Pakistan: Cough syrup suspected in 33 deaths

slimvictor

slimvictor

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Authorities are investigating cough syrup believed to have killed 33 people in eastern Pakistan in the past three days, a government official said Saturday, the second time in recent months that suspect medicine is thought to have caused multiple deaths.

(...)

The deaths from the cough syrup occurred in Gujranwala and villages surrounding the city, said Abdul Jabbar Shaheen, the top administrative official in Gujranwala. Another 54 people are being treated at hospitals in the city who are also believed to have consumed the syrup. Those involved are thought to be laborers or drug addicts who drank the syrup to get high, said Shaheen.

Chemical samples collected from the victims' stomachs contained dextromethorphan, a synthetic morphine derivative used in cough syrup that can have mind-altering effects if consumed in large quantities, said Shaheen. It is being investigated whether the people affected by the syrup in Gujranwala drank too much of it, or whether there was a problem with the medicine itself, he said.

Twenty-three people died in the nearby city of Lahore in November after drinking bad cough syrup sold under the brand name Tyno. They were also described at the time as people who consumed the drug to get high.

Shaheen said the cough syrup involved in the incidents in and around Gujranwala was not sold under a single brand. He said there were some people in the city involved in the business of making cough syrup specifically to sell to drug addicts, and officials were trying to arrest the culprits.

Officials temporarily closed one Lahore-based pharmaceutical company whose cough syrup was found in the possession of some of those affected in Gujranwala and were investigating whether it caused any of the deaths, said Shaheen.


cont at
http://seattletimes.com/html/nationworld/2020005415_apaspakistan.html
 
I read about this yesterday. I guess I am still confused as to what the cause was. As we see here people on this board slug large amounts of dextromethorphan and are ok. So maybe it was spiked with something different? That is a lot of deaths, so something is up.
 
Cough syrup is often not just DXM. Imagine, for instance, if these particular brands had Tylenol mixed into them. One bottle could potentially have 10-20 grams of APAP!

And Tylenol is not the only possibility.
 
I'd imagine there's some ingredient causing the issue, with that many fatalities.
 
I do not know about the regulations within Pakistan, but I agree, this MUST be from an added ingredient, possibly without label warnings.

I couldn't imagine an epidemic up and appearing within a matter of days. I assume there are NOT regular deaths from cough syrup in Pakistan, these few days there have been. It only makes sense that they OD'd on another ingredient. I've been wrong before, though.
 
Another possibility is that there was a lot of DXM in the syrup. What is the lethal dose? What would 10 grams do to a person? What would an ounce do?

I mean, the article does mention that some brands were adding more DXM to the formula in order to appeal to the recreational market. Maybe they went too far?
 
What about other ROAs?

This trip report from Erowid must be quoted here. It's not entirely pertinent, but it is awesome.

Rectal Robo

Okay, I was stupid, very stupid. Don't do this. And if you do, read everything I say!

11:15 injected about 7cc /water 4cc/generic light dry rum and approx 500mg pure dxm into my rectal cavity

11:43 slight discomfort in within my lower intestinal region, similar to normal DXM gas

12:03 rush to the bathroom without even getting dressed, landing on the pot without even closing the door releasing more anal force than i have ever experienced, including my recent encounter with food poisoning

Okay, this experience is very similar to severe hershey squirts, with the addition of dxm ejecting itself from your body. I dont know how many times ive chatted with people before during and after they snorted dxm, and not to forget my own near death experience doing it as well, just imagine that 100x!!!

I know the exact moment the powder hits my asshole, I bite my lips really hard while trying to scream, but I cant because all sensory is focused on the Birth of Satan. THis is truly horrible but not long lasting, and solved by wiping my ass with toilet paper. Unfortunatly I took this to be the alcohol coming in contact with my asshole....

12:15 all showered up and laying in bed in disbelief of what i had actually done, listening to music, suddenly noticing a very slight enhancement and serenity to to my overall consciousness, with a deeper focus and involvment towards it.

1:03 after several trips to the pot to 'blow off steam' remaining inside me, i contemplate on Gdog's enema recommendation and grin to myself thinking how could i possibly have anymore fecal matter waiting to be born? considering trying it again, this time with a lesser dose.

1:05 That becomes a reality and this time i find myself shoving about 300mg pure in a cap up my ass as far as it could go

1:11 reconnecting with feelings recently experienced, i found myself quickly squatting on the can hoping i dont poop out the dxm. yup. it happens. i quickly clean up and get myself showered and just sit on the toilet smoking cigarette after cigareette.

1:50 Realized that almost a very small fraction of my intestinal merchandise had been excreted the first time, and considering that maybe having shit deep within my bowels might be my problem i decide to give myself an enema, and try again.

2:00 on the dot i shove another pill up my ass, this time about 500mg

2:40 i sit here and think, man what if i took to much? what if i get so completely fucked up, this is the longest ive gone without discomfort of any kind yet, i guess ill wait and see. im pretty accustomed to running to the toilet and releasing pressure now. ill just lie down and ride it out.

2:50 okay fuck this bullshit. i got all gassy and shit again. only this time it was fucking BLOOD.
Click to expand...

http://www.erowid.org/experiences/exp.php?ID=16566
 
Erowid says that between 2500-3000mg is the danger zone (of course danger is possible earlier) for respiratory failure.

I guess it is not too far fetched that the companies adding more DXM could have taken it this far. Possibly some of these people needed 2 full bottles to get where they wanted to be. Sad none the less. Very strange situation.
 
I doubt DXM was the only ingredient. Someone swigging a bottle or two of this would likely be getting a frighteningly mind-altering dose of a 1st generation antihistamine / anticholinergic, plus DXM. Plus probably some local herbs or chemicals traditionally used in Pakistani folk medicine for cough.
 
^ agreed.

Funny, when I was in pakistan (2003) the main cough syrup available was shunned by many because of the DXM it contained. It had a whopping dose of codeine ( like 3-400 mg per bottle) but that included several hundred milligrams of DXM as well. You could also get it with chlorophenermine as well, yuck. So most folk just went down to the market stalls and got opium, at a fraction of the cost. Or heroin, which was about 100x more expensive but still a deal compared to the west. My how things have changed.
 
Probably not DXM killing people. I ate like 2 grams of DXM or more and my annoying grandma called the ambulance on me even though I was mostly concious and sorta responsive. But then like an hour later, I decided to be violent in the ER and got injected with halidol, ativan, and benadryl, and my respiration and heart rate did not stop.

Last time I got high in detox and had my blood pressure taken, my blood pressure increased to 140/something and my heart rate increased by like ten. Anecdotally, DXM isn't a downer.
 
lazydullard said:
Probably not DXM killing people. I ate like 2 grams of DXM or more and my annoying grandma called the ambulance on me even though I was mostly concious and sorta responsive. But then like an hour later, I decided to be violent in the ER and got injected with halidol, ativan, and benadryl, and my respiration and heart rate did not stop.

Last time I got high in detox and had my blood pressure taken, my blood pressure increased to 140/something and my heart rate increased by like ten. Anecdotally, DXM isn't a downer.
Click to expand...

yeah i really hate it when my relatives take me to hospital after i overdose on drugs. what a bummer:\
 
lazydullard said:
Last time I got high in detox and had my blood pressure taken, my blood pressure increased to 140/something and my heart rate increased by like ten. Anecdotally, DXM isn't a downer.
Click to expand...

It's serotonergic. I think that's the reason for elevated blood pressure:

SERT and NET inhibitor (Ki = 23 nM and 240 nM, respectively)
Click to expand...

But it's metabolized into a potent NMDA antagonist, so there's a tensive tug-of-war there.

edit: Wait, DXO is legal?
 
^ it is the only compound I can think of that was moved from schedule one to unscheduled. At least off hand. I've always wondered why it was unscheduled. ?

lazydullard said:
Probably not DXM killing people. I ate like 2 grams of DXM or more and my annoying grandma called the ambulance on me even though I was mostly concious and sorta responsive. But then like an hour later, I decided to be violent in the ER and got injected with halidol, ativan, and benadryl, and my respiration and heart rate did not stop.

Last time I got high in detox and had my blood pressure taken, my blood pressure increased to 140/something and my heart rate increased by like ten. Anecdotally, DXM isn't a downer.
Click to expand...

I just wanted to say I liked this post a lot.
 
that trip report is hilarious. thats a lot of deaths from bad cough syrup. ive had drugs from pakistan and they sucked. if you have ever had an onax alprazolam bar before you know what i mean. same thing with the ketamine. dont know how the package got thru customs but it did lol
 
one of the funnier trip reports i have seen...

and it almost sounds like the government there is trying to minimize the situation by blaming it on the people instead of a faulty product
 
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