integrated into the much tidier dextromethophan article. But it makes sense to have a lot of information on DXM's non-medical use, given White's FAQ being a famously complete account and given the wealth of other DXM knowledge. --Tarnas 21:31, 31 July 2005 (UTC)

No, there's no reason to merge the articles. Please do not do so. The subject of the drug itself and its usage to get high are two different things. Again, if the articles get merged, then the article on DXM will mostly be about what it's like to get high off of it. This is a very bad precident and does not reflect that DXM is primarily an anti-tussive. The vast, vast majority of people use DXM to control their cough, not to get high. Why should the article focus on what a small minority of people do? I mean, come on here... Gasoline can be inhaled as a dissociative but the majority of the gasoline article doesn't focus on this fact. Keeping them separate is very important because Wikipedia should appeal to ALL people, not just teens and college students who like to read about recreational drugs. What on earth is the harm in keeping them separate? And if other drug articles are like that, it's a problem that needs to be fixed (unless, arguably, its a drug like LSD or meth in which the majority of users do so to get high). Don't merge. RJSampson 00:35, 1 August 2005 (UTC)

• That makes sense I guess, though I'll have to mull it over and look into other precedents. The majority of literature written on DXM has probably been written about it's non-medical usage, but there's virtue in keeping the topics separate for the purpose of avoiding confrontation. I can't think of another drug like DXM off the top of my head that is legally used very widely yet is still such a legitimate psychoactive: nutmeg, though it isn't nearly as effective of a psychoactive and doesn't warrant as much documentation, or maybe commonly abused prescription drugs such as oxycodone, though the illicit use of oxycodone is covered comparatively briefly in that article and doesn't at all match to the usage pattern of a hallucinagen like DXM. Perhaps ketamine is the closest case (not to mention being close in psychoactive nature), where there's a long history of legal medical and academic uses as well as a long history of illicit personal use. Thinkin' about it... --Tarnas 01:43, 1 August 2005 (UTC)

Well, the majority of the literature on DXM has been written about its medical use. You're just looking in the wrong place. A brief search on Pubmed alone yields several hundred journal articles (which have a higher degree of legitamacy than most forms of literature). The internet, of course, is the domain of the young (for the most part) and is not representative of the real state of many things in the world. I just don't see the harm in keeping separate articles. I see very real harm in merging them, making the DXM article dwell excessively on the non-medical use by a very small minority. RJSampson 02:07, 2 August 2005 (UTC)

• Come on, there's plenty of academic dextromethorphan research, but not every "dextromethorphan" hit deals for more than a half-second or two with DXM. There's also a ton of anecdotal DXM literature, much of which is of questionable value. We just have to balance quantity against relevance. You've got a real thing for associating "the young" and "college kids" with DXM, but I think that's probably just the impression a person could get from reading what's (readily available, e.g. erowid) online, like you say about the opposite opinion. There's plenty of people of all kinds interested in the topic.
       As for merging or not, see ketamine, for example, which I just edited a bunch: it still needs work, but it certainly doesn't fail by virtue of uniting both medical and non-medical ketamine topics. The harm in keeping the DXM articles separate is that the "non-medical" use article will become an undisciplined playground for exactly the people you anticipate messing up the medical article. If, however, the topic of DXM's non-medical use exists in the context of the very encyclopedic discussion of its medical use, there's bound to be a greater impetus (read, greater number of responsible editors) keeping the whole project sane. —Tarnas 02:35, 2 August 2005 (UTC)

I think you make a good point here.. indeed, when recreational information is present, it runs the risk of falling victim to undisciplined edits (even by those under the influence of said drug as they type, as we've seen). Of all places, we don't want that to happen on the medical (main) article. I don't think that keeping them separate presents any better chance of more mature editors gravitating to one article over the other. I'm sure most people reading the regular article, with an inclination to edit, will look at the click on the link to the non-medical article. Let people go to town about getting high on the getting high article. If anything, the most passionate editors here on the subject are those concerned with the recreational use of cough syrup. There's not much more to be said about DXM (medically) that hasn't been said already, so that article should stay as it is. And let's not kid here.. DXM use recreationally is definitely the domain of the young. Sure, there might be an exception to the rule here and there, but the vast, vast majority of abusers ending up in hospitals are children (teens). But that's neither here nor there. I really think we should just keep these two articles separate. It just looks plain silly to focus the article on what a small minority does in their free time with the drug. Ketamine is quite different, as it's strictly a veterinary drug (now anyway), and will not be of interest to anyone other than vets, people concerned about vet surgery, and recreational users and people curious about its recreational use. The majority of human users of Ketamine use it to get high. This is absolutely not the case with DXM, which is used overwhelmingly to control cough. RJSampson 05:36, 3 August 2005 (UTC)

I don't care either way right now, but don't misunderstand me: recreational drug use information isn't inherently undisciplined, it can become undisciplined out of context, and you display exactly the attitude I'm against: "Let people go to town about getting high on the getting high article." People will pack junk into any article of any kind on Wikipedia, recreational drug articles are no special case, so why marginalize them? Instead, I say bring them into the fold, which is the precedent in other drug articles. I also think your estimation of ketamine and its article's attraction is incorrect: half is about medicine, half about tripping, and it has usefulness to lots of different people, veternarians and party kids yes, but also to many psychologists, EMTs, and others.
     The general population that you refer to don't go to the store to buy "dextromethorphan", they go to buy packaged cough medicines. The people interested in the chemical dextromethorphan don't need to be protected from information about its use as a halluncinogen. You write with a lot of insensitivity for a topic which could use good editors.
     As for the medical end of DXM, I think you're wrong to say that "There's not much more to be said about DXM (medically) that hasn't been said already". You yourself pointed out a wealth of DXM medical knowledge, and of all places this sure is the one for integrating that sort of thing into a single, concise, coherent text. —Tarnas 06:22, 3 August 2005 (UTC)

I should apologize about my "going to town" comment. That was made facetiously and wasn't conducive to our debate here. Indeed, we should be against that very thing, the packing of junk, and I share your thoughts exactly. Furthermore, your your citation of my comment that the medical info is pretty much complete is also important, and I think you've pointed out another mistake I made. Indeed, there could be a lot to add to it in the future. I think what I was trying to say is that I believe that most of the additional information to be added will most likely be on the recreational side of things, and not the medical side. In fact, the actual prescribing information as I wrote it was only added just recently.. ie, up to this point, the article has focused almost exclusively on its recreational use (this point meaning before they were separated). I think the ketamine article is just fine the way it is, actually, and very appropriate to the current state of its usage. The 50/50 nature of it seems appropriate, and separating the articles in that case would result in two paltry entries on the drug. But here's the problem with merging the DXM articles: The non-medical use article is about four times longer than the main article is. Therefore, once merged, the main article will predominantly focus on its use to get high in extreme detail. Given the high level of detail present in the non-medical use article, it easily stands on its own, just as does the main article. Granted, people don't go to the store to buy "dextromethorphan" but as consumers become more educated and discriminating, perhaps they'll look up the ingredients to learn about exactly what they're putting into their body. Anyway, keeping the articles separate doesn't protect information from anyone.. that info is just a click away. Now, if the main article could have a single paragraph that summarized DXM's recreational use, that would be appropriate. But again, the extreme detail (which is not present in most other drug articles) about getting high would make the main article too focused on the recreational experience, to an extent unlike any other medically-accepted drug article.

I sense we are both growing weary with this exchange of views. I appreciate the fact that you are arguing intellectually and in a civil manner.. I find that rare on wikipedia. But in the sake of opening things up, can we get several other users' input? RJSampson 06:49, 3 August 2005 (UTC)

Makes sense. :D  —Tarnas 08:15, 3 August 2005 (UTC)

Melding Together

Was that so hard? I Just took the basic and/or relevant Information from the Non-Medical use article, mixed it with the information on this article, and *Bam*, instant article. Anyways, since the information on both of them is correct, I decided not to delete the info on the Non-Medical use article.I Gave it a Redirect, though if you wish to set it back up, just go to the edit page and delete the redirect code, its all in there.-MeDP.

Where did the non-medical info go?

Sorry if I'm missing something obvious, but where did all the non-medical info mentioned above and still visible in eg. this edit just go? I'm fine with putting it somewhere else, but we should at least mention that DXM has potential for more than just stopping coughs, and provide some sort of clear link to the new location! Jpatokal 07:53, 28 November 2005 (UTC) (cough, cough)

See: non-medical use of dextromethorphan. --Arm 09:44, 28 November 2005 (UTC)

Merging non-medical use of dextromethorphan with main article

I think we should decide whether to merge the two articles. I'd be willing to do the work if the consensus is that the articles belong together. What do you think? Peoplesyak 23:02, 12 January 2006 (UTC)

I've weighed in on this before... I believe that we should not merge the articles. This is a unique situation in which the information on its non-medical use is often highly subjective and the length of it is too overwhelming to merge with the main article. I feel that this fact becomes extremely important when looking at the primary use of Dextromethorphan. The vast, vast majority of people use DXM when they're sick, and not to get high. When merged, the overwhelming majority of the article will focus on getting high off of it, and this is very inappropriate. This has been discussed to death and I really think it should remain as is. RJSampson 20:14, 13 January 2006 (UTC)

I've taken the liberty of making the link a little more visible in the main article; I think this helps a lot without merging. Mgcsinc 15:42, 14 January 2006 (UTC)

That helps, Mgcsinc; just not a good idea to merge RJSampson 06:32, 17 January 2006 (UTC)

Dextromethorphan Hallucinations

In undocumented events, Dextromethorphan has been known to cause intense hallucinations in the sense of seeing things or people who arn't there, such as seeing a fairy dancing ontop of a television and disapearing after a few seconds. These kind of hallucinations more commonly happen right when the user wakes up after a short amount of sleep.

I think this post would be more appropriate in the non-medical use of dextromethorphan talk page. Why? Because if your getting such realistic and fully formed hallucinations, then you are probably taking alot more then the recommended dose. --Arm 05:09, 22 February 2006 (UTC)

Unless one has an allergy to the substance. I'm allergic to Tylenol of all things and have hallucinated from child's doses. DEL 66.57.225.195 21:53, 19 July 2006 (UTC)

What's the point of the post anyway? --Muugokszhiion 06:25, 23 February 2006 (UTC)

Reduces opiate tolerance

Read the "DXM for Chronic Pain" and "DXM for Drug Addiction" sections this erowid page. They provide references you can use to verify rather than relying on Erowid itself. I was informed by an expert that DXM and all other drugs which mitigate opiate tolerance are mediocre, at best. Nathan J. Yoder 08:19, 20 April 2006 (UTC)

Reference required

"Psychosis can develop with even one use." Please

someone fix this

the entire recreational use section is filled with either wrong or sourceless data

"Psychosis can develop with even one use." -- that's total bull. there's not a single drug in the world that's known to cause psychosis, much less in a single use.

Cite Source In Pharmacology

Please cite a source for the information that says DXM is a dopamine reuptake inhibitor.

Done. Link: http://www.nhtsa.dot.gov/people/injury/research/job185drugs/dextromethorphan.htm -- ×××jijin+machina | Chat Me!××× -- 20:43, 2 September 2006 (UTC)

Effect with SSRI's

Can anyone speak to the way this drug reacts along with SSRI's

Fluoxetine and other SSRI antidepressants, as well as tricyclics and lithium (and of course MAOIs) may interact with DXM to cause serotonin syndrome (see Section 6.2.9). This condition, although rarely fatal, is not terribly pleasant. Vascular disease may increase the chance for serotonin syndrome with DXM + antidepressants (364), and other disease conditions may do so as well. Some DXM users who have taken DXM while on antidepressants have reported unpleasant reactions that sound a lot like serotonin syndrome, so you might want to watch out. Some of the symptoms of serotonin syndrome include muscle rigidity, confusion, diarrhea, incoordination, low-grade fever, sweating, muscle tremor, mania, agitation, exaggerated reflexes, and nausea.

http://www.erowid.org/chemicals/dxm/faq/dxm_general_info.shtml#toc.4.16

The entire recreational section can be cited using Erowid, however I'm guessing that isn't considered a valid source. User experiences simply haven't been documented in any credible source. The US military hasn't experimented with it like they have with other hallucinogens :) But as for SSRI's, we can accurately assume the interactive effects with DXM because it is a matter of fact that all drugs that metabolize via the CYP2D6 pathway will interact with each other, at least decreasing each-others' effectiveness. Therefore most drugs that compete for CYP2D6 will carry an interactivity warning against use with other such drugs that metabolize the same way, and the effects of such an interaction are public knowledge. Equazcion 13:41, 5 February 2007 (UTC)

Proposed deletion of Non-medical use of dextromethorphan

AfD Proposed Deletion Discussion Equazcion 16:50, 6 February 2007 (UTC)

I just thought everyone should know this, me and my friend just went to the store and they would not let me (im 16) buy sparklers, but they let my friend who is only (15) buy robitussin max, which is 15% dxm, i thought it was funny, and f'ed up.

Merge from Non-medical use of dextromethorphan

Please merge any relevant content from Non-medical use of dextromethorphan per Wikipedia:Articles for deletion/Non-medical use of dextromethorphan. Thanks. —Quarl ^(talk) 2007-02-10 23:47Z

• For those who were proponents of keeping the old non-medical use article, I would suggest collecting the data there that doesn't already exist in this article and inserting it (use the link above to see the deleted non-medical use article). Use your judgment as to what really deserves to be merged in; the recreational section of this article is already pretty long. As far as the History section, it's too long to merge in its current state, but perhaps condensing it into one or two paragraphs of "historical milestones" would make it an adequate sub-section of "recreational use" in this article. Equazcion 08:49, 13 February 2007 (UTC)

controlled

I don't know if its law or something else but Safeway and everyone else around me required you to be 18+ to buy it now i do not know if its state or federal laws or just a common business practice but in any case i feel it should be mentioned somewhereUser:Shimonnyman 08:35, 16 April 2007 (UTC)

Tolerance

Does anybody have any information on tolerance, in reference to recreational use? Such as how quickly it develops and how long it lasts? 209.247.22.129 15:29, 18 April 2007 (UTC)

Tolerance is pretty high and develops quickly. You'll need more to get the same recreational effect after, say, just 5 recreational doses spread over two weeks. Don't quote me on this, and I don't know any references offhand, but I read about this somewhere, and I'm also using some... let's call it personal observation.

Its more like pcp

Most people say its more like pcp than anything else. I haven't tried either so I wouldn't know —The preceding unsigned comment was added by 141.155.144.199 (talk) 01:20, 29 April 2007 (UTC).

There is plenty of first hand account discussions at fourth-plateau.org. You may have to register to get into some good discussions. But there are people there that have been using this drug for a long time.

Regarding the Recreational Section

Dosage of DXM for recreational purposes is fairly inaccurate when measured purely by mg of DXM, and is most often noted by mg/kg. For someone weighing 113 kg, for example, 600mg is unlikely to cause profound dissociation, while 600mg would be very intense for someone weighing 68 kg.AudhumlaX (talk) 06:00, 8 December 2007 (UTC)

Perhaps there should be a note saying that the doses listed in the 1981 paper are wrong, because 15mg/kg is as much as anyone should take, 30mg/kg i assume would be nearly lethal. A far cry from a low dose. —Preceding unsigned comment added by 64.235.79.242 (talk) 04:13, 15 February 2008 (UTC)

Good work! .. needs a WP:LEDE

This is an informative article; some good work has been put into it! :-)

Just a note: a WP:LEDE should be placed before the TOC, and should summarize the article. Please see WP:LEDE for its appropriate nature and location.

Ling.Nut 13:54, 28 July 2007 (UTC)

Thanks. There were many others involved of course, but speaking for everyone, thanks for the compliment :)

Equazcion (Talk • Contribs)

14:01, 28 July 2007 (UTC)

• There's lotsa stuff in the article that needs to have a summary sentence or two in the lede, esp. its abuse for narcotic purposes... the lede is too much about the chemical properties, at present... Cheers! Ling.Nut 15:42, 28 July 2007 (UTC)

• Threw something together, very short for now but I'll be working on it more. Thanks for the advice :)
  Equazcion (Talk • Contribs)
  07:03, 29 July 2007 (UTC)

GA Review

This article is a bit more than a start, but falls well short of the GA criteria on several points, primarily points 1 (well written), 2 (factually accurate), and 3 (broad in coverage). I would also argue that it fails criterion 4 (neutrality) as well, because it seems a little too heavy on the recreational use aspects and less on the medical and scientific. There's quite a bit of work left to be done here.

• The lead section does not accurately summarize the article.

Done

Equazcion •✗/C • 08:19, 12/22/2007

• The 'Chemistry' section primarily contains relatively trivial (yet important) information. It contains no information whatsoever on the synthesis of the drug. Perhaps a chemical sketch would help here.

Graphic of the molecule is there, synthesis info still needed.

Equazcion •✗/C • 08:19, 12/22/2007

• The 'indications' section looks like several sentences may have been copied from various other sources. There are also several single-sentence paragraphs. Consider rewriting, adding more details, and combining paragraphs.

Done, I think. Additional indications are now in a list format.

Equazcion •✗/C • 08:19, 12/22/2007

• The article as a whole tends to overuse the abbreviation 'DXM', which makes for some awkward prose. A good, thorough copyedit would help here, as well as with other issues. Things like, "20 degrees Celcius" should be written as "20°C". Check the manual of style for more information on formatting.

Done.

Equazcion •✗/C • 08:19, 12/22/2007

• The pharmacokinetics section contains no reference citations whatsoever, and is very short.
• The 'side effects' section is very awkwardly organized with its short subsection on Olney's lesions, which primarily links to a separate article. Consider removing the subsection and incorporating some general info on olney's lesions into the main section itself, and link to the article as a 'see also' link, instead of a 'main article' link.

Done.

Equazcion •✗/C • 08:19, 12/22/2007

• The 'drug interactions' and 'contraindications' sections are entirely dependent on a single reference, and many of the bullet points were probably copied verbatim. The reference is to a "fact sheet" hosted on the National Highway and Traffic Safety Information website (nhtsa.gov). While the site technically meets the standards per WP:RS, it is probably providing relatively minimal information, pertinent to the enforcement of laws that they are concerned with. A more scientific or medically related reference would be far more important here.
• The first and only mention of "Robitussin" is way down in the third & final paragraph of the history section?!?! Who makes Robitussin? This should be mentioned.
• Consider drastically reducing the 'recreational use' section, and combining it with the 'history' section. The subsections on 'duration' and 'psychopharmacology' can be reduced & paraphrased into the pharmacology main section. Consider rewriting and reresearching generalized statements like, "In other words, taking a recreational dose of an eight-hour DXM-containing cough suppressant will generally produce recreational effects lasting eight hours." and "The time until wear-off depends on the tolerance of the individual user ..." ("wear-off"? gimme a break!)

Actually considering a split. Agree the recreational stuff should be reduced in this article but expanded info has merit for a separate article.

Equazcion •✗/C • 08:45, 12/22/2007

Done. Equazcion •✗/C • 22:25, 25 Mar 2008 (UTC)

• The 'classification' subsection under 'recreational use' contains two sentences, and is cited by www.erowid.org (several other sources site this website as well). I don't think I'd completely trust a site that claims to work with, "experiential experts to develop and publish new resources." Looking further, it looks like this site is probably more connected to the recreational use of various psychoactive substances, as opposed to legitimate medical or academic sites.
• Additionally, consider looking closer at several of the sites listed under the 'external links' section (erowid.org, dextroverse.org, third-plateau.org, fourth-plateau.org). Most look like recreational use fansites and/or forums. Not a single official manufacturer or other scientific site is included here.

There's probably more to talk about, but hopefully this will help guide editors towards GA status. Cheers! Dr. Cash 06:35, 1 August 2007 (UTC)

That is some very comprehensive input, thank you so much. I hope to take care of these items soon, and also hope others read your notes and help out. Thanks again, this is very helpful.

Equazcion (Talk • Contribs)

17:50, 2 August 2007 (UTC)

I hope to start working on these. I'm gonna cross off items as they get completed. I invite anyone else to work on items and cross them off when finished. Thanks.

Equazcion •✗/C • 07:43, 12/22/2007

Dextroverse

I have taken Dextroverse off the external links, it is a website glorifying drug abuse and doesn't contain accurate or useful information about dextromethorphan. If this website should be linked anywhere it would be in an article about the phenomenon of IRC servers and forums used by teenagers to brag about their dangerous abuse of over-the-counter drugs, especially the deadly coricidin which has been linked to most dxm-related deaths. It was either put on here by someone who didn't know what it was about or by a member of the place itself looking to advertise. —The preceding unsigned comment was added by 68.118.76.8 (talk) 22:42, August 20, 2007 (UTC)

I think it should probably stay in the article. External links aren't references, they're just portals to further information. They don't need to be 100% neutral referenceable material. Dextroverse is a prominent site and it's important to understanding recreational DXM use as a cultural phenomenon.

Equazcion (Talk • Contribs)

22:59, 20 August 2007 (UTC)

I second it staying in the article. I used to post on the forums there and a lot of intelligent discussion does occur. In the future, please have some tolerance for lifestyle choices that differ from your own.68.211.162.60 (talk) 20:54, 19 December 2007 (UTC)D

I also support it staying, it's a comprehensive DXM website, and also is on the first page of a Google search of 'DXM'. --Mark PEA (talk) 23:50, 20 December 2007 (UTC)

Just cause you disagree with some peoples lifestyles does not mean in should be taken off, it has further information for dextromethorphan.71.126.103.8 (talk) 02:36, 23 December 2007 (UTC)

William White

What, no mention of William White's comprehensive DXM FAQ? Captain Zyrain 21:38, 26 September 2007 (UTC)

References to that FAQ have been inserted and removed many times in the past. Having not been an officially published/accepted medical study, I don't think it would be appropriate to reference it -- at least not in this article. If the recreational use portion were split off into its own article, as has been suggested more than a few times, then I think that article would warrant mention of the FAQ.

Equazcion • argue/improves • 23:03, 09/26/2007

ketamine is not neurotoxic

i deleted the ketamine because it is not neurotoxic like its sister chemical pcp. id like to see a reference that ketamine is neurotoxic. ~matt —Preceding unsigned comment added by 72.66.229.183 (talk) 14:42, 11 October 2007 (UTC)

Ketamine most certainly is neurotoxic: http://toxsci.oxfordjournals.org/cgi/content/full/81/2/364. Most narcotic drugs are neurotoxic -- that's how they produce their effects, by damaging the brain a little each time you use them. Even alcohol is neurotoxic.

Equazcion • argue/improves • 16:48, 10/12/2007

Why have you blasted out a blanket statement like "they produce their effects, by damaging the brain". There are drugs which can produce psychoactive effects that are actually neuroprotective, i.e nootropics such as racetams and GHB. --Mark PEA (talk) 23:56, 20 December 2007 (UTC)

If you have any more problems regarding this issue please continue the discussion here rather than "edit warring" over it. I'm glad to address your concerns and improve the article if need be, but it's frustrating to carry on the exchange through edit summaries. Thanks.

Equazcion • argue/improves • 06:10, 10/13/2007

ok lets clarify slightly. to compare neurotoxicity of ketamine to PCP is just plain incorrect. They use ketamine safely on infants and the elderly. And to reply to your comment about alchohol of course its neurotoxic, and no where near the level of ketamine. PCP activly kills your brain, ketamine does not. and it is again untrue to say that ketamine works because its damaging your brain is so oversimple and incorrect it bothers me. it works because of a chemical reaction in your brain. next you will tell me LSD is neurotoxic. if you do not want to revert it thats fine, but i would advise finding something closer to pcp to label neurotoxic, because with ketamine its negligible. ~~ —Preceding unsigned comment added by 72.66.237.229 (talk) 20:43, 17 October 2007 (UTC)

The point of the statement was really to compare the visible hallucinogenic effects to those of PCP and Ketamine, and not the actual neurotoxicity. I just realized someone added neurotoxicity in at some point, even though we have no ref that explicitly compares that aspect of all three drugs. I've tweaked the statement to reflect this, removing the neurotoxicity claim altogether. Hope it looks okay to you now :)

Equazcion • argue/improves • 20:56, 10/17/2007

wow thats awesome thanks for changing it. i had a rude tone, sorry about that but it looks fine now. thankyou 72.66.250.72 17:10, 24 October 2007 (UTC)

No problem :)

Equazcion • argue/improves • 17:17, 10/24/2007

Extra Sources

Hey, I think this is a really solid article, and I'd like to contribute what I can to help improve it, but since I'm relatively new to wikipedia, I wanted to ask before I go tinkering with someone's hard work. I noticed one of the major points Dr. Cash made in his comments above was the use of a single reference or no references (in the case of the pharmacokinetics section). If you'd like, I'd be happy to research and provide additional sources to support the parts of the article that require it, as well as editing the text as needed. I'm currently in pharmacy school working on my doctor of pharmacy degree, and one of the benefits of my school robbing me of all my money is that I receive access to an enormous amount of medical/pharmacy information through online journals and databases. Gimme a shout if that would be helpful, preferably through email (higginsr@acp.edu if for some reason it doesn't show up elsewhere on this site). Be well. Ohnoitsthefuzz (talk) 04:33, 15 December 2007 (UTC)

That would of course be very helpful, and don't be hesitant to tinker with the material. On Wikipedia you have the right to tinker as much as you like without regard for anyone's feelings. The only downside is that you likewise can't be offended when others tinker with your work. My only words of caution are that online databases make poor article sources if the average person doesn't have access to them for free. Journals are fine, as long as print versions exist that people can look up (just include issue and page numbers). Thanks!

Equazcion • argue/improves • 22:04, 12/19/2007