Last week, we talked about the dangers associated with Tylenol overdoses. Now, we turn our attention to cough syrups.
You may recall a tragic story in the news several weeks ago: A man from North Carolina is accused of killing his wife. The twist is that he claims he does not remember performing the action and stated on his 911 call that he had taken a large dose of an over-the-counter medication to help him sleep and because “it makes you feel good.” This article isn’t about arguing his guilt or innocence, however, there is at least some science behind his claim. And what he blames is probably sitting in your medicine cabinet right now.
Many popular cough syrups contain the medication dextromethorphan (abbreviated DXM). DXM is a derivative of the medication Morphine Sulfate, the same medication you might be prescribed for pain. Morphine, along with other opioid agonists such as Fentanyl and Demerol, works by blocking certain receptors in the central nervous system; they are called opioid receptors.
We traditionally think about these as blocking pain sensation, but certain opioid receptors also block the cough reflex. DXM is an isolated chemical that is derived from Morphine that targets those receptors. Thus, it is a powerful cough suppressant and used in DayQuil, Robitussin, and Elixsure among others.
The problem occurs when people take DXM (or any medication for that matter) at a higher than necessary dose, overuse it, or take it for reasons other than it was intended to be used. Using a higher than recommended dose can activate other opioid receptors inside the brain which will give the sensation of euphoria and pain blocking that is common to other opioids that specifically target these receptors. Mixing DXM with alcohol causes an exaggerated effect. This has led to the popularity of “purple drink” in some communities.
DXM abuse (because that’s what it is when taken not as directed) causes many of the classic opioid signs and symptoms. These include euphoria and sleepiness, but also many negative consequences.
Opioid receptors are responsible for breathing regulation and blood pressure as well. Overdosing on DXM can cause decreased respirations and a sharp drop in blood pressure. When mixed with alcohol, the effect can turn deadly.
Also of interest, DXM can cause lapses in memory. This is what the husband from North Carolina stated happened on the night his wife was killed. All of this from a substance found in most of the homes in our area!
As I mentioned last week, I am in not against the use of this medication. Please, do not pour your expensive cough medication down the drain! It is an extremely safe, well-researched medication that poses virtually no risks to you when taken as directed. Remember, read those labels and do not exceed maximum doses and never mix any medicine with alcohol.
Next week, we will conclude our discussion with one of the oldest medications in the country: Aspirin. Stay safe out there.
