Five deaths resulting from abuse of dextromethorphan sold over the internet

[Holy_cow]

J Anal Toxicol. 2009 Mar;33(2):99-103.

Five deaths resulting from abuse of dextromethorphan sold over the internet.

Logan BK, Goldfogel G, Hamilton R, Kuhlman J.
NMS Labs, 3701 Welsh Road, Willow Grove, Pennsylvania 19090.

Dextromethorphan is a widely available over-the-counter antitussive that produces intoxicating, hallucinogenic, and dissociative effects at doses significantly exceeding the therapeutic range. We report the deaths of five teenage males in three incidents in three states (WA, FL, and VA) who purposefully ingested large doses of dextromethorphan for recreational purposes and died as a result of the direct toxic effects of the drug. The dextromethorphan was obtained from the same internet supplier in each case. Postmortem blood dextromethorphan concentrations ranged from 950 to 3230 ng/mL (median 1890 ng/mL). Three subjects had diphenhydramine present, one had a trace of alprazolam, and two were positive for cannabinoids. In each case, the death was attributed to dextromethorphan toxicity or toxicity from dextromethorphan and other drugs. The article discusses the metabolism, pharmacology, and potential for drug interactions for dextromethorphan and the likely mechanisms for toxicity. The dextromethorphan concentrations in all five subjects significantly exceeded the therapeutic range and are consistent with concentrations reported in other cases of dextromethorphan abuse and toxicity. The deaths resulted in the prosecution of three individuals involved in sale or distribution of the drug.

PMID: 19239735 [PubMed - in process]

 

[jesusisawombat]

The deaths resulted in the prosecution of three individuals involved in sale or distribution of the drug.

I wonder if the same situation would arise with they bought it OTC at a pharmacy?

 

[Hammilton]

No because these people were selling a pharmaceutical illegally. The FDA has to approve pharmaceutical formulations, dosing, package instructions; They did none of this.

So why ought it?

Selling pure powder to high school and middle school kids is exactly the sort of thing that would merit this. You sell to adults, adults should make their own decisions regarding their bodies. Kids who rely on their parents to provide food and clothes and a roof? That's entirely different.

 

[stimutant]

yep.

 

[phr]

PubMed articles don't necessarily fit into the typical article mold that we post here in DiTM. But, they're cool with me if they're recent, deal with subjects covered in DiTM, and they're linked to.

 

[garuda]

No because these people were selling a pharmaceutical illegally. The FDA has to approve pharmaceutical formulations, dosing, package instructions; They did none of this.

So why ought it?

Selling pure powder to high school and middle school kids is exactly the sort of thing that would merit this. You sell to adults, adults should make their own decisions regarding their bodies. Kids who rely on their parents to provide food and clothes and a roof? That's entirely different.

So where did these kids get a credit card? I ordered bulk DXM powder once upon a time and there was nothing to suggest it was for human consumption, it came in a foil baggie with nothing but a chemical assay. How is that a pharmaceutical?

 

[Kaneh Bosm]

According to Erowid, 2,500 - 20,000 mg is the risk of death dose. A bottle has about 200-300 mg and that is enough to really get you trashed. Why would these kids take so much, I was freaking out after one bottle.

 

[Hammilton]

So where did these kids get a credit card? I ordered bulk DXM powder once upon a time and there was nothing to suggest it was for human consumption, it came in a foil baggie with nothing but a chemical assay. How is that a pharmaceutical?

First, it's incredibly easy for anyone to get a credit card. You don't even have to lie about your birth date. I've had one since I was 12. I never used it much, but I always had it.

Hell, there was just a bit from the Twin Cities Fox Affiliate (channel 9, I forget the call letters) about a little girl who filled the thing out in crayon and sent it in. She was 3 (she had her grandfather's help) but with entirely truthful data, she was approved and given a 14K USD credit line. Thats 2 thousand more than my first credit line!