"Collect a few boxes of right beauty"

"I ate too much and rushed to the emergency room and almost had to wash my stomach"

"Spit to death"...

Behind these hidden "black words", there is a hidden danger of abuse of dextromethorphan, the "miracle drug for cough". Dextromethorphan, which belongs to opioids, has something in common with morphine in its mechanism of action, and in recent years, some young people have taken a large amount of dextromethorphan in order to get pleasure addiction.

Recently, Chengdu Xindu Public Security discovered and seized the excessive abuse of dextromethorphan by four minors in a community. They invited on the Internet, and then gathered together with liquor to take 4-14 tablets of dextromethorphan orally, and when they were found by the police, they were dancing and excited, and one of them was delirious and gradually lost his cognition, and was sent to the hospital for treatment.

On November 11, a reporter from Chengdu Business Daily-Red Star News also found on the online social platform that many young netizens shared their experiences and feelings of "drug abuse" and resold dextromethorphan, and the IP addresses of netizens were distributed in Beijing, Shanghai, Jiangxi, Chongqing and other places. However, the "List of Prohibited Online Sales of Drugs (First Edition)" clearly states that dextromethorphan oral unilateral preparations are prohibited from being retailed through the Internet. The reporter visited offline and found that a small number of pharmacies can still sell dextromethorphan hydrobromide tablets as a prescription drug without issuing a prescription.

Explanation of terms

Dextromethorphan

Dextromethorphan, commonly referred to as dextromethorphan hydrobromide, is a derivative of dextromorphine with antitussive effects, and is often used to treat cough caused by various respiratory infections.

Dextromethorphan is addictive when taken in large amounts, and there will be euphoria, drunkenness, high excitement, paresthesia, visual and auditory hallucinations, etc.; If the dosage is continued to be increased, central depression such as decreased responsiveness and orientation, drowsiness, coma, respiratory depression and even death may occur.

Abuse of dextromethorphan 4 minors were seized

Recently, the police of Chengdu Xindu Public Security Dafeng North Police Station found in their work that 4 people in a small area had illegal abuse of dextromethorphan tablets, of which 3 people were dancing and energetic when they were seized by the police, and the other person Zhang was lying on the bed in a state of delirium and confusion. According to the more sober Xu, the four people at the scene were friends, and several people had taken 4 to 14 dextromethorphan tablets orally in the room with liquor.

Immediately, the police took the 4 people back to the police station and found that the 4 people continued to behave strangely and had empty eyes, among which Zhang was suspected of gradually falling into a state of loss of cognition. The police immediately dialed 120 and sent Zhang to the hospital for treatment. According to the doctor's diagnosis, Zhang was impaired with drug toxicity consciousness, and after several hours of gastric lavage and rescue, Zhang is now fine. Later, the police sent the urine samples of the four people to a professional appraisal agency for identification, and relevant components were detected in the samples of the four people.

The reporter learned that the above four people are all minors. They were invited through the Internet to take an overdose of dextromethorphan together to get pleasure. "They will have a lot of black words inside, which ordinary people can't understand, and these black words cover many aspects such as dosage, way of taking, and time of taking." The police revealed that "O" stands for "OD", which translates as overdose, "T" refers to tablets or tablets, referring to dextromethorphan units of measurement, and "Dextromethorphan", "Graceful" and "Youmi" are other names for the cough medicine dextromethorphan.

The dextromethorphan hydrobromide they consumed was a prescription drug, and the group of people bought it through online gray channels and illegal sales in offline pharmacies.

According to Zhang, "because it was illegal to smoke 'etomidate', the four people turned to abuse dextromethorphan tablets, which have the same hallucinogenic effect as 'etomidate', through inquiries and inquiries." Etomidate is the "top e-cigarette" that has been popular in some young people's circles. There are similar parts of the ingredients that can achieve similar or diminished effects, causing young people to turn to dextromethorphan, which is more readily available.

At present, the police have notified the families of the four minors, and the relevant work is being further carried out.

"Cough medicine" is sought after and has online and offline channels

On social platforms, you can still see many young people discussing and pursuing dextromethorphan. In the Weibo "#Youmei#" topic, last week alone, a number of young netizens shared their experiences of taking dextromethorphan, "o too much (overdose) rushed to the emergency room and almost gave me gastric lavage", "30t (30 tablets) I didn't feel it for half an hour", "Yesterday I was angry o20t (20 tablets of drugs), I couldn't tell the difference between reality and dreams, and I didn't know where I was".

On the Internet, there are also posts of netizens meeting to take drugs together and asking for dextromethorphan everywhere. Judging from the IP address, this group of young people who are interested in "Right America" are all over Beijing, Shanghai, Fujian, Chongqing, Shandong and other provinces, municipalities and autonomous regions.

The tablet "dextromethorphan hydrobromide tablets" is produced by a number of pharmaceutical companies, including China Resources Shuanghe, Taihua Pharmaceutical, Neptunus Pharmaceutical, Yiling Pharmaceutical, Huanan Pharmaceutical, Shanghai Shangyao Xinyi Pharmaceutical Factory, Livzon Group Livzon Pharmaceutical Factory, Xinya Pharmaceutical and Baiyunshan Pharmaceutical.

In December 2021, the State Food and Drug Administration announced that dextromethorphan, an over-the-counter (OTC) drug (hydrobromide), would be converted to a prescription drug (RX). On December 12, 2022, the "List of Prohibited Online Sales of Drugs (First Edition)" was officially implemented, which clarified that dextromethorphan oral unilateral preparations are prohibited from being retailed online. The reporter searched and found that in Haikou, Ruichang and other cities, pharmacies were fined for selling dextromethorphan in violation of regulations.

On November 11, the reporter visited a number of pharmacies in Qingyang District and Chenghua District of Chengdu and successfully bought multiple boxes of dextromethorphan, with prices ranging from 30 yuan to 15 yuan per box. Because dextromethorphan hydrobromide tablets are prescription drugs, patients need to have a prescription or an electronic prescription before they can be issued. However, at the two pharmacies in Wannian Street and Baohe Street in Chenghua District, the reporter did not issue any prescription and did not show identity information to buy dextromethorphan hydrobromide tablets.

On December 12, the reporter reported the matter to the Chengdu Chenghua District Market Supervision Bureau. On the same day, the Wannianchang Market Supervision and Administration Office and the Baohe Market Supervision and Administration Office immediately organized law enforcement personnel to conduct on-site inspections of the two pharmacies to verify and investigate the relevant situation. After verification, the problem was found to be true, and the two pharmacies had committed the illegal act of selling prescription drugs without a prescription.

In accordance with the relevant provisions of the Drug Administration Law of the People's Republic of China, the law enforcement officers gave the pharmacy a warning and administrative punishment, and ordered the pharmacy to immediately make rectifications, requiring the sale of prescription drugs with prescriptions in accordance with the provisions on the management of drug classification. Subsequently, law enforcement officers conducted special inspections on retail pharmacies around the jurisdiction to regulate the sales of prescription drugs in retail pharmacies. In the next step, the Chenghua District Market Supervision Bureau will carry out a special action on the sale of prescription drugs in retail pharmacies, and increase efforts to investigate and deal with violations of laws and regulations in the sale of prescription drugs.

Expert analysis

Long-term abuse can cause damage to the brain and it is difficult to quit

"Dextromethorphan is an opioid drug, and it has something in common with morphine in its mechanism of action, both act on opioid receptors, but there are differences in the intensity of action and the location of the receptors." Zhai Haifeng, an associate researcher at the China Institute of Drug Dependence at Peking University, told reporters that dextromethorphan itself is a relatively weak σ opioid receptor agonist, which usually acts on the opioid receptors of the medulla oblongata to exert antitussive effects.

"In high doses, dextromethorphan acts like morphine on opioid receptors in the limbic midbrain, causing euphoria, euphoria, and addiction. With normal use, 1-2 tablets each time can have a cough suppressant effect without obvious euphoria; If you use 5 or 10 tablets at a time, you may feel euphoric, and after a long time, you will become addicted; What's more, some people will continue to increase the dosage in order to pursue higher pleasure and the resulting tolerance. At this time, if there is a management loophole in the circulation link, dextromethorphan can be easily obtained, and dextromethorphan abuse may occur. Zhai Haifeng explained.

What happens after dextromethorphan abuse? Zhai Haifeng explained, "Dextromethorphan is a central drug, and if used in large doses, it will increase the risk of respiratory depression. In extreme cases, death may occur due to respiratory depression. Long-term abuse can cause brain damage and mental confusion. ”

For people who abuse dextromethorphan, Zhai Haifeng recommends seeking help from professionals in professional hospitals and psychological counseling institutions, because it is difficult to quit by relying on personal strength. If you quit suddenly, "relatively speaking, the withdrawal symptoms may not be as strong as morphine and heroin addiction, but the person concerned will have some psychological and physical discomfort, such as muscle pain, tears, runny nose and other symptoms, depending on the degree of addiction and physical condition of the individual." ”

News Links

Say "no" to substance abuse! Previously, etomidate had been officially listed

In February this year, the State Food and Drug Administration, the Ministry of Public Security, and the State Post Bureau issued a notice on the "Notice of the General Department of the State Food and Drug Administration, the General Office of the Ministry of Public Security, and the Office of the State Post Bureau on Further Strengthening the Administration of Compound Diphenoxylate Tablets and Other Drugs" (hereinafter referred to as the "Notice").

The "Notice" makes it clear that there is a problem of abuse of five types of drugs such as dextromethorphan oral unilateral preparations in some parts of China, and the abusers are mainly teenagers, which seriously endangers the physical and mental health and life safety of the public, especially teenagers. The "Notice" puts forward requirements such as strictly controlling the production of drugs, strengthening the supervision of drug business links, and strengthening the inspection of delivery channels.

"At the national level, if a drug is highly addictive and has a relatively strong risk of abuse, the state will strengthen the management of the drug according to the size of the risk of abuse, and may even control it as a psychotropic or narcotic drug." Zhai Haifeng made an analogy, for example, in the past, dextromethorphan was an over-the-counter drug, and users could easily buy it from pharmacies; In 2021, the National Medical Products Administration (NMPA) converted the oral monolithine hydrobromide from an over-the-counter drug to a prescription drug, making it more difficult for abusers to obtain dextromethorphan according to prescription drug management.

"If the risk of abuse is found to be increasing in the future, the state will adopt stricter management measures." Zhai Haifeng analysis.

A similar example is etomidate. Since October 10 this year, the State Food and Drug Administration has included etomidate (except for pharmaceutical preparations containing etomidate approved for marketing in China) in the list of Class II psychotropic drugs. Etomidate is the "top e-cigarette" that has been popular in some young people's circles. Since the beginning of this year, the State Food and Drug Administration, the Ministry of Public Security, and the National Health Commission have twice issued announcements on the adjustment of narcotic drugs and psychotropic substances, adding 1 kinds of narcotic drugs to the list.

Police remind: When taking medicines, you should strictly follow the doctor's instructions, use the drug according to the drug instructions, and avoid overdosing and over-using, overdose not only can not cure the disease but also hurt the body, and long-term use is more likely to form addiction! Call on the general public to use drugs safely and say "no" to abuse together.