Substance abuse dextromethorphan

There is increasing concern over the street abuse of dextromethorphan, which is available in a variety of products. There have been a few reports of abuse and a handful of case reports of overdose and death. Nevertheless, dextromethorphan was specifically left out of the Controlled Substances Act (CSA) of 1970 and has not been added to the Drug Enforcement Administration (DEA) scheduling process despite these reports. This decision was made because dextromethorphan is not considered a narcotic and is generally thought to have a low addiction potential. However, the DEA is monitoring dextromethorphan and may add it to its list of controlled substances at some point in the future. 

The World Health Organization classified dextromethorphan as a non-analgesic, non-addictive substance in the late 1960s. In 1970, the Controlled Substance Act further added weight to this notion that dextromethorphan is not in the same class of drugs as its opiate forbearers in its abuse potential. This led to the decision of the DEA to leave dextromethorphan off its schedules of controlled substances. 

Despite the undoubted increase in the abuse of dextromethorphan, it is not scientifically known how addictive the substance is. Officially, it is not considered a strongly addictive substance. However, the pattern of abuse would suggest that its addictive potential is greatly underrated. 

The Drug Enforcement Administration (DEA) and Food and Drug Administration (FDA) are aggressively monitoring the use and abuse of dextromethorphan. It is conceivable that dextromethorphan could be first classified as a drug obtainable only with a prescription. Furthermore, the DEA could place dextromethorphan on one of its schedules of controlled substances, which would force physicians, pharmacists, nurses, and hospitals to record the administration of the drug. At this stage, the former is far more likely than the latter since it has not been proven that dextromethorphan is an addictive substance. 

Dextromethorphan HBr is the ( + )-isomer of the 3-methoxy form of the synthetic opioid levorphanol. It lacks the analgesic, respiratory depressant, and abuse potential of p opioid agonists but retains the centrally acting antitussive action. Dextromethorphan is not an opioid and is not listed in the Controlled Substances Act. Its effectiveness as an antitussive is less than that of codeine. Dextromethorphan is available in a number of nonprescription cough formulations. 

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