TripSit Wiki - User contributions [en]

Ketamine

2016-02-19T22:38:51Z

GrimReaper:

[[File:Ketanest10.png|300px]]

'''Ketamine''' is a ''dissociative anesthetic'' that belongs to the arylcyclohexylamine class, and commonly used in human medical and veterinary care. It has a very wide safety margin, with an anesthetic dose being as much as ten times a recreational dose in an inexperienced user.
Ketamine is generally sold to the recreational user in one of two forms: in the evaporated salts, which are sold as a powder, or crystals (often referred to as shards), as well as in multi-dose vials for use in veterinary and human medicine. These vials may have concentrations ranging from 5mg/mL all the way up to 100mg/mL, and vary by manufacturer. One manufacturer, Parke-Davis, reports cases of accidental overdoses of ketamine as much as ten times higher than that required for surgery (which is to say 40-100x a recreational dose) "with no obvious, lasting effects." It is, therefore, reasonable to consider it a drug of relatively safe usage. Because ketamine is a dissociative and an anesthetic, users are prone to becoming injured by interaction with their environment and have died from things such as drowning (DM Turner). Overdose, however, is unlikely.

== History ==
Ketamine was originally produced by Parke-Davis laboratories in the early 1960s, and its recreational use was first reported in 1965; by the early 1970s, the US FDA was concerned about its use as a recreational drug. In the early 1990s, the US "Drug Czar" labeled ketamine as an "emerging drug" because of its involvement in the electronic music scene, and by 1999, it had been scheduled in the United States (Schedule III), although this designation is only applicable when the drug is intended for use in humans.

== Dosage ==
Ketamine is usually either injected intramuscularly (although intravenous administration does happen) or insufflated. Additional routes of administration are "plugging" (rectal) and orally. Oral availability of ketamine is poor.

These numbers are quoted directly from Erowid (which uses subjective dosage reports). Individual dosages will vary based on route of administration, tolerance and weight of the user, purity of the drug, as well as other conditions. It is always wise to start with a small dose and work up to a recreational dose. Remember, you cannot take less of the drug you have taken, but you can always take more.

=== A note on the "K-hole" ===
[[File:Ketamine.png|left|Ketamine molecule]]

There is no "guaranteed" dose to "hole" with ketamine. The "k-hole" as it is called is a state of full dissociative anesthesia in which the user is able to retain a semblance of consciousness. The effect associated with this is ego death; that is, the dissolution of the ego, the loss of the perspective of "I" in perception. It is a tricky dose to attain. Reaching too far with dosage will result in full anesthesia without memory of the experience and is worthless for recreational or psychonautical purposes. Too low a dosage will result in a mild sedation and body load, but no ego death, and redosing when anesthetized is tricky.

It is posited that using a needle and a precisely measured dose is more likely to get a user to a full state of ego death, the k-hole, due to the lack of titration of dosage, rapid come-up, and exactly-metered dosage. Finding a dosage that "works for you" is important, and there will need to be a period of experimentation before such a dose is found. Assuming the user does not approach this dose very often, tolerance should not build, and it can be consistently used to reach that level of effect/ego death.

It may be helpful for the user to measure out doses in syringes before using if a re-dose is desired; pulling a new shot can be difficult while under the effects of ketamine, and takes time while the drug is wearing off. Administering a shot while anesthetized can be perilous at best; for this reason, re-dosing is not recommended. If one must re-dose, use of an "auto-ject" like device (a spring loaded syringe) is convenient.

Because the "k-hole" involves full dissociative anesthesia, it is crucial that the user be in a safe place, physically, such as lying flat in bed. It may be useful to have a sitter present because arousal from the k-hole may be disorienting.

Understand, however, that there is no guaranteed mechanism for "reaching the hole," and it takes practice. Become familiar with the drug before taking large doses such as those required to reach the "hole." Find a dose that works for you.

=== Oral ===

1-4mg/lb of body mass. Doses higher than 3mg/lb may exceed the recreational window and leave the user anesthetized rather than "tripping." Doses of 2-3mg/lb may incur greater (short-term) memory loss and have little additional value as a psychedelic.

=== Insufflated ===

Threshold effects may begin at about .25mg/lb body mass, and recreational doses can range up to 2mg/lb, with common doses being 1mg/lb of body mass. As above, higher doses may not yield greater desirable effect. Ketamine is reported to be fairly gentle on the nasal tissues compared to brominated phenethylamines and organofluorides.

=== Intramuscular injection ===

Typically 1mg/lb body mass for IM injection is quite sufficient for a full dissociative experience. Doses of .5-.75mg/lb are more "threshold" and cogent experiences. Doses exceeding 1mg/lb body mass usually result in full anesthesia with little recall of the experience and may take longer to recover. There may be short-term memory loss with higher doses.

=== Intravenous injection ===

Intravenous injection is possible with ketamine. The doses are the same as for intramuscular injection. However, with intravenous injection, the user can become fully anesthetized before she is able to remove the needle from her body. For this reason alone intravenous injection of ketamine is discouraged. Additionally, intramuscular injection provides a near-identical experience with the only major difference being a shorter (< 1 minute vs < 2 minutes) come-up.

== Duration ==

{| class="wikitable"
|+ Oral
|-
| Onset || 10-75 minutes
|-
| Total || 1-2 hours
|}

{| class="wikitable"
|+ Insufflation
|-
| Onset || 7.5-20 minutes
|-
| Total || 1-2 hours
|}

{| class="wikitable"
|+ Intramuscular
|-
| Onset || <2 minutes
|-
| Peak || 1-2 hours
|-
| After-effects || 60 minutes
|}

== Effects ==

=== Positive ===

* Ego death is a state often sought in the use of psychedelics, and ketamine is often considered to be a very quick route to ego death, in a repeatable, safe way.
* Some users report euphoria.
* Pain relief.
* There has been some indication that ketamine, in low doses (20-30mg), can be an effective anti-depressant.

=== Neutral ===

=== Negative ===

* Long-term, chronic usage may lead to psychosis.
* Bladder and lower urinary tract discomfort, up to and including tissue necrosis requiring replacement of bladder, ureters, and urethra, has been reported<ref>https://www.erowid.org/chemicals/ketamine/ketamine_article2.shtml</ref>. If these effects are noticed, discontinue use immediately. There is no known treatment for this except cessation of use. Symptoms may subside with discontinuation.
* Ketamine is well-known in the psychedelics community to be habit-forming. It may not be technically 'physically addictive', but certainly psychological dependence is an issue that is widely reported.
* Any substance used intramuscularly or intravenously can be associated with abscesses among other hazards.

=== After effects ===

* Ketamine takes much longer to return to a complete baseline than is immediately apparent to the user. While major effects subside in usually less than an hour, some research has shown it can take a day or longer for more subtle psychological effects to subside. For this reason, it is important to be careful with redosing and daily usage.

== Harm Reduction ==

See [[Dissociatives#Harm_Reduction|Dissociative Harm Reduction]] for general information.

==Preparation of injectable ketamine solution from "street" ketamine ==
It is assumed that ketamine provided is simply the evaporated shards of veterinary-grade ketamine (e.g., Ketalar, Ketaset, etc). These instructions do not cover "extraction" of ketamine from non-ketamine-containing mixtures. Additionally, the assumed route of administration here is intramuscular, not intravenous; intravenous solutions can have a higher concentration of ketamine per ml.

=== A note on purity of "street" ketamine ===
Anecdotal evidence suggests that even the "cleanest" ketamine available on the street cannot be sterile, or even assured to be 100% ketamine (common household dust and debris being an example of non-deliberate contamination; too small to see in a powder, but big enough to cause a problem for injection). If the procedure below is followed without the step of using the syringe filter of appropriate depth, particulate will appear in the final solution. These particles may be made sterile by boiling or the addition of benzyl alcohol. However, they can clog needles, and more importantly, they can lead to abscesses (sterile and non-sterile) in the muscles chosen for injection. This can become a medical emergency, and may need to be [http://www.thegooddrugsguide.com/gallery/before-and-after-drug-abuse/steroid-abuse/abusing-fake-steroids.htm surgically removed] ('''warning: graphic content'''). Early treatment is possible with antibiotics. An abscess will feel like a "lump" under the skin at the injection site, will usually be visibly raised, and warm to the touch. Seek treatment early if you have these symptoms.

=== Material ===

* Sterile saline solution
* Ketamine powder or "shards"
* Benzyl alcohol
* Sterile 10ml multi-dose vials
* Septums ("tops") per each multi-dose vial
* Sterile glass stirring rods
* Sterile beaker or graduated cylinder of greater than 50ml capacity
* Sterile syringe filters (22μm)
* Sterile 20cc syringes
* Temperature-controlled hot plate with magnetic stirring device or glass stirring rods, above

=== Preparation ===

Ketamine is quite soluble in water up to about 200mg/ml when warm and closer to 100mg/ml at room temperature.

# To begin, measure out one gram (1g) of ketamine per 10ml of saline solution used. Heat water in the beaker or cylinder to 80°C.
::''note:'' boiling is preferable but will throw off the total volume of water and thus the ratio of ketamine per cc.
# Per 10ml, measure out .1ml of benzyl alcohol (1%), and dispense to each multi-dose vial.
::''note:'' benzyl alcohol and benzyl benzoate are soluble in water, but require stirring and heating. Either should stay in solution after the water is heated and subsequently cools.

# Add ketamine powder to the heated water.
# Stir using a glass stirring rod or magnetic stirring device.
# When powder is visibly dissolved in the sterile solution, meter out 10ml of the solution using a 20cc syringe per 10ml vial.
# Using the 22μm syringe filter, add 10ml of the ketamine solution per multi-dose vial, pushing through (not pulling through) the syringe filter.
# Apply septum to each multi-dose vial and allow solution to cool to at most 30°C.

=== Notes on parenteral usage ===

Always use a test injection of e.g., 1/10th cc (in this case, 10mg) before actually using a therapeutic or recreational dose.

Benzyl benzoate may be used instead of benzyl alcohol at 1-2% per volume as a preservative/antimicrobial agent.

Ketamine is highly soluble in water at room- and body temperature. That said, for intramuscular injection, it is very important to ensure the solution will not "crash" (come out of solution) post-injection because of the solution cooling. Under no circumstances should you prepare a solution of greater than 100mg/ml or inject a solution that is above body temperature.
:''' ''note'' ''': left in a multi-dose vial or in syringes, ketamine can come out of solution if the ambient temperature dips low enough. there is at least one anecdote of a winter breeze through a domicile cooling both syringes and a vial sufficiently that crystals began to condense from the solution. obviously one should not attempt to inject the contents of a syringe if crystalline content is evident.

With benzyl alcohol or benzyl benzoate, in sterile sealed vials, having been processed through a syringe filter, and kept above freezing, this solution should remain quite stable and sterile indefinitely.

== Chemistry and Pharmacology ==

=== Pharmacokinetics ===

Ketamine is absorbable via intravenous, intramuscular, oral, and topical routes due to both its water and lipid solubilities.<ref>http://www.ncbi.nlm.nih.gov/pubmed/19546251</ref> When administered orally, it undergoes first-pass metabolism, where it is biotransformed in the liver by CYP3A4 (major), CYP2B6 (minor), and CYP2C9 (minor) isoenzymes into norketamine (through N-demethylation) and finally dehydronorketamine.<ref>http://www.ncbi.nlm.nih.gov/pubmed/18175098</ref> Intermediate in the biotransformation of norketamine into dehydronorketamine is the hydroxylation of norketamine into 5-hydroxynorketamine by CYP2B6 and CYP2A6. Dehydronorketamine, followed by norketamine, is the most prevalent metabolite detected in urine.<ref>http://www.dovepress.com/to-use-or-not-to-use-an-update-on-licit-and-illicit-ketamine-use-peer-reviewed-article-SAR</ref> As the major metabolite of ketamine, norketamine is one-third to one-fifth as potent anesthetically, and plasma levels of this metabolite are three times higher than ketamine following oral administration.<ref>http://www.ncbi.nlm.nih.gov/pubmed/19546251</ref><ref>http://www.ncbi.nlm.nih.gov/pubmed/1308374</ref>Bioavailability through the oral route reaches 17–20%; bioavailability through other routes are as follows: 93% intramuscularly, 25–50% intranasally, 30% sublingually, and 30% rectally.<ref>http://www.ncbi.nlm.nih.gov/pubmed/21419322</ref><ref>http://www.ncbi.nlm.nih.gov/pubmed/18175098</ref> Peak plasma concentrations are reached within a minute intravenously, 5–15 min intramuscularly, and 30 min orally.<ref>http://www.ncbi.nlm.nih.gov/pubmed/1308374</ref> Ketamine's duration of action in a clinical setting is 30 min to 2 h intramuscularly and 4–6 h orally.<ref>http://www.ncbi.nlm.nih.gov/pubmed/21419322</ref>

Plasma concentrations of ketamine are increased by diazepam and other CYP3A4 inhibitors.<ref>http://www.ncbi.nlm.nih.gov/pubmed/21419322</ref>

=== Pharmacodynamics ===

Pharmacologically, ketamine is classified as an NMDA receptor antagonist.<ref>http://www.ncbi.nlm.nih.gov/pubmed/2858237</ref> At high, fully anesthetic level doses, ketamine has also been found to bind to μ-opioid receptors type 2 in cultured human neuroblastoma cells – however, without agonist activity<ref>http://www.ncbi.nlm.nih.gov/pubmed/14530949</ref> and to sigma receptors in rats.<ref>http://www.ncbi.nlm.nih.gov/pubmed/11900615</ref> Ketamine also interacts with muscarinic receptors, descending monoaminergic pain pathways and voltage-gated calcium channels,[61]and it inhibits hyperpolarization-activated cyclic nucleotide–modulated (HCN1) cation channels.

== Images ==

<gallery mode="packed-hover">
Image:Ketamine_hcl.jpg|''Ketamine Vial''
Image:K_baggie.jpg|''Bag of Ketamine''
Image:K_lines.jpg|''Lines of ketamine''
Image:Ketamine_crystals.jpg|''Ketamine Crystals''
</gallery>

== Legal status ==

* United States: Schedule III<ref>http://www.justice.gov/dea/druginfo/ds.shtml</ref>
In some countries, such as Thailand and Mexico, ketamine is available over-the-counter without a prescription; legality for human use is questionable, however.

== References ==

<references />

[[Category:Dissociative]]
[[Category:Psychedelic]]
[[Category:Drugs]]

File:Ketanest10.png

2016-02-19T22:36:16Z

GrimReaper:

Drug combinations

2016-01-18T12:38:35Z

GrimReaper:

'''WARNING! For educational purposes: We do not endorse any of these combinations. This page will always be 'work in progress'. It is extremely important to be safe at all times! '''

[[File:Combo_2.png|1000px|center]]

== Overview ==
If you want to give us some feedback/recommendation/comment on the chart, you can contact us:

[http://chat.tripsit.me/?nick=AskContent?#content Join #content channel on IRC]

Email: '''content@tripsit.me''', or email GrimReaper directly at '''grimreaper@tripsit.me'''

== Chart versions ==

'''[http://wiki.tripsit.me/images/d/d6/TripSitDrugComboChart.gif English]'''

'''[http://wiki.tripsit.me/images/5/5b/TripSitDrugComboChart-Portuguese.png Portuguese]'''

'''[http://wiki.tripsit.me/images/d/d4/TripSitDrugComboChart-German.png German]'''

'''[http://wiki.tripsit.me/wiki/File:TripSitDrugComboChart-Polish.gif Polish]'''

== Specific Combinations ==

=== LSD & Mushrooms ===
=== LSD & DMT ===
* http://www.ncbi.nlm.nih.gov/pubmed/3006089

* http://deepblue.lib.umich.edu/bitstream/handle/2027.42/26285/0000370.pdf

=== LSD & Mescaline ===
=== LSD & DOx ===
=== LSD & NBOMes ===
=== LSD & 2C-x ===
=== LSD & 2C-T-x ===
=== LSD & αMT ===
=== LSD & 5-MeO-xxT ===
=== LSD & Cannabis ===
=== LSD & Ketamine ===
=== LSD & MXE ===
=== LSD & DXM ===
=== LSD & Nitrous ===
=== LSD & Amphetamines ===
=== LSD & MDMA ===
=== LSD & Cocaine ===
=== LSD & Caffeine ===
=== LSD & Alcohol ===
=== LSD & GHB\GBL ===
* http://www.ncbi.nlm.nih.gov/pubmed/16483730

=== LSD & Opioids ===
* http://www.ncbi.nlm.nih.gov/pubmed/547279

* http://www.ncbi.nlm.nih.gov/pubmed/3006089

* "Low doses antagonized the effects of both hallucinogens, whereas larger doses enhanced their effects."

* http://www.ncbi.nlm.nih.gov/pubmed/3006089

* http://deepblue.lib.umich.edu/bitstream/handle/2027.42/26285/0000370.pdf

=== LSD & Tramadol ===
* http://www.ncbi.nlm.nih.gov/pubmed/3006089

=== LSD & Benzodiazepines ===
=== LSD & MAOIs ===
* http://www.ncbi.nlm.nih.gov/pubmed/8788508

* http://www.ncbi.nlm.nih.gov/pubmed/108709

* https://www.erowid.org/references/refs_view.php?A=ShowDocPartFrame&ID=2439&DocPartID=2199

=== LSD & SSRIs ===
* http://www.nature.com/npp/journal/v14/n6/full/1380431a.html

* http://www.ncbi.nlm.nih.gov/pubmed/8726753

=== Mushrooms & DMT ===
=== Mushrooms & Mescaline ===
=== Mushrooms & DOx ===
=== Mushrooms & NBOMes ===
=== Mushrooms & 2C-x ===
=== Mushrooms & 2C-T-x ===
=== Mushrooms & αMT ===
=== Mushrooms & 5-MeO-xxT ===
=== Mushrooms & Cannabis ===
=== Mushrooms & Ketamine ===
=== Mushrooms & MXE ===
=== Mushrooms & DXM ===
=== Mushrooms & Nitrous ===
=== Mushrooms & Amphetamines ===
=== Mushrooms & MDMA ===
=== Mushrooms & Cocaine ===
=== Mushrooms & Caffeine ===
=== Mushrooms & Alcohol ===
=== Mushrooms & GHB\GBL ===
=== Mushrooms & Opioids ===
=== Mushrooms & Tramadol ===
=== Mushrooms & Benzodiazepines ===
=== Mushrooms & MAOIs ===
=== Mushrooms & SSRIs ===
=== DMT & Mescaline ===
=== DMT & DOx ===
=== DMT & NBOMes ===
=== DMT & 2C-x ===
=== DMT & 2C-T-x ===
=== DMT & αMT ===
=== DMT & 5-MeO-xxT ===
=== DMT & Cannabis ===
=== DMT & Ketamine ===
=== DMT & MXE ===
=== DMT & DXM ===
=== DMT & Nitrous ===
=== DMT & Amphetamines ===
=== DMT & MDMA ===
=== DMT & Cocaine ===
=== DMT & Caffeine ===
=== DMT & Alcohol ===
=== DMT & GHB\GBL ===
=== DMT & Opioids ===
* http://www.ncbi.nlm.nih.gov/pubmed/3006089

=== DMT & Tramadol ===
* http://www.ncbi.nlm.nih.gov/pubmed/3006089

=== DMT & Benzodiazepines ===
=== DMT & MAOIs ===
=== DMT & SSRIs ===
=== Mescaline & DOx ===
=== Mescaline & NBOMes ===
=== Mescaline & 2C-x ===
=== Mescaline & 2C-T-x ===
=== Mescaline & αMT ===
=== Mescaline & 5-MeO-xxT ===
* The 5-MeO class of tryptamines can be unpredictable in their interactions.

=== Mescaline & Cannabis ===
=== Mescaline & Ketamine ===
=== Mescaline & MXE ===
=== Mescaline & DXM ===
=== Mescaline & Nitrous ===
=== Mescaline & Amphetamines ===
* The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops.

=== Mescaline & MDMA ===
=== Mescaline & Cocaine ===
* The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops.

=== Mescaline & Caffeine ===
* High doses of caffeine are uncomfortable and this will be magnified by psychedelics.

=== Mescaline & Alcohol ===
=== Mescaline & GHB\GBL ===
=== Mescaline & Opioids ===
=== Mescaline & Tramadol ===
* This combination can cause seizures due to the lowering of the threshold by tramadol and the potential of mescaline to cause seziures.

=== Mescaline & Benzodiazepines ===
=== Mescaline & MAOIs ===
=== Mescaline & SSRIs ===
=== DOx & NBOMes ===
=== DOx & 2C-x ===
=== DOx & 2C-T-x ===
=== DOx & αMT ===
=== DOx & 5-MeO-xxT ===
* The 5-MeO class of tryptamines can be unpredictable in their interactions, particularly increasing the risk of unpleasant physical side effects.

=== DOx & Cannabis ===
=== DOx & Ketamine ===
* Ketamine and psychedelics tend to potentiate each other - go slowly.

=== DOx & MXE ===
* As an NMDA antagonist MXE potentiates DOx which can be unpleasantly intense.

=== DOx & DXM ===
* The DOx class as psychedelic stimulants have the potential to mask the effects of DXM and could lead to redosing to an unsafe level. DXM can also potentiate DOx resulting in an unpleasantly intense experience.

=== DOx & Nitrous ===
=== DOx & Amphetamines ===
* The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of amphetamine can easily lead to thought loops. Coming down from amphetamines while the DOx is still active can be quite anxiogenic.

* http://www.ncbi.nlm.nih.gov/pubmed/1208759

=== DOx & MDMA ===
* The combined stimulating effects of the two can be uncomfortable. Coming down on the MDMA while the DOx is still active can be quite anxiogenic.

=== DOx & Cocaine ===
* The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of cocaine can easily lead to thought loops. Coming down from cocaine while the DOx is still active can be quite anxiogenic.

=== DOx & Caffeine ===
* High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating it may cause some physical discomfort.

=== DOx & Alcohol ===
* Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk.

=== DOx & GHB\GBL ===
=== DOx & Opioids ===
* No unexpected interactions.

=== DOx & Tramadol ===
* Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

=== DOx & Benzodiazepines ===
=== DOx & MAOIs ===
=== DOx & SSRIs ===
=== NBOMes & 2C-x ===
=== NBOMes & 2C-T-x ===
=== NBOMes & αMT ===
=== NBOMes & 5-MeO-xxT ===
* The 5-MeO class of tryptamines can be unpredictable in their interactions and the NBOMes are known to be unpredictable even alone. This combination is best avoided.

=== NBOMes & Cannabis ===
=== NBOMes & Ketamine ===
=== NBOMes & MXE ===
=== NBOMes & DXM ===
=== NBOMes & Nitrous ===
=== NBOMes & Amphetamines ===
* Amphetamines and NBOMes both provide considerable stimulation. When combined they can result in tachycardia, hypertension, vasoconstriction and in extreme cases heart failure. The anxiogenic and focusing effects of stimulants are also not good in combination with psychedelics as they can lead to unpleasant thought loops. NBOMes are known to cause seizures and stimulants can increase this risk.

=== NBOMes & MDMA ===
=== NBOMes & Cocaine ===
* Cocaine and NBOMes both provide considerable stimulation. When combined they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.

=== NBOMes & Caffeine ===
* Caffiene can bring out the natural stimulation from psychedelic drugs to make it uncomfortable. High doses can cause anxiety which is hard to handle while tripping.

=== NBOMes & Alcohol ===
=== NBOMes & GHB\GBL ===
=== NBOMes & Opioids ===
=== NBOMes & Tramadol ===
* Tramadol is well known to lower seizure threshold and NBOMes have also shown a tendency to cause severe seizures.

=== NBOMes & Benzodiazepines ===
=== NBOMes & MAOIs ===
=== NBOMes & SSRIs ===
=== 2C-x & 2C-T-x ===
=== 2C-x & αMT ===
=== 2C-x & 5-MeO-xxT ===
* The 5-MeO psychedelics can interact unpredictably to potentiate other psychedelics.

=== 2C-x & Cannabis ===
=== 2C-x & Ketamine ===
=== 2C-x & MXE ===
=== 2C-x & DXM ===
=== 2C-x & Nitrous ===
=== 2C-x & Amphetamines ===
* The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally uneccessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

=== 2C-x & MDMA ===
=== 2C-x & Cocaine ===
* The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

=== 2C-x & Caffeine ===
* High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== 2C-x & Alcohol ===
=== 2C-x & GHB\GBL ===
=== 2C-x & Opioids ===
=== 2C-x & Tramadol ===
* Tramadol is well known to lower seizure threshold and psychedelics raise the risk of seizures.

=== 2C-x & Benzodiazepines ===
=== 2C-x & MAOIs ===
=== 2C-x & SSRIs ===
=== 2C-T-x & αMT ===
=== 2C-T-x & 5-MeO-xxT ===
=== 2C-T-x & Cannabis ===
=== 2C-T-x & Ketamine ===
=== 2C-T-x & MXE ===
=== 2C-T-x & DXM ===
=== 2C-T-x & Nitrous ===
=== 2C-T-x & Amphetamines ===
=== 2C-T-x & MDMA ===
=== 2C-T-x & Cocaine ===
=== 2C-T-x & Caffeine ===
* High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== 2C-T-x & Alcohol ===
* Both these classes of compound can interact unpredictably. Caution should be exercised.

=== 2C-T-x & GHB\GBL ===
=== 2C-T-x & Opioids ===
* No expected interactions, some Opioids have Serotonin action, and could lead to Serotonin Syndrome or a seizure. These are pretty much only to Pentazocine, Methadone, Tramadol, Tapenatdol.

=== 2C-T-x & Tramadol ===
=== 2C-T-x & Benzodiazepines ===
=== 2C-T-x & MAOIs ===
=== 2C-T-x & SSRIs ===
=== αMT & 5-MeO-xxT ===
=== αMT & Cannabis ===
=== αMT & Ketamine ===
=== αMT & MXE ===
=== αMT & DXM ===
=== αMT & Nitrous ===
=== αMT & Amphetamines ===
=== αMT & MDMA ===
=== αMT & Cocaine ===
=== αMT & Caffeine ===
* High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== αMT & Alcohol ===
* αMT has a broad mechanism of action in the brain and so does alcohol so the combination can be unpredictable.

=== αMT & GHB\GBL ===
=== αMT & Opioids ===
* No unexpected interactions

=== αMT & Tramadol ===
=== αMT & Benzodiazepines ===
=== αMT & MAOIs ===
=== αMT & SSRIs ===
=== 5-MeO-xxT & Cannabis ===
=== 5-MeO-xxT & Ketamine ===
=== 5-MeO-xxT & MXE ===
=== 5-MeO-xxT & DXM ===
=== 5-MeO-xxT & Nitrous ===
=== 5-MeO-xxT & Amphetamines ===
* The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

=== 5-MeO-xxT & MDMA ===
* Some of the 5-MeO tryptamines are a bit unpredictable and should be mixed with MDMA with care.

=== 5-MeO-xxT & Cocaine ===
* The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

=== 5-MeO-xxT & Caffeine ===
=== 5-MeO-xxT & Alcohol ===
=== 5-MeO-xxT & GHB\GBL ===
=== 5-MeO-xxT & Opioids ===
=== 5-MeO-xxT & Tramadol ===
=== 5-MeO-xxT & Benzodiazepines ===
=== 5-MeO-xxT & MAOIs ===
=== 5-MeO-xxT & SSRIs ===
=== Cannabis & Ketamine ===
=== Cannabis & MXE ===
=== Cannabis & DXM ===
=== Cannabis & Nitrous ===
=== Cannabis & Amphetamines ===
=== Cannabis & MDMA ===
=== Cannabis & Cocaine ===
=== Cannabis & Caffeine ===
=== Cannabis & Alcohol ===
=== Cannabis & GHB\GBL ===
=== Cannabis & Opioids ===
=== Cannabis & Tramadol ===
=== Cannabis & Benzodiazepines ===
=== Cannabis & MAOIs ===
=== Cannabis & SSRIs ===
=== Ketamine & MXE ===
=== Ketamine & DXM ===
=== Ketamine & Nitrous ===
=== Ketamine & Amphetamines ===
* Amphetamine worsens Ketamines ataxia.

* http://www.ncbi.nlm.nih.gov/pubmed/23660488

=== Ketamine & MDMA ===
=== Ketamine & Cocaine ===
=== Ketamine & Caffeine ===
* No unexpected interactions.

* http://onlinelibrary.wiley.com/doi/10.1111/j.1742-7843.2009.00382.x/full

=== Ketamine & Alcohol ===
* Both substances cause ataxia and bring a very high risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

* http://onlinelibrary.wiley.com/doi/10.1002/jemt.22045/abstract

=== Ketamine & GHB\GBL ===
* Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

* http://www.ncbi.nlm.nih.gov/pubmed/16483730

=== Ketamine & Opioids ===
* Both substances bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

* http://www.ncbi.nlm.nih.gov/pubmed/21224020

=== Ketamine & Tramadol ===
* No unexpected interactions.

=== Ketamine & Benzodiazepines ===
* Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

=== Ketamine & MAOIs ===
=== Ketamine & SSRIs ===
=== MXE & DXM ===
* http://i.imgur.com/zmqaw.jpg

* http://www.sciencedirect.com/science/article/pii/S0014488607002543

=== MXE & Nitrous ===
=== MXE & Amphetamines ===
* Risk of tachycardia, hypertension, and manic states.

* http://www.ncbi.nlm.nih.gov/pubmed/25060403

=== MXE & MDMA ===
* There have been reports of risky serotonergic interactions when the two are taken at the same time, but MXE taken to the end of an MDMA experience does not appear to cause the same issues.

=== MXE & Cocaine ===
* Stimulants taken with MXE can lead to hypermanic states much more easily, especially if sleep is avoided.

=== MXE & Caffeine ===
* No likely interactions.

=== MXE & Alcohol ===
* There is a high risk of memory loss, vomiting and severe ataxia from this combination.

=== MXE & GHB\GBL ===
* Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

=== MXE & Opioids ===
* This combination can potentiate the effects of the opioid.

=== MXE & Tramadol ===
=== MXE & Benzodiazepines ===
* Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess.

=== MXE & MAOIs ===
=== MXE & SSRIs ===
* Depending on the SSRI this combination can be unpredictable.

=== DXM & Nitrous ===
=== DXM & Amphetamines ===
* Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.

=== DXM & MDMA ===
=== DXM & Cocaine ===
* Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.

=== DXM & Caffeine ===
* High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== DXM & Alcohol ===
* Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Additionally CNS depression can lead to difficulty breathing. Avoid on anything higher than 1st plateau.

=== DXM & GHB\GBL ===
* Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position. This combination is hard to predict.

=== DXM & Opioids ===
* CNS depression, difficult breathing, heart issues, hepatoxic, just very unsafe combination all around. Additionally, there is a reverse cross tolerance between opiates/dxm. I.E. if one takes dxm, their tolerance of opiates goes down slightly, thus causing additional synergistic effects.

=== DXM & Tramadol ===
=== DXM & Benzodiazepines ===
* Small doses of benzos can end a bad trip, but both substances potentiate the ataxia and sedation caused by the other and this can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

=== DXM & MAOIs ===
* High risk of serotonin syndrome.

=== DXM & SSRIs ===
* High risk of serotonin syndrome.

=== Nitrous & Amphetamines ===
=== Nitrous & MDMA ===
=== Nitrous & Cocaine ===
=== Nitrous & Caffeine ===
=== Nitrous & Alcohol ===
* This combination can lead to vomiting.

=== Nitrous & GHB\GBL ===
=== Nitrous & Opioids ===
=== Nitrous & Tramadol ===
=== Nitrous & Benzodiazepines ===
=== Nitrous & MAOIs ===
=== Nitrous & SSRIs ===
=== Amphetamines & MDMA ===
* Amphetamines increase the neurotoxic effects of MDMA.

=== Amphetamines & Cocaine ===
* This combination of stimulants will increase strain on the heart. It is not generally worth it as cocaine has a mild blocking effect on dopamine releasers like amphetamine.

=== Amphetamines & Caffeine ===
* This combination of stimulants is not generally necessary and may increase strain on the heart, as well as potentially causing anxiety and greater physical discomfort.

=== Amphetamines & Alcohol ===
* Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel the alcohol and the stimulant less. Extended release formulations may severely impede sleep, further worsening the hangover.

=== Amphetamines & GHB\GBL ===
* Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

=== Amphetamines & Opioids ===
* Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

=== Amphetamines & Tramadol ===
* Tramadol and stimulants both increase the risk of seizures.

=== Amphetamines & Benzodiazepines ===
* http://www.ncbi.nlm.nih.gov/pubmed/17320309

=== Amphetamines & MAOIs ===
=== Amphetamines & SSRIs ===
=== MDMA & Cocaine ===
* Cocaine blocks some of the desirable effects of MDMA while increasing the risk of heart attack.

=== MDMA & Caffeine ===
* Caffiene is not really necessary with MDMA and increases any neurotoxic effects from MDMA.

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3492978/

* http://link.springer.com/article/10.1007/s00213-010-1864-1

* http://www.sciencedirect.com/science/article/pii/S0028390805003114

* http://www.ncbi.nlm.nih.gov/pubmed/24211539

=== MDMA & Alcohol ===
* Both MDMA and alcohol cause severe dehydration. Approach this combination with caution, moderation and sufficient hydration.

* http://www.ncbi.nlm.nih.gov/pubmed/21040238

* http://www.ncbi.nlm.nih.gov/pubmed/21756931

=== MDMA & GHB\GBL ===
* http://www.ncbi.nlm.nih.gov/pubmed/16234132

* http://www.ncbi.nlm.nih.gov/pubmed/22554869

* http://www.ncbi.nlm.nih.gov/pubmed/20730418

* http://www.ncbi.nlm.nih.gov/pubmed/16483730

=== MDMA & Opioids ===
=== MDMA & Tramadol ===
* Tramadol and stimulants both increase the risk of seizures.

=== MDMA & Benzodiazepines ===
=== MDMA & MAOIs ===
=== MDMA & SSRIs ===
=== Cocaine & Caffeine ===
* Both stimulants, risk of tachycardia, hypertension, and in extreme cases heart failure.

=== Cocaine & Alcohol ===
* Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel he alcohol less. Cocaine is potentiated somewhat by alcohol because of the formation of cocaethylene.

=== Cocaine & GHB\GBL ===
* Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest. Likewise the G can wear off and leave a dangerous concentration of cocaine behind.

=== Cocaine & Opioids ===
* Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

=== Cocaine & Tramadol ===
* Tramadol and stimulants both increase the risk of seizures.

=== Cocaine & Benzodiazepines ===
=== Cocaine & MAOIs ===
=== Cocaine & SSRIs ===
* Risk of serotonin syndrome, Likely to make the SSRI's innefective with regular cocaine use. The SSRIs may also make the cocaine less effective. Mental stability and cocaine don't go together.

* http://www.ncbi.nlm.nih.gov/pubmed/23761390

* http://www.ncbi.nlm.nih.gov/pubmed/20195220

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377381

=== Caffeine & Alcohol ===
* http://www.ncbi.nlm.nih.gov/pubmed/20001110

=== Caffeine & GHB\GBL ===
=== Caffeine & Opioids ===
=== Caffeine & Tramadol ===
* http://www.ncbi.nlm.nih.gov/pubmed/20837047

=== Caffeine & Benzodiazepines ===
=== Caffeine & MAOIs ===
=== Caffeine & SSRIs ===
* http://journals.lww.com/jpharmacogenetics/abstract/1996/06000/a_fluvoxamine_caffeine_interaction_study.3.aspx

=== Alcohol & GHB\GBL ===
* Even in very low doses this combination rapidly leads to memory loss, severe ataxia and unconsciousness. There is a high risk of vomit aspiration while unconscious.

* http://www.ncbi.nlm.nih.gov/pubmed/15274975

=== Alcohol & Opioids ===
* Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely.

=== Alcohol & Tramadol ===
* Heavy CNS depressants, risk of seizures. Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely.

=== Alcohol & Benzodiazepines ===
* Ethanol ingestion may potentiate the CNS effects of many benzodiazepines. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Blacking out and memory loss is almost certain.

=== Alcohol & MAOIs ===
* The chemical tyramine in alcoholic beverages can have dangerous reactions with MAOIs, causing an increase in blood pressure.

=== Alcohol & SSRIs ===
* Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

* http://www.ncbi.nlm.nih.gov/pubmed/15739105

=== GHB\GBL & Opioids ===
* The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

* http://www.ncbi.nlm.nih.gov/pubmed/7782758

=== GHB\GBL & Tramadol ===
* The sedative effects of this combination can lead to dangerous respiratory depression.

* http://www.ncbi.nlm.nih.gov/pubmed/7782758

=== GHB\GBL & Benzodiazepines ===
* The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

* http://www.ncbi.nlm.nih.gov/pubmed/16483730

=== GHB\GBL & MAOIs ===
* No study, but MAO B inhibitors should enhance the effects, no interaction with MAO A.

=== GHB\GBL & SSRIs ===
=== Opioids & Tramadol ===
* Concomitant use of tramadol increases the seizure risk in patients taking other opioids. These agents are often individually epileptogenic and may have additive effects on seizure threshold during coadministration. Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present.

=== Opioids & Benzodiazepines ===
* Central nervous system and/or respiratory-depressant effects may be additively or synergistically present. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position Blackouts/memory loss likely.

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3454351/

=== Opioids & MAOIs ===
* Coadministration of monoamine oxidase inhibitors (MAOIs) with certain opioids has been associated with rare reports of severe and fatal adverse reactions. There appear to be two types of interaction, an excitatory and a depressive one. Symptoms of the excitatory reaction may include agitation, headache, diaphoresis, hyperpyrexia, flushing, shivering, myoclonus, rigidity, tremor, diarrhea, hypertension, tachycardia, seizures, and coma. Death has occurred in some cases.

* http://www.ncbi.nlm.nih.gov/pubmed/17157368 (?)

* http://www.ncbi.nlm.nih.gov/pubmed/2891392

* http://www.if-pan.krakow.pl/pjp/pdf/2013/3_593.pdf

=== Opioids & SSRIs ===
* http://www.ncbi.nlm.nih.gov/pubmed/23391344

* http://www.ncbi.nlm.nih.gov/pubmed/20513454

* http://www.ncbi.nlm.nih.gov/pubmed/16005413

* http://www.ncbi.nlm.nih.gov/pubmed/18676387

* http://www.ncbi.nlm.nih.gov/pubmed/17381671

=== Tramadol & Benzodiazepines ===
* Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present. Vomit aspiration a risk when passed out, lay down in recovery position if ingested.

* http://www.ncbi.nlm.nih.gov/pubmed/12842359

=== Tramadol & MAOIs ===
* http://www.ncbi.nlm.nih.gov/pubmed/16051647

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750095/

=== Tramadol & SSRIs ===
* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2714818/

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750095/

=== Benzodiazepines & MAOIs ===
=== Benzodiazepines & SSRIs ===
* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446479/

* http://www.ncbi.nlm.nih.gov/pubmed/9435993

=== MAOIs & SSRIs ===
* http://www.ncbi.nlm.nih.gov/pubmed/24577320

[[Category:Guides]]

Main Page

2016-01-18T10:49:23Z

GrimReaper:

{{DISPLAYTITLE:Welcome to TripSit Wiki!}}
<table style="display:block;" cellpadding=0>
<tr>
<td valign=top width=30% bgcolor=#f1f1f1>
=== Drug Knowledge ===
*'''List of [[:Category:Drugs|Psychoactive Substances]]'''
*Main pages for drug classes:
**[[Hallucinogens]]
***[[Psychedelics]]
***[[Dissociatives]]
**[[Stimulants]]
**[[Depressants]]
***[[Opioids]]
***[[Benzodiazepines]]
**[[Antidepressants]]
**[[Deliriants]]
**[[:Category:Ethnobotanical|Ethnobotanicals]]
**[[Research Chemicals]]

* [[Drug combinations]]
* [http://drugs.tripsit.me/ Factsheets]
* [[Glossary]]

=== [[Guides]] ===

* [[Addiction]]
* [[Overdose]]
* [[Panic Attacks]]
* [[How To Deal With A Bad Trip]]
* [[Common Misconceptions About Psychedelics]]
* [[Quick Guide to Plugging]]
* [[Quick Guide to Stimulant Comedowns]]
* [[Quick Guide to Volumetric Dosing]]
* [[Cold Water Extraction]]

=== Tripsitting ===
* [[How_To_Tripsit_Online|How to Tripsit online]]
* [[How_To_Tripsit_In_Real_Life|How to Tripsit in real life]]

=== Harm Reduction Supplies & Testing ===
* [[Scales]]
* [[Test Kits]]
* [[Sources for Laboratory Analysis]]

</td>
<td valign=top width=30% bgcolor=#f1f1f1>
=== [[:Category:Common Drugs|Common Drugs]] ===

* '''[[:Category:Psychedelic|Psychedelics]]'''
** [[2C-X|2C-X series]]
** [[AMT|αMT]]
** [[Cannabis]]
** [[DMT]]
** [[DOx|DOx series]]
** [[LSA]]
** [[LSD]]
** [[Mescaline]]
** [[Mushrooms]]
** [[NBOMes|NBOMe series]]

* '''[[:Category:Dissociative|Dissociatives]]'''
** [[3-MeO-PCP]]
** [[DXM]]
** [[Diphenidine]]
** [[Ketamine]]
** [[MXE]]
** [[Nitrous Oxide]]
** [[PCP]]
** [[Salvia]]

* '''[[:Category:Stimulant|Stimulants]]'''
** [[Adderall]]
** [[Amphetamine]]
** [[Cocaine]]
** [[MDA]]
** [[MDMA]]
** [[Mephedrone]]
** [[Methamphetamine]]
** [[Methylphenidate]]

* '''[[:Category:Depressant|Depressants]]'''
** [[Alcohol]]
** [[Etizolam]]
** [[GHB]]
** [[Kava]]
** [[Zolpidem]]

* '''[[:Category:Opioid|Opioids]]'''
** [[Buprenorphine]]
** [[Codeine]]
** [[Heroin]]
** [[Hydrocodone]]
** [[Kratom]]
** [[Morphine]]
** [[Oxycodone]]
** [[Tramadol]]
</td>

<td valign=top width=20%>
=== Important Pages ===
* [[TripSit Rules]]
* [[Network Terms of Service]]
* [[List of staff and their roles]]
* [[TripSit's Plans]]
* [[How to help TripSit]]

=== IRC ===
* [[IRC_User_Guide|'''New user guide''']]
* [http://tripsit.me/tripsitapp/ Tripsit's portable IRC distribution]
* [[Channels]]
** [http://chat.tripsit.me/?nick=Social?#tripsit #tripsit]
** [http://chat.tripsit.me/?nick=Social?#home #home]
** [http://chat.tripsit.me/?nick=Social?#drugs #drugs]
* [[How_to_connect_through_Tor|How to Connect through Tor]]
* [[List of IRC bot commands]]
* Moderation [[Commands reference]]

=== Forum ===
* [http://nexus.tripsit.me Nexus] - TripSit forum

=== TripRadio ===
* [http://radio.tripsit.me Listen Now]

* [[Radio|General info]]
* [[DJ Application|We need DJs!]]
* [[How to DJ|How to setup DJ software]]
</td>

</tr>
</table>

[[About|About Tripsit wiki]]

TripSit wiki currently has [[Special:Statistics|{{NUMBEROFPAGES}} pages]].

View a [[Special:AllPages|list of all pages]].

Main Page

2016-01-18T10:49:01Z

GrimReaper:

{{DISPLAYTITLE:Welcome to TripSit Wiki!}}
<table style="display:block;" cellpadding=0>
<tr>
<td valign=top width=30% bgcolor=#f1f1f1>
=== Drug Knowledge ===
*'''List of [[:Category:Drugs|Psychoactive Substances]]'''
*Main pages for drug classes:
**[[Hallucinogens]]
***[[Psychedelics]]
***[[Dissociatives]]
**[[Stimulants]]
**[[Depressants]]
***[[Opioids]]
***[[Benzodiazepines]]
**[[Antidepressants]]
**[[Deliriants]]
**[[:Category:Ethnobotanical|Ethnobotanicals]]
**[[Research Chemicals]]

* [[Drug combinations]]
* [http://drugs.tripsit.me/ Factsheets]
* [[Glossary]]

=== [[Guides]] ===

* [[Addiction]]
* [[Overdose]]
* [[Panic Attacks]]
* [[How To Deal With A Bad Trip]]
* [[Common Misconceptions About Psychedelics]]
* [[Quick Guide to Plugging]]
* [[Quick Guide to Stimulant Comedowns]]
* [[Quick Guide to Volumetric Dosing]]
* [[Cold Water Extraction]]

=== Tripsitting ===
* [[How_To_Tripsit_Online|How to Tripsit online]]
* [[How_To_Tripsit_In_Real_Life|How to Tripsit in real life]]

=== Harm Reduction Supplies & Testing ===
* [[Scales]]
* [[Test Kits]]
* [[Sources for Laboratory Analysis]]

</td>
<td valign=top width=30% bgcolor=#f1f1f1>
=== [[:Category:Common Drugs|Common Drugs]] ===

* '''[[:Category:Psychedelic|Psychedelics]]'''
** [[2C-X|2C-X series]]
** [[AMT|αMT]]
** [[Cannabis]]
** [[DMT]]
** [[DOx|DOx series]]
** [[LSA]]
** [[LSD]]
** [[Mescaline]]
** [[Mushrooms]]
** [[NBOMes|NBOMe series]]

* '''[[:Category:Dissociative|Dissociatives]]'''
** [[3-MeO-PCP]]
** [[DXM]]
** [[Diphenidine]]
** [[Ketamine]]
** [[MXE]]
** [[Nitrous Oxide]]
** [[PCP]]
** [[Salvia]]

* '''[[:Category:Stimulant|Stimulants]]'''
** [[Adderall]]
** [[Amphetamine]]
** [[Cocaine]]
** [[MDA]]
** [[MDMA]]
** [[Mephedrone]]
** [[Methamphetamine]]
** [[Methylphenidate]]

* '''[[:Category:Depressant|Depressants]]'''
** [[Alcohol]]
** [[Etizolam]]
** [[GHB]]
** [[Kava]]
** [[Zolpidem]]

* '''[[:Category:Opioid|Opioids]]'''
** [[Buprenorphine]]
** [[Codeine]]
** [[Heroin]]
** [[Hydrocodone]]
** [[Kratom]]
** [[Morphine]]
** [[Oxycodone]]
** [[Tramadol]]
</td>

<td valign=top width=20%>
=== Important Pages ===
* [[TripSit Rules]]
* [[Network Terms of Service]]
* [[List of staff and their roles]]
* [[TripSit's Plans]]
* [[How to help TripSit]]

=== IRC ===
* [[IRC_User_Guide|'''New user guide''']]
* [http://tripsit.me/tripsitapp/ Tripsit's portable IRC distribution]
* [[Channels]]
** [http://chat.tripsit.me/?nick=Social?#tripsit #tripsit]
** [http://chat.tripsit.me/?nick=Social?#home #home]
** [http://chat.tripsit.me/?nick=Social?#drugs #drugs]
* [[How_to_connect_through_Tor|How to Connect through Tor]]
* [[List of IRC bot commands]]
* Moderation [[Commands reference]]

=== Forum ===
[http://nexus.tripsit.me Nexus] - TripSit forum

=== TripRadio ===
* [http://radio.tripsit.me Listen Now]

* [[Radio|General info]]
* [[DJ Application|We need DJs!]]
* [[How to DJ|How to setup DJ software]]
</td>

</tr>
</table>

[[About|About Tripsit wiki]]

TripSit wiki currently has [[Special:Statistics|{{NUMBEROFPAGES}} pages]].

View a [[Special:AllPages|list of all pages]].

Main Page

2016-01-18T10:47:48Z

GrimReaper:

{{DISPLAYTITLE:Welcome to TripSit Wiki!}}
<table style="display:block;" cellpadding=0>
<tr>
<td valign=top width=30% bgcolor=#f1f1f1>
=== Drug Knowledge ===
*'''List of [[:Category:Drugs|Psychoactive Substances]]'''
*Main pages for drug classes:
**[[Hallucinogens]]
***[[Psychedelics]]
***[[Dissociatives]]
**[[Stimulants]]
**[[Depressants]]
***[[Opioids]]
***[[Benzodiazepines]]
**[[Antidepressants]]
**[[Deliriants]]
**[[:Category:Ethnobotanical|Ethnobotanicals]]
**[[Research Chemicals]]

* [[Drug combinations]]
* [http://drugs.tripsit.me/ Factsheets]
* [[Glossary]]

=== [[Guides]] ===

* [[Addiction]]
* [[Overdose]]
* [[Panic Attacks]]
* [[How To Deal With A Bad Trip]]
* [[Common Misconceptions About Psychedelics]]
* [[Quick Guide to Plugging]]
* [[Quick Guide to Stimulant Comedowns]]
* [[Quick Guide to Volumetric Dosing]]
* [[Cold Water Extraction]]

=== Tripsitting ===
* [[How_To_Tripsit_Online|How to Tripsit online]]
* [[How_To_Tripsit_In_Real_Life|How to Tripsit in real life]]

=== Harm Reduction Supplies & Testing ===
* [[Scales]]
* [[Test Kits]]
* [[Sources for Laboratory Analysis]]

</td>
<td valign=top width=30% bgcolor=#f1f1f1>
=== [[:Category:Common Drugs|Common Drugs]] ===

* '''[[:Category:Psychedelic|Psychedelics]]'''
** [[2C-X|2C-X series]]
** [[AMT|αMT]]
** [[Cannabis]]
** [[DMT]]
** [[DOx|DOx series]]
** [[LSA]]
** [[LSD]]
** [[Mescaline]]
** [[Mushrooms]]
** [[NBOMes|NBOMe series]]

* '''[[:Category:Dissociative|Dissociatives]]'''
** [[3-MeO-PCP]]
** [[DXM]]
** [[Diphenidine]]
** [[Ketamine]]
** [[MXE]]
** [[Nitrous Oxide]]
** [[PCP]]
** [[Salvia]]

* '''[[:Category:Stimulant|Stimulants]]'''
** [[Adderall]]
** [[Amphetamine]]
** [[Cocaine]]
** [[MDA]]
** [[MDMA]]
** [[Mephedrone]]
** [[Methamphetamine]]
** [[Methylphenidate]]

* '''[[:Category:Depressant|Depressants]]'''
** [[Alcohol]]
** [[Etizolam]]
** [[GHB]]
** [[Kava]]
** [[Zolpidem]]

* '''[[:Category:Opioid|Opioids]]'''
** [[Buprenorphine]]
** [[Codeine]]
** [[Heroin]]
** [[Hydrocodone]]
** [[Kratom]]
** [[Morphine]]
** [[Oxycodone]]
** [[Tramadol]]
</td>

<td valign=top width=20%>
=== Important Pages ===
* [[TripSit Rules]]
* [[Network Terms of Service]]
* [[List of staff and their roles]]
* [[TripSit's Plans]]
* [[How to help TripSit]]

=== IRC ===
* [[IRC_User_Guide|'''New user guide''']]
* [http://tripsit.me/tripsitapp/ Tripsit's portable IRC distribution]
* [[Channels]]
** [http://chat.tripsit.me/?nick=Social?#tripsit #tripsit]
** [http://chat.tripsit.me/?nick=Social?#home #home]
** [http://chat.tripsit.me/?nick=Social?#drugs #drugs]
* [[How_to_connect_through_Tor|How to Connect through Tor]]
* [[List of IRC bot commands]]
* Moderation [[Commands reference]]

=== TripRadio ===
* [http://radio.tripsit.me Listen Now]

* [[Radio|General info]]
* [[DJ Application|We need DJs!]]
* [[How to DJ|How to setup DJ software]]
</td>

</tr>
</table>

[[About|About Tripsit wiki]]

TripSit wiki currently has [[Special:Statistics|{{NUMBEROFPAGES}} pages]].

View a [[Special:AllPages|list of all pages]].

Main Page

2016-01-18T10:46:00Z

GrimReaper:

{{DISPLAYTITLE:Welcome to TripSit Wiki!}}
<table style="display:block;" cellpadding=0>
<tr>
<td valign=top width=30% bgcolor=#f1f1f1>
=== Drug Knowledge ===
*'''List of [[:Category:Drugs|Psychoactive Substances]]'''
*Main pages for drug classes:
**[[Hallucinogens]]
***[[Psychedelics]]
***[[Dissociatives]]
**[[Stimulants]]
**[[Depressants]]
***[[Opioids]]
***[[Benzodiazepines]]
**[[Antidepressants]]
**[[Deliriants]]
**[[:Category:Ethnobotanical|Ethnobotanicals]]
**[[Research Chemicals]]

* [[Drug combinations]]
* [http://drugs.tripsit.me/ Factsheets]
* [[Glossary]]

=== [[Guides]] ===

* [[Addiction]]
* [[Overdose]]
* [[Panic Attacks]]
* [[How To Deal With A Bad Trip]]
* [[Common Misconceptions About Psychedelics]]
* [[Quick Guide to Plugging]]
* [[Quick Guide to Stimulant Comedowns]]
* [[Quick Guide to Volumetric Dosing]]
* [[Cold Water Extraction]]

=== Tripsitting ===
* [[How_To_Tripsit_Online|How to Tripsit online]]
* [[How_To_Tripsit_In_Real_Life|How to Tripsit in real life]]

=== Harm Reduction Supplies & Testing ===
* [[Scales]]
* [[Test Kits]]
* [[Sources for Laboratory Analysis]]

</td>
<td valign=top width=30% bgcolor=#f1f1f1>
=== [[:Category:Common Drugs|Common Drugs]] ===

* '''[[:Category:Psychedelic|Psychedelics]]'''
** [[2C-X|2C-X series]]
** [[AMT|αMT]]
** [[Cannabis]]
** [[DMT]]
** [[DOx|DOx series]]
** [[LSA]]
** [[LSD]]
** [[Mescaline]]
** [[Mushrooms]]
** [[NBOMes|NBOMe series]]

* '''[[:Category:Dissociative|Dissociatives]]'''
** [[3-MeO-PCP]]
** [[DXM]]
** [[Diphenidine]]
** [[Ketamine]]
** [[MXE]]
** [[Nitrous Oxide]]
** [[PCP]]
** [[Salvia]]

* '''[[:Category:Stimulant|Stimulants]]'''
** [[Adderall]]
** [[Amphetamine]]
** [[Cocaine]]
** [[MDA]]
** [[MDMA]]
** [[Mephedrone]]
** [[Methamphetamine]]
** [[Methylphenidate]]

* '''[[:Category:Depressant|Depressants]]'''
** [[Alcohol]]
** [[Etizolam]]
** [[GHB]]
** [[Kava]]
** [[Zolpidem]]

* '''[[:Category:Opioid|Opioids]]'''
** [[Buprenorphine]]
** [[Codeine]]
** [[Heroin]]
** [[Hydrocodone]]
** [[Kratom]]
** [[Morphine]]
** [[Oxycodone]]
** [[Tramadol]]
</td>

<td valign=top width=20%>
== Community ==
=== Important Pages ===
* [[TripSit Rules]]
* [[Network Terms of Service]]
* [[List of staff and their roles]]
* [[TripSit's Plans]]
* [[How to help TripSit]]

=== IRC ===
* [[IRC_User_Guide|'''New user guide''']]
* [http://tripsit.me/tripsitapp/ Tripsit's portable IRC distribution]
* [[Channels]]
** [http://chat.tripsit.me/?nick=Social?#tripsit #tripsit]
** [http://chat.tripsit.me/?nick=Social?#home #home]
** [http://chat.tripsit.me/?nick=Social?#drugs #drugs]
* [[How_to_connect_through_Tor|How to Connect through Tor]]
* [[List of IRC bot commands]]
* Moderation [[Commands reference]]

=== TripRadio ===
* [http://radio.tripsit.me Listen Now]

* [[Radio|General info]]
* [[DJ Application|We need DJs!]]
* [[How to DJ|How to setup DJ software]]
</td>

</tr>
</table>

[[About|About Tripsit wiki]]

TripSit wiki currently has [[Special:Statistics|{{NUMBEROFPAGES}} pages]].

View a [[Special:AllPages|list of all pages]].

Opium derivaties

2015-12-05T13:33:25Z

GrimReaper: Created page with "<html><head><meta content="text/html; charset=UTF-8" http-equiv="content-type"><style type="text/css">ol{margin:0;padding:0}.c10{padding-top:0pt;padding-bottom:9pt;line-height..."

<html><head><meta content="text/html; charset=UTF-8" http-equiv="content-type"><style type="text/css">ol{margin:0;padding:0}.c10{padding-top:0pt;padding-bottom:9pt;line-height:1.3;orphans:2;widows:2;direction:ltr}.c1{padding-bottom:8pt;line-height:1.65;orphans:2;widows:2;direction:ltr;height:11pt}.c4{padding-top:0pt;padding-bottom:0pt;line-height:1.3;orphans:2;widows:2;direction:ltr}.c9{margin-left:58pt;line-height:1.65;orphans:2;widows:2;direction:ltr}.c8{margin-left:87pt;line-height:1.65;orphans:2;widows:2;direction:ltr}.c0{margin-left:29pt;line-height:1.65;orphans:2;widows:2;direction:ltr}.c6{padding-bottom:8pt;line-height:1.65;orphans:2;widows:2;direction:ltr}.c3{orphans:2;widows:2;direction:ltr;height:11pt}.c5{font-size:17pt;font-family:"Georgia";color:#252525;font-weight:bold}.c11{background-color:#ffffff;max-width:468pt;padding:72pt 72pt 72pt 72pt}.c2{background-color:#ffffff;color:#252525}.c7{font-weight:bold}.title{padding-top:0pt;color:#000000;font-size:26pt;padding-bottom:3pt;font-family:"Arial";line-height:1.15;page-break-after:avoid;orphans:2;widows:2;text-align:left}.subtitle{padding-top:0pt;color:#666666;font-size:15pt;padding-bottom:16pt;font-family:"Arial";line-height:1.15;page-break-after:avoid;orphans:2;widows:2;text-align:left}li{color:#000000;font-size:11pt;font-family:"Arial"}p{margin:0;color:#000000;font-size:11pt;font-family:"Arial"}h1{padding-top:20pt;color:#000000;font-size:20pt;padding-bottom:6pt;font-family:"Arial";line-height:1.15;page-break-after:avoid;orphans:2;widows:2;text-align:left}h2{padding-top:18pt;color:#000000;font-size:16pt;padding-bottom:6pt;font-family:"Arial";line-height:1.15;page-break-after:avoid;orphans:2;widows:2;text-align:left}h3{padding-top:16pt;color:#434343;font-size:14pt;padding-bottom:4pt;font-family:"Arial";line-height:1.15;page-break-after:avoid;orphans:2;widows:2;text-align:left}h4{padding-top:14pt;color:#666666;font-size:12pt;padding-bottom:4pt;font-family:"Arial";line-height:1.15;page-break-after:avoid;orphans:2;widows:2;text-align:left}h5{padding-top:12pt;color:#666666;font-size:11pt;padding-bottom:4pt;font-family:"Arial";line-height:1.15;page-break-after:avoid;orphans:2;widows:2;text-align:left}h6{padding-top:12pt;color:#666666;font-size:11pt;padding-bottom:4pt;font-family:"Arial";line-height:1.15;page-break-after:avoid;font-style:italic;orphans:2;widows:2;text-align:left}</style></head><body class="c11"><h2 class="c10"><a name="h.4eutgyx9e7k9"></a>OPIUM DERIVATIVES</h2>OPIUM ALKALOIDSThebaine - 6, 14 dimethoxy version of OM. Stimulant rather than analgesic, high dose causes ODALKALOID SALT MIXTURESPantopon - Preparation of all alkaloids present in opium without plant matter. Injectable and almost as potent as morphine.MORPHINE FAMILY6-MDDM - 80x potency of M, faster onset and less body loadAzidomorphine - 40x potency of M with high affinity to μHydromorphinol - Derivative of M but more potent, with a steeper dose-response curve and a longer half life. Script in Sweden.Methyldesorphin - 15x potency of M. Is found in KrokodilMorphinan-6-one (MR-2096) - OM analogue at roughly 5-7mg dosage. RC. FULL NAME: (N-tetrahydrofurfuryl)noroxymorphoneN-Phenethylnormorphine - 8-14x potency of M.RAM-378* - N-Phenethyl analogue of Hydromorphinol. It is probably more potent as a result.3, 6 MORPHINE DIESTERSDiacetyldihydromorphine - Occasionally used an alternative to diamorphine, of which it is faster acting, longer lasting and has less side effects such as euphoria and addiction. However it is equipotent with morphine.Dipropanoylmorphine - Ester of M used to treat severe pain. Rarely used but considered to be safer and less adictive than M. As such carries less side effects, such as euphoria. Slower acting, longer lasting and slightly more potent than M.Nicomorphine - 2-3x the potency of M and commonly prescribed in German speaking countriesCODEINE-DIONINE FAMILYHeterocodeine - Reverse isomer of codeine. 6x potency of M, while Codeine is a prodrug, HC is a direct agonist.Myrophine* - Morphine + 3-benzyl & 6-myristyl chain and acts as a prodrug to M. Has a slow onset of effects and longer duration but reduced potency. Does NOT produce addiction or dependance regardless of dose.<h2 class="c4"><a name="h.tvg02qdpstzz"></a>MORPHINONES AND MORPHOLS</h2>14-Cinnamoyloxycodeinone - 100x potency of M, interesting.14-Methoxymetopon - 500x potency of M, can be up to one million x the potency of M if injected into spine.14-Phenylpropoxymetopon - 2000+x potency of M, when injected into spine up to 1,000,000x. 14-MOP has ceiling effect on respiratory depression (!!) but 14-PPOP untested3-Acetyloxymorphone - Acetylated analogue of OM7-Spiroindanyloxymorphone - odd OM analogue, selective d agonistAcetylmorphone - Acetoxy version of Hydromorphone, has a higher BA as a result.Chloroxymorphamine - Derivative of OM and irreversible full agonistIBNtxA - Naltrexone analogue. It is a u opioid agonist however it is not percieved as rewarding in animals, it also does not produce respiratory depression or constipation.Methyldihydromorphine - Related to heterocodeine not dihydrocodeine. Could be 6-9x potency of morphine and a drug of abuse.Metopon - Methylated Hydromorphone, less potent. Interesting though, could have more euphoriaN-Phenethyl-14-ethoxymetopon - 60x potency of M but produces less constipation. d & u agonist.Oxymorphol - 6-hydrogenated OMPentamorphone - few x stronger than fent. short duration but low respiratory depression.Semorphone - 2x potency of M. Partial u agonist and has a ceiling effect on both analgesia and respiratory depression.Thebacon - Thebaine analogue and fairly uninteresting<h2 class="c4"><a name="h.pob25uo1vi3u"></a>MORPHIDES</h2>Chloromorphide - 10x potency of M, Chlorine group attached to the 3 position. Extension of this into other halogens must be made.HYDRAZONESOxymorphazone - half potency as OM but higher doses last up to 48hrs - irreversible full μ agonistHALOGENATED MORPHINE DERIVATIVES1-Iodomorphine - While an increase in activity had not been noted, research into fluorinated morphine analogues is being conducted.1-Bromocodeine -1-Chlorocodeine -<h2 class="c4"><a name="h.9gh5hyjaxn3f"></a>MORPHINANS</h2>Butorphanol - partial ant.-ag. at μ opioid and competitive antagonist/partial agonist at κ opioid. dysphoria is common at normal dose.Drotebanol - Morphinan derivative synthesised from Thebaine with analgesic effects several times more potent than codeine but weaker than morphine. Moderately addictive but limited physical dependance. Under Metabanyl when available as a script.Dextromethorphan (-) - NMDA antagonist / σ1 & σ2 sigma agonist / a3b4, a4b2, a7 nACH antagonist, (very weak) μ, δ & κ opioid agonist, SERT & NET inhibitor, NADPH Oxidase inhibitor. (Race)Methorphan = racemicDextrorphan (-) - NMDA antagonist / σ1 & σ2 sigma agonist / a3b4, a4b2, a7 nACH antagonist, L-Type voltage-gated calcium channel (LVGCC) blocker, SRI.Cyclorphan - mixed antagonist-agonist with affinity for κLevophenacylmorphan - 10x potency of MLevofurethylnormorphanol (Ro4-1539) - potent μ opioid agonist 30-60x potency of Levorphanol.Levomethorphan (+) - NDMA antagonist, σ1 & σ2 sigma agonist, μ, δ & κ opioid agonist.Levorphanol (+) - μ, κ & δ agonist, 4-8x potency of M, long duration, no cross tolerance with morphineNorlevorphanol - Opioid analgesic, uninteresting.Phenomorphan - 10x potency of Levorphanol.└--> N-(2-(2-furyl)ethyl) analogue - 60x Levorphanol└--> N-(2-(2-thienyl)ethyl) analogue - 45x LevorphanolProxorphan - partial κ agonist, lesser partial μ agonistRo4-1539 (Furethylnorlevorphanol) - 30-60x the potency of M. One of the more potent u agonists from the Morphans.(Race)Methorphan: L(eft) (+) Levomethorphan >< Dextromethorphan (-) D(exter) --> l=OPIATE >< d=HALLUCINOGENIC OPIATE└--> Racemic mix of both isomers, embodying their properties.Morphinan (Racemorphan): l (+) Levorphanol >< Dextrorphan (-) d --> l=OPIATE >< d=HALLUCINOGENIC OPIATE└--> Racemic mix of both isomers, embodying their properties.(Race)Allorphan: l (+) Levallorphan >< Dextrallorphan (-) d --> l= ANTI-OPIOID >< d=NMDA ANTAGONISTS└--> Racemic mix of both isomers, embodying their properties.3-Hydroxymorphinan: l (+) Norlevorphanol >< Nordextrorphan (-) d --> l=OPIATE >< d=NOOTROPIC└--> Racemic mix of both isomers, embodying their properties.Oxilorphan: μ antagonist & weak partial κ agonistDimemorfan - SIGMAERGIC DRUGXorphanol - mixed ant.-ag. produces convulsions at highest dose tested.Cyprodime - Selective μ opioid antagonist with no affinity for κ or δ receptorsSamidorphan - selective μ antagonist. potential for addiction treatment.<h2 class="c4"><a name="h.xvpsc3y3ocp3"></a>BENZOMORPHANS</h2>Butinazocine - benzomorphan opioid that was never marketed-----------------\ The Benzomorphans haveCarbazocine - benzomorphan opioid that was never marketed \ to be my favourite structures.Etazocine - partial opioid agonist with mixed ant.-ag. effects. low potency \_ The Cubist narcotics.Ethylketocyclozocine - partial opioid agonist with mixed ant.-ag. effects The Picassopiates.Ibazocine - benzomorphan opioid that was never marketed They serve no real functionMoxazocine - 10x potency of M, partial/mixed ant.-ag. _ except to look pretty toTonazocine - partial agonist at μ & δ, no adverse effects on breathing / afficionados such as I.Volazocine - benzomorphan opioid that was never marketed / As do I to afficionados suchFluorophen - radioligand, full μ agonist (6x M) & lower affinity for δ / as they, and they to afficonadosZenazocine - partial agonist at μ & δ-------------------------------------/ such as we, and we are such afficionados.Eptazocine - Japanese κ agonist & μ antagonistPentazocine - mixed ant.-ag. (-) is the κ agonist side, the (+) displays 10x the affinity for sigma receptors. NO μ agonismPhenazocine - related to ^ but stronger analgesic, 4x potency of MCyclazocine - mixed ant.-ag.Dezocine - Mixed ant.-ag. with high κ antagonism. Low dose=euphoria (μ) High dose=dysphoria (κ). Wierd structure8-Carboxamidocyclazocine (8-CAC) - κ & μ agonist, long duration.Bremazocine - κ agonist related to PentazocineMetazocine - analgesic; mixed ant.-ag. at μ, activity also at κ and sigmaAlazocine - σ1 agonist, κ opioid agonist & slight NMDA antagonist<h2 class="c4"><a name="h.lenpn09g2hk1"></a>4-PHENYLPIPERIDINES MEPERIDINES</h2>4-Fluoropethidine - In comparison to pethidine, it is 50% less potent as an analgesic but 50% more potent as a DRI. (4-iodo & 3, 4-dichloro only increase these differences)Anileridine - Another banned pethidine analogue, probably abused. Higher analgesia than Meperidine due to n-aminophenyl group and acts withing 15 mins orally, lasting 2-3 hours.Benzethidine - 4-phenylpiperidine analogue of pethidine. Probably somewhat more potent and euphoric. Never scripted.Carperidine - fairly normal opiate but unused in medicine and currently LEGAL (08/06/2013)Furethidine - 4-Phenylpiperidine analogue of pethidine. Probably a lot more potent and abuse prone. Never prescribed.Morpheridine - related to meperidine but 4x the potency and does not cause convulsionsPhenoperidine - 20-200x the potency of Pethidine. Less hypnotic and than morphine but more emetic (nausea). This can be cured by Haloperidol.Piminodine - similar dose to M, used in 60's and 70's but was banned. It was probably abused widely.<h2 class="c4"><a name="h.s6xst1ershvm"></a>PRODINES</h2>Allylprodine - Prodine analogue 23x potency of MProsidol - Russian Prodine analogue<h2 class="c4"><a name="h.q1f4qwlmedmx"></a>KETOBEMIDONES</h2>Acetoxyketobemidone - Unschedualed analogue of ketobemidoneBemidone - Analogue of Pethidine but significantly less potent, however it has NMDA antagonism like KetoB.Ketobemidone - μ opioid antagonist & NMDA antagonist. More addictive than M<h2 class="c4"><a name="h.proo2zrtju01"></a>OTHER</h2>Loperamide - Peripheral opioid so it cannot cross BBB. useful anti-Diarrhoea med. When used in conjuction with Quinine or Omerprazole can cross BBB and opioid effects are seen.Picenadol - R isomer (or Levopicenadol) is pure μ agonist while S is antagonist. Racemic is mixed that casues low abuse potential but has low κ activity<h2 class="c4"><a name="h.vbd7zdw8xe6"></a>OPEN CHAIN OPIOIDS AMIDONES</h2>4,4-Diphenyl-7-Pyrrolidin-1-ylheptan-3-one - Experimental analoge of Dipipanone and PhenadoxoneDipipanone - Lost Ark of the Covenant.Phenadoxone - methadone analogue, similar dose to M, lasts 1-4 hoursLevacetylmethadol - Methadone analogue with u agonism and noncompetitive a3b4 NACh antagonism. Brand name Orlaam, prescribed to those unresponsive to methadone or subutex. Long half life (3 days) and heavier affect.Norpipanone - Was not under international control until case reports of addiction arose.METHADOLSDimepheptanol - related to methadone, has two isomers which also have two isomers so 6 possible isomers including racemicMORAMIDESPalfium (Dextomoramide) - 3x potency of M but shorter acting. High BA & fast acting, oral feels like shooting. Low LD50 & inconsistent potency (one day you may need 5mg, next day 3mg)THIAMBUTENESThiambutenes - Dimethyl-TAB, Diethyl-TAB, Ethylmethyl-TAB. Used in vetinary medicine in Japan. Banned in virtually all countried due to high abuse potential. Anticholinergic and antihistamine properties!<h2 class="c4"><a name="h.1ev5bdlh8c7s"></a>PHENALKOXAMS</h2>Dextropropoxyphene - Low potency opiate not absorbed by CYP2D6. Also is a potent, noncompetitive α3β4 NACh antagonist and a weak SRI.Dimenoxadol - Benzillic Acid derivative related to methadone. Banned due to high abuse potential it seems.Dioxaphetyl butyrate - Banned opioid similar to methadone. Possibly in use or previously in use as a med under the names Amidalgon & Spasmoxal.<h2 class="c4"><a name="h.fn9aa9vja4h1"></a>AMPROMIDES</h2>Diampromide - Banned Analgesic related to Propiram. Similar potency to M.Propiram - Slightly more potent than codeine, 3-6hr duration. mixed μ ant.-ag. favouring agonism. affinity for κ & δ, sigma and nmda. 97% oral BA!Phenampromide<h2 class="c4"><a name="h.7xf0ejb1nuj6"></a>OTHERS</h2>IC-26 - Methadone analogue with similar potency but Unscheduled.Lefetamine - Weak opiate on the same scale as codeine but has DRI properties.R-4066 - methadone analogue with 212x the potency but a much shorter duration at 3 hours.<h2 class="c4"><a name="h.ezmn8g105ugs"></a>ANILIDOPIPERIDINES</h2>3-Methylfentanyl - 400-6000x potency of M depending on isomer (cis-iso more potent)Alfentanil - 1/4 the potency and 1/3 the duration of fent but 4x quicker onset. The businessman's lunch of opiates.Acetyl-Fentanyl - 6.66x the potency of morphine. Less euphoria.Butyl-Fentanyl - ^^Betahydroxythiofentanyl - one of the more favoured fent. analogues by addicts, implying euphoria.Carfentanil - 100x potency of fent., 10000x the potency of M. Used in spetznaz hostage crisis. 10,000x potency of M. Activity in humans starts at 1μg.Lofentanil - more potent and with a longer duration than carfentanil.Mirfentanil - fent. analogue with strong selevtivity over μ. Lower doses it antagonises effects caused by lesser opioids but at higher doses is resistant to antagonists, suggesting it has non-opioid mechanisms.Ohmefentanyl - 6300x morphine at it's most active isomer. Analogues of this are even stronger with one possessing 30,000x the potency of M.R-30490 - analogue of carfentanil. Most selective μ agonist of all fentanyl analoguesRemifentanil - Potent ultra short acting fent. analogue. Potency from between 20 and 100ug. Used in medicine as an anaesthetic under Ultiva.Sufentanil - 5-10x potency of fent.<h2 class="c4"><a name="h.e7n37rs50yzd"></a>ORIPAVINE DERIVATIVES</h2>7-PET - 300x potency of M, 3-OH derivative is 2200x potency of M. Unscheduled.Acetorphine - 8700x potency of MBU-48 - Etorphine derivative. Selective δ agonist and produces only convulsions with slight antidepression.Buprenorphin - SubutexCyprenorphine - Buprenorphine analogue, ant.-ag. effects but with higher affinity towards κ.Dihydroetorphine -1000-12000x potency of M depending on RoA. Less addictive than other opiates and is used in a similar fashion to Subutex in China.Etorphine - 1000-3000x potency of M. μ, κ & δ opioid agonist. weak affinity for ORL1 nociceptin/orphanin FQ receptor.<h2 class="c4"><a name="h.fmbzzzbxhbhw"></a>PIRINITRAMIDES</h2>Bezitramide - (Burgodin?)Piritramide - 0.65-0.75x M but still effect is strong and long lasting. Has a small but dedicated fanclub on the 'street'<h2 class="c4"><a name="h.ug6gnbqtad0y"></a>BENZIMIDAZOLES</h2>Etonitazene - Most potent nitazene at 1000-1500x potency of M. Strange structure, abstract from other opioids, with an indole body.xxxNitazene - Differing potencies depending on substitution on the lower 4-phenyl.<h2 class="c4"><a name="h.zibqc0da8j6g"></a>INDOLES</h2>18-Methoxycoronaridine - Ibogaine derivative, selective α3β4 nicotinic antagonist, however no affinity for α4β2, NMDA or seretonin. Retains modest affinity at μ & κ opioid.7-Hydroxymitragynine - Alkaloid in Kratom. Some 17x potency of M. 30x potency of Mitragynine.Conolidine - Alkaloid. Could provide analgesic effects.First isolated in the bark of Tabernaemontana divaricata (Crepe Jasmine) Shrub. Rather uninteresting.Eseroline - Metabolite of the ACh inhibitor physostigmine but potent μ agonistHodgkinsine - alkaloid found in Psychotria colorata plants. Has antiviral, antibacterial and antifungal properties. Also μ opioid agonist & NMDA antagonist.Ibogaine - Addiction CURE. HT2a agonist, κ opioid agonist, NMDA antagonistMitragynine - Alkaloid in Kratom. Fairly selective μ agonist but little affinity for δ & κ.Noribogaine - Metabolite of Ibogaine. Potent SRI, κ antagonist, weak μ full agonistPericine - Indole alkaloid found in the three Picralima Nitida, commonly known as Akuamma. Binds to MU. ~6x as potent then coeine. May have convulsant effects. Another rather uninteresting thing.Voacangine - precursor to Ibogine used by iboga plant. Displays similar effects towards addiction as Ibogaine.<h2 class="c4"><a name="h.2hs6eknq0s5c"></a>DIPHENYLMETHYLPIPERAZINES</h2>BW373U86 - Selective δ agonist at 15x stronger affinity. Analgesic and anti-depressant properties along with BDNF release. Produces convulsions at high doses and reverses respiratory depression produced by μ agonism. Also protects heart muscle cells from death during oxygen deprivation, a result of heart attacks.DPI-227 - highly selective δ agonist with antidepressant effects but produces fewer convulsions than most other dugs in it's family.DPI-3290 - Potent δ & μ agonist but produces little respiratory depression.<h2 class="c4"><a name="h.mw6zbh9aqgsr"></a>OPIOID PEPTIDES</h2>Biphalin - endogenous eptide with high affinity for δ & μ receptors. Potency almost 7x greater than Etorphine and 7000x M. Low side effects; no dependancy caused.Casomorphins - opiates found in Cow's milk.DAMGO - synthetic opiate peptide with high μ selectivity. When administered alongside M for 7 days, M had the same effect at the same dose as the first day. I.e. removes tolerance.Deltorphin - High affinity and selectivity, naturally occuring δ opioid agonist.Dermorphin - South American Tree frog skin. Natural opioid peptide. High potency (30-40x M) and selectivity to μ but may be less likely to cause tolerance and addiction.Dynorphins - endogenous opioid peptides, primarily k agonists. Useful in the analysis of addiction.Leu-enkephalin - Endogeneous opioid petide that acts as a δ & μ agonist with strong selectivity for δ.Met-enkephalin - Opioid Growth Factor (OGF), Endogenous opioid peptide. Primary ligand of the δ receptor along with Leu-enkephalin (high potency and selectivity at δ). Low BA & is metabolised rapidly.Opiorphin - Endogenous opioid isolated from human saliva.<h2 class="c4"><a name="h.n1ymizr893hr"></a>OTHERS</h2>3-HO-TCP - PCP analogue. More glutamergic than the PCP analogue.3-HO-BCP - substitutes for both cocaine and morphine at ~5mg (made-up)AD-1211 - Structure looks unrelated to /most/ other opioid drugs. Mixed Agonist-antagonist at opioid recepts similar to pentazocine. Little to no developement of tolerance/dependence in animal studies.AH-7921 - Selective μ agonist, with 80% potency of M. distributed as an RC, TRs show that it has very little euphoria, indicating euphoria comes from somewhere else. Perhaps sigma? Other opioids are heavily potentiated by it. Perhaps μ agonism is purely analgesic and high comes from a combination of μ & δ with each multiplying the affect of the other. This indicates ultimate opiate high would be moderately selective δ agonistAzaprocin - Azaprocin - ~10x potency of M. Faster onset and short duration of actin. Discoved in 1963, never been marketed. The derivative subbed on the phenyl ring with a p-nitro group would be more potent by roughly 2.5. (So 25x potency of M) The open ringed 2,6-dimethylpiperazine analouges would also be active.BRL-52537 - Highly potent and selective κ agonist. Neuroprotective.Bromadol (BDPC) - 500-10,000x potency of M. Similar to PCP analogues & -HO bonds within them.C-8813 (Thiobromadol) - 591x potency of M. μ agonist & δ antagonist to reduce repiratory depression. Making the drug safer.Ciramadol - Opioid related to PCP, Tramadol & Tapentadol. mixed ant.-ag. for μ, low abuse potential and ceiling on respiratory depression.Enadoline - Highly selective κ agonist. Produces visual distortions, dissociation and of course dysphoria similar to Salvia.Herkinorin - Analogue of Salvinorin A but the complete opposite. 100x higher μ affinity and 50x lower κ affinity. Also; "does not promote the recruitment of β-arrestin-2 to the intracellular domain of the μ-opioid receptor, or induce receptor internalization". This means Herkinorin may not produce tolerance or dependance.HZ-2 - κ-opioid agonist, same potency as morphine, long duration, high oral BAICI-199,441 - high potency, highly selective κ agonist with analgesic effectsMethopholine - Isoquinilone derivative with same efficacy as codeine. Could produces corneal opacity. Analogues are more potent with 4'-nitromethopholine at 20x codeine.MT-45 - 80% of M. mixed ant.-ag. and mild NMDA antagonistNortilidine - Equipotency of M. Opioid activity is in (1S,2R) iso, NMDA antagonism is in (1R,2S) iso. Also acts as a DRI.O-Desmethyltramadol - metabolite of Tramadol. Considerably more potent than Tramadol. Both (+) & (-) isomers lose SRI function but (-) retains NRI functionality. RC.Salvinorin A - Highly potent κ agonist and even more potent D2 partial agonist. Use in therapy for addiction.Salvinorin B ethoxymethyl ether - semi-synthetic analogue of Salv. A. Longer duration @ ~3hrs, active at 50ug & 3000x (!) selectivity over μ & δSalvinorin B methoxymethyl ether - Similar to ^^ but less selective. 5x potency as Salvinorin A. Deacetylised from Salvinorin A.SC-17599 - selective μ agonist with little or no affinity for δ & κ. Potency in between pethidine & morphine.RWJ-394674 - potent and selective δ agonist, however once inside body it is dealkylated to its monodesethyl metabolite RWJ-413216 which is a potent μ agonist with less affinity for δ. δ activity counteracts the respiratory depression the μ causes. Only prominent side effect is sedation (and euphoria!)TAN-67 - potent and selective δ1 agonist. Has analgesic properties & releases dopamine in the brain. Neuro & cardiac protective properties.Tapentadol - μ & σ agonist & SNRI. Potency in between M & Tram.Tifluadom - Benzo derivative but without GABAa agonism. Instead selective κ agonism.U-50488 - highly selective κ agonist with analgesic effectsU-69,593 - Potent and selective κ1 agonist. Produces; antinociception, anti-inflammation, anxiolysis (low doses), respiratory depression & diuresis. Also inhibits periphery oxytocin secretion. Not sure if hallucinogenic.W-15 - 5.4x Morphine. RC.W-18 - 10,000x potency of M, structure abstract from any other drug. These super potent opioids are used in vetenarian practice for tranquilising elephants.<h2 class="c4"><a name="h.9fm8fumapvkz"></a>OPIOID ANTAGONISTS AND INVERSE AGONISTS</h2>(selective δ antagonists may reduce physical addiction without causing w/d if attatched to an opioid)Chlornaltrexamine - Irreversible mixed ant.-ag. at μ opioid. 22x more potent than MCyprodime - Selective μ opioid antagonist with no affinity for κ or δ receptorsDiprenorphine - Strongest opiate antagonist available. 100x potency of Nalorphine. Used to reverse effects of super-potent opioids.Levallorphan - μ opioid antagonist, when used with opiate, it potentiates it and removes addiction potential or induces withdrawal in addicts.Nalbuphine - mixed ant.-ag. as is common with this class, there occurs analgesia with no addictive properties.Naloxazone - Irreversible μ opioid receptor antagonistNaloxonazine - Very Potent Irreversible μ opioid antagonist. dimerizes from Naloxazone under acidic conditionsNaltrexone - Competitive antagonist at μ & κ receptors, and to a lesser extent, δ. Modulation of the dopaminergic mesolimbic pathway makes it good for countering alcohol dependance as well as Opiate addiction. Blocks the euphoric effects of opioids and is used in rapid detoxification and attenuation of withdrawal. If opiates are used simultaneously, oD may occur.Samidorphan - selective μ antagonist. potential for addiction treatment.<h2 class="c4"><a name="h.umaotbij0l73"></a>UNCATEGORISED OPIOIDS</h2>FE 200665 - Is an all D-Amino acid peptide that acts as a restucted K-opioid receptor agnoist. Was dosed at 0.36mg/kg IV. Was compared to 15mg oxycodone. Slightly less than the potency of hydrocodone. Caused Hyperalgesic response in a skin pinch test. Also known as CR665.SoRI-9409 - mixed μ agonist & δ antagonist. moderate analgesia without development of tolerance. Anti-addictive effects for all dopaminergic drugs.Synthetic Conotoxin - Snail toxin derived painkiller 1000x potency of morphine. Non-addictive<h2 class="c4"><a name="h.d6s1h4pfd9bm"></a>RELATED COMPOUNDS</h2>Amiphenazole - treatment for OD. counteracts respiratory depression. If Morphine-N-oxide is taken on this, M's potency will increase.Chitosan - linear polysaccharide that can give Morphine up to 60% BA intranasally. Powdered & the ratio is 1.3g : 6.7g (morpine : chitosan)BIMU-8 - NOOTROPICNMDA antagonists - Inhibit development of tolerance to morphineTezampanel - ANXIOLYTICIbudilast - NOOTROPICNuciferineTetrahydropalmatine - ANXIOLYTICLofexidine - ANXIOLYTICd & l Phenylalanine (DLPA) - Increases dopamine and endorphin levels, reducing opiate tolerance and even providing an analgesic effect of it's own.<h2 class="c4"><a name="h.2odbztqfyv"></a>CCK ANTAGONISTS</h2>Proglumide - Acts as a d opioid agonist and non selective CCK antagonist. Enhances analgesia produced by opioids and can prevent or even reverse the development of toleranceDevazepide - No affinity for GABAa, selective CCKa antagonist.Lorglumide - Selective CCKa antagonist for treatment of gastrointestinal problems and some forms of cancer as well as Opioid interacting properties.<h2 class="c4"><a name="h.gyzuflofunhv"></a>NOCICEPTINERGIC DRUGS</h2>(ORL-1 ant. & ag.'s)J-113,397 - Highly selective ORL-1 antagonist. Prevents development of opiate tolerance, stimulates dopamine release, cognitive enhancerSB-612,111 - Selective ORL-1 antagonist but several times the potency of ^^MCOPPB - Potent, selective ORL-1 agonist with only moderate affinity for μ, even less for δ & κ. Anxiolytic with no inhibition of memory, motor function or sedationNNC 63-0532 - Potent, selective ORL-1 agonist.Ro64-6198 - Potent, selective ORL-1 agonist with 100x selectivity over others. In rats produced anxiolytic but no anticonvulsant effects. Impairs Short term memory & increases appetite. Reduces analgesic effects of M but no preventing tolerance. In primates it showed analgesic behaviour without respiratory depression.Menabitan - potent cannabinoid receptor agonist with anti-nociceptive effects<h2 class="c4"><a name="h.y6ktw3o6ih7q"></a>ENKEPHALIN PROTEASE INHIBITORS</h2>RB-101*** - Inhibits enzymes responsible for breaking down enkephalin (regulates nociceptin). Weak μ & δ affinity and slight σ1. Potentiates opiates, stops withdrawal symptoms, no addiction potential, produces no respiratory depression. Also exerts very potent antidepressant and anxiolytic effects. Not orally active so analogues vv were developed.RB-120 - Orally active version of ^^. This is best atm.RB-3007 - Another Enkeph. PI & Nociceptin antagonist</body></html>

Quick Guide to Common Opiates

2015-12-05T11:27:09Z

GrimReaper: Blanked the page

Tripsit:Substance template

2015-12-05T11:25:15Z

GrimReaper: Undo revision 4732 by GrimReaper (talk)

[[File:Example.jpg|thumb|250px|right]]
General info here

== History ==
Some history here

== Usage ==
Ritual use, different types of administration and how to do it, etc.
== Dosage ==

General note/warning about dosage

{| class="wikitable"
|+ Oral
|-
| Threshold || x mg
|-
| Light || x mg
|-
| Common || x mg
|-
| Strong || x mg
|}

== Duration ==

{| class="wikitable"
|+ Oral
|-
| Onset || x minutes
|-
| Total || x hours
|-
| After-effects || x hours (dose-dependent)
|}

== Effects ==

=== Postive ===

* effect

=== Neutral ===

*effect

=== Negative ===

*effect

== Images ==
<gallery>
File:Example.jpg| ''Example image 1''
File:Example.jpg| ''Example image with link: [[TripSit Rules]]''
</gallery>

== Harm Reduction ==
General info and things to avoid.

*warning 1

*warning 2

=== WARNING ===
Warning text

=== Potentiators ===

*substance 1

*substance 2
=== Interactions ===
Check out our [[Drug Combinations]] page and chart for interactions and combinations of common drugs.

== Chemistry and Pharmacology ==

=== LD50 ===

== Legal status==
* USA:
* UK:

== Links ==

=== Further Reading ===

=== Off-Site Resources ===

Tripsit:Substance template

2015-12-05T11:17:23Z

GrimReaper: Blanked the page

Quick Guide to Common Opiates

2015-12-05T11:16:49Z

GrimReaper:

N-(2-(2-furyl)ethyl) analogue - 60x Levorphanol
└--> N-(2-(2-thienyl)ethyl) analogue - 45x Levorphanol
Proxorphan - partial κ agonist, lesser partial μ agonist
Ro4-1539 (Furethylnorlevorphanol) - 30-60x the potency of M. One of the more potent u agonists from the Morphans.
(Race)Methorphan: L(eft) (+) Levomethorphan >< Dextromethorphan (-) D(exter) --> l=OPIATE >< d=HALLUCINOGENIC OPIATE

└--> Racemic mix of both isomers, embodying their properties.
Morphinan (Racemorphan): l (+) Levorphanol >< Dextrorphan (-) d --> l=OPIATE >< d=HALLUCINOGENIC OPIATE
└--> Racemic mix of both isomers, embodying their properties.
(Race)Allorphan: l (+) Levallorphan >< Dextrallorphan (-) d --> l= ANTI-OPIOID >< d=NMDA ANTAGONISTS
└--> Racemic mix of both isomers, embodying their properties.
3-Hydroxymorphinan: l (+) Norlevorphanol >< Nordextrorphan (-) d --> l=OPIATE >< d=NOOTROPIC
└--> Racemic mix of both isomers, embodying their properties.
Oxilorphan: μ antagonist & weak partial κ agonist
Dimemorfan - SIGMAERGIC DRUG
Xorphanol - mixed ant.-ag. produces convulsions at highest dose tested.
Cyprodime - Selective μ opioid antagonist with no affinity for κ or δ receptors
Samidorphan - selective μ antagonist. potential for addiction treatment.

BENZOMORPHANS
Butinazocine - benzomorphan opioid that was never marketed-----------------\ The Benzomorphans have
Carbazocine - benzomorphan opioid that was never marketed \ to be my favourite structures.
Etazocine - partial opioid agonist with mixed ant.-ag. effects. low potency \_ The Cubist narcotics.
Ethylketocyclozocine - partial opioid agonist with mixed ant.-ag. effects The Picassopiates.
Ibazocine - benzomorphan opioid that was never marketed They serve no real function
Moxazocine - 10x potency of M, partial/mixed ant.-ag. _ except to look pretty to
Tonazocine - partial agonist at μ & δ, no adverse effects on breathing / afficionados such as I.
Volazocine - benzomorphan opioid that was never marketed / As do I to afficionados such
Fluorophen - radioligand, full μ agonist (6x M) & lower affinity for δ / as they, and they to afficonados
Zenazocine - partial agonist at μ & δ-------------------------------------/ such as we, and we are such afficionados.
Eptazocine - Japanese κ agonist & μ antagonist
Pentazocine - mixed ant.-ag. (-) is the κ agonist side, the (+) displays 10x the affinity for sigma receptors. NO μ agonism
Phenazocine - related to ^ but stronger analgesic, 4x potency of M
Cyclazocine - mixed ant.-ag.
Dezocine - Mixed ant.-ag. with high κ antagonism. Low dose=euphoria (μ) High dose=dysphoria (κ). Wierd structure
8-Carboxamidocyclazocine (8-CAC) - κ & μ agonist, long duration.
Bremazocine - κ agonist related to Pentazocine
Metazocine - analgesic; mixed ant.-ag. at μ, activity also at κ and sigma
Alazocine - σ1 agonist, κ opioid agonist & slight NMDA antagonist

4-PHENYLPIPERIDINES MEPERIDINES
4-Fluoropethidine - In comparison to pethidine, it is 50% less potent as an analgesic but 50% more potent as a DRI. (4-iodo & 3, 4-dichloro only increase these differences)
Anileridine - Another banned pethidine analogue, probably abused. Higher analgesia than Meperidine due to n-aminophenyl group and acts withing 15 mins orally, lasting 2-3 hours.
Benzethidine - 4-phenylpiperidine analogue of pethidine. Probably somewhat more potent and euphoric. Never scripted.
Carperidine - fairly normal opiate but unused in medicine and currently LEGAL (08/06/2013)
Furethidine - 4-Phenylpiperidine analogue of pethidine. Probably a lot more potent and abuse prone. Never prescribed.
Morpheridine - related to meperidine but 4x the potency and does not cause convulsions
Phenoperidine - 20-200x the potency of Pethidine. Less hypnotic and than morphine but more emetic (nausea). This can be cured by Haloperidol.
Piminodine - similar dose to M, used in 60's and 70's but was banned. It was probably abused widely.
PRODINES
Allylprodine - Prodine analogue 23x potency of M
Prosidol - Russian Prodine analogue
KETOBEMIDONES
Acetoxyketobemidone - Unschedualed analogue of ketobemidone
Bemidone - Analogue of Pethidine but significantly less potent, however it has NMDA antagonism like KetoB.
Ketobemidone - μ opioid antagonist & NMDA antagonist. More addictive than M
OTHER
Loperamide - Peripheral opioid so it cannot cross BBB. useful anti-Diarrhoea med. When used in conjuction with Quinine or Omerprazole can cross BBB and opioid effects are seen.
Picenadol - R isomer (or Levopicenadol) is pure μ agonist while S is antagonist. Racemic is mixed that casues low abuse potential but has low κ activity

OPEN CHAIN OPIOIDS AMIDONES
4,4-Diphenyl-7-Pyrrolidin-1-ylheptan-3-one - Experimental analoge of Dipipanone and Phenadoxone
Dipipanone - Lost Ark of the Covenant.
Phenadoxone - methadone analogue, similar dose to M, lasts 1-4 hours
Levacetylmethadol - Methadone analogue with u agonism and noncompetitive a3b4 NACh antagonism. Brand name Orlaam, prescribed to those unresponsive to methadone or subutex. Long half life (3 days) and heavier affect.
Norpipanone - Was not under international control until case reports of addiction arose.
METHADOLS

Dimepheptanol - related to methadone, has two isomers which also have two isomers so 6 possible isomers including racemic
MORAMIDES

Palfium (Dextomoramide) - 3x potency of M but shorter acting. High BA & fast acting, oral feels like shooting. Low LD50 & inconsistent potency (one day you may need 5mg, next day 3mg)
THIAMBUTENES

Thiambutenes - Dimethyl-TAB, Diethyl-TAB, Ethylmethyl-TAB. Used in vetinary medicine in Japan. Banned in virtually all countried due to high abuse potential. Anticholinergic and antihistamine properties!
PHENALKOXAMS
Dextropropoxyphene - Low potency opiate not absorbed by CYP2D6. Also is a potent, noncompetitive α3β4 NACh antagonist and a weak SRI.
Dimenoxadol - Benzillic Acid derivative related to methadone. Banned due to high abuse potential it seems.
Dioxaphetyl butyrate - Banned opioid similar to methadone. Possibly in use or previously in use as a med under the names Amidalgon & Spasmoxal.
AMPROMIDES
Diampromide - Banned Analgesic related to Propiram. Similar potency to M.
Propiram - Slightly more potent than codeine, 3-6hr duration. mixed μ ant.-ag. favouring agonism. affinity for κ & δ, sigma and nmda. 97% oral BA!
Phenampromide
OTHERS
IC-26 - Methadone analogue with similar potency but Unscheduled.
Lefetamine - Weak opiate on the same scale as codeine but has DRI properties.
R-4066 - methadone analogue with 212x the potency but a much shorter duration at 3 hours.

ANILIDOPIPERIDINES
3-Methylfentanyl - 400-6000x potency of M depending on isomer (cis-iso more potent)
Alfentanil - 1/4 the potency and 1/3 the duration of fent but 4x quicker onset. The businessman's lunch of opiates.
Acetyl-Fentanyl - 6.66x the potency of morphine. Less euphoria.
Butyl-Fentanyl - ^^
Betahydroxythiofentanyl - one of the more favoured fent. analogues by addicts, implying euphoria.
Carfentanil - 100x potency of fent., 10000x the potency of M. Used in spetznaz hostage crisis. 10,000x potency of M. Activity in humans starts at 1μg.
Lofentanil - more potent and with a longer duration than carfentanil.
Mirfentanil - fent. analogue with strong selevtivity over μ. Lower doses it antagonises effects caused by lesser opioids but at higher doses is resistant to antagonists, suggesting it has non-opioid mechanisms.
Ohmefentanyl - 6300x morphine at it's most active isomer. Analogues of this are even stronger with one possessing 30,000x the potency of M.
R-30490 - analogue of carfentanil. Most selective μ agonist of all fentanyl analogues
Remifentanil - Potent ultra short acting fent. analogue. Potency from between 20 and 100ug. Used in medicine as an anaesthetic under Ultiva.
Sufentanil - 5-10x potency of fent.
ORIPAVINE DERIVATIVES
7-PET - 300x potency of M, 3-OH derivative is 2200x potency of M. Unscheduled.
Acetorphine - 8700x potency of M
BU-48 - Etorphine derivative. Selective δ agonist and produces only convulsions with slight antidepression.
Buprenorphin - Subutex
Cyprenorphine - Buprenorphine analogue, ant.-ag. effects but with higher affinity towards κ.
Dihydroetorphine -1000-12000x potency of M depending on RoA. Less addictive than other opiates and is used in a similar fashion to Subutex in China.
Etorphine - 1000-3000x potency of M. μ, κ & δ opioid agonist. weak affinity for ORL1 nociceptin/orphanin FQ receptor.

PIRINITRAMIDES
Bezitramide - (Burgodin?)
Piritramide - 0.65-0.75x M but still effect is strong and long lasting. Has a small but dedicated fanclub on the 'street'

BENZIMIDAZOLES
Etonitazene - Most potent nitazene at 1000-1500x potency of M. Strange structure, abstract from other opioids, with an indole body.
xxxNitazene - Differing potencies depending on substitution on the lower 4-phenyl.

INDOLES
18-Methoxycoronaridine - Ibogaine derivative, selective α3β4 nicotinic antagonist, however no affinity for α4β2, NMDA or seretonin. Retains modest affinity at μ & κ opioid.
7-Hydroxymitragynine - Alkaloid in Kratom. Some 17x potency of M. 30x potency of Mitragynine.
Conolidine - Alkaloid. Could provide analgesic effects.First isolated in the bark of Tabernaemontana divaricata (Crepe Jasmine) Shrub. Rather uninteresting.
Eseroline - Metabolite of the ACh inhibitor physostigmine but potent μ agonist
Hodgkinsine - alkaloid found in Psychotria colorata plants. Has antiviral, antibacterial and antifungal properties. Also μ opioid agonist & NMDA antagonist.
Ibogaine - Addiction CURE. HT2a agonist, κ opioid agonist, NMDA antagonist
Mitragynine - Alkaloid in Kratom. Fairly selective μ agonist but little affinity for δ & κ.
Noribogaine - Metabolite of Ibogaine. Potent SRI, κ antagonist, weak μ full agonist
Pericine - Indole alkaloid found in the three Picralima Nitida, commonly known as Akuamma. Binds to MU. ~6x as potent then coeine. May have convulsant effects. Another rather uninteresting thing.
Voacangine - precursor to Ibogine used by iboga plant. Displays similar effects towards addiction as Ibogaine.
DIPHENYLMETHYLPIPERAZINES
BW373U86 - Selective δ agonist at 15x stronger affinity. Analgesic and anti-depressant properties along with BDNF release. Produces convulsions at high doses and reverses respiratory depression produced by μ agonism. Also protects heart muscle cells from death during oxygen deprivation, a result of heart attacks.
DPI-227 - highly selective δ agonist with antidepressant effects but produces fewer convulsions than most other dugs in it's family.
DPI-3290 - Potent δ & μ agonist but produces little respiratory depression.

OPIOID PEPTIDES
Biphalin - endogenous eptide with high affinity for δ & μ receptors. Potency almost 7x greater than Etorphine and 7000x M. Low side effects; no dependancy caused.
Casomorphins - opiates found in Cow's milk.
DAMGO - synthetic opiate peptide with high μ selectivity. When administered alongside M for 7 days, M had the same effect at the same dose as the first day. I.e. removes tolerance.
Deltorphin - High affinity and selectivity, naturally occuring δ opioid agonist.
Dermorphin - South American Tree frog skin. Natural opioid peptide. High potency (30-40x M) and selectivity to μ but may be less likely to cause tolerance and addiction.
Dynorphins - endogenous opioid peptides, primarily k agonists. Useful in the analysis of addiction.
Leu-enkephalin - Endogeneous opioid petide that acts as a δ & μ agonist with strong selectivity for δ.
Met-enkephalin - Opioid Growth Factor (OGF), Endogenous opioid peptide. Primary ligand of the δ receptor along with Leu-enkephalin (high potency and selectivity at δ). Low BA & is metabolised rapidly.
Opiorphin - Endogenous opioid isolated from human saliva.

OTHERS
3-HO-TCP - PCP analogue. More glutamergic than the PCP analogue.
3-HO-BCP - substitutes for both cocaine and morphine at ~5mg (made-up)
AD-1211 - Structure looks unrelated to /most/ other opioid drugs. Mixed Agonist-antagonist at opioid recepts similar to pentazocine. Little to no developement of tolerance/dependence in animal studies.
AH-7921 - Selective μ agonist, with 80% potency of M. distributed as an RC, TRs show that it has very little euphoria, indicating euphoria comes from somewhere else. Perhaps sigma? Other opioids are heavily potentiated by it. Perhaps μ agonism is purely analgesic and high comes from a combination of μ & δ with each multiplying the affect of the other. This indicates ultimate opiate high would be moderately selective δ agonist
Azaprocin - Azaprocin - ~10x potency of M. Faster onset and short duration of actin. Discoved in 1963, never been marketed. The derivative subbed on the phenyl ring with a p-nitro group would be more potent by roughly 2.5. (So 25x potency of M) The open ringed 2,6-dimethylpiperazine analouges would also be active.
BRL-52537 - Highly potent and selective κ agonist. Neuroprotective.
Bromadol (BDPC) - 500-10,000x potency of M. Similar to PCP analogues & -HO bonds within them.
C-8813 (Thiobromadol) - 591x potency of M. μ agonist & δ antagonist to reduce repiratory depression. Making the drug safer.
Ciramadol - Opioid related to PCP, Tramadol & Tapentadol. mixed ant.-ag. for μ, low abuse potential and ceiling on respiratory depression.
Enadoline - Highly selective κ agonist. Produces visual distortions, dissociation and of course dysphoria similar to Salvia.
Herkinorin - Analogue of Salvinorin A but the complete opposite. 100x higher μ affinity and 50x lower κ affinity. Also; "does not promote the recruitment of β-arrestin-2 to the intracellular domain of the μ-opioid receptor, or induce receptor internalization". This means Herkinorin may not produce tolerance or dependance.
HZ-2 - κ-opioid agonist, same potency as morphine, long duration, high oral BA
ICI-199,441 - high potency, highly selective κ agonist with analgesic effects
Methopholine - Isoquinilone derivative with same efficacy as codeine. Could produces corneal opacity. Analogues are more potent with 4'-nitromethopholine at 20x codeine.
MT-45 - 80% of M. mixed ant.-ag. and mild NMDA antagonist
Nortilidine - Equipotency of M. Opioid activity is in (1S,2R) iso, NMDA antagonism is in (1R,2S) iso. Also acts as a DRI.
O-Desmethyltramadol - metabolite of Tramadol. Considerably more potent than Tramadol. Both (+) & (-) isomers lose SRI function but (-) retains NRI functionality. RC.
Salvinorin A - Highly potent κ agonist and even more potent D2 partial agonist. Use in therapy for addiction.
Salvinorin B ethoxymethyl ether - semi-synthetic analogue of Salv. A. Longer duration @ ~3hrs, active at 50ug & 3000x (!) selectivity over μ & δ
Salvinorin B methoxymethyl ether - Similar to ^^ but less selective. 5x potency as Salvinorin A. Deacetylised from Salvinorin A.
SC-17599 - selective μ agonist with little or no affinity for δ & κ. Potency in between pethidine & morphine.
RWJ-394674 - potent and selective δ agonist, however once inside body it is dealkylated to its monodesethyl metabolite RWJ-413216 which is a potent μ agonist with less affinity for δ. δ activity counteracts the respiratory depression the μ causes. Only prominent side effect is sedation (and euphoria!)
TAN-67 - potent and selective δ1 agonist. Has analgesic properties & releases dopamine in the brain. Neuro & cardiac protective properties.
Tapentadol - μ & σ agonist & SNRI. Potency in between M & Tram.
Tifluadom - Benzo derivative but without GABAa agonism. Instead selective κ agonism.
U-50488 - highly selective κ agonist with analgesic effects
U-69,593 - Potent and selective κ1 agonist. Produces; antinociception, anti-inflammation, anxiolysis (low doses), respiratory depression & diuresis. Also inhibits periphery oxytocin secretion. Not sure if hallucinogenic.
W-15 - 5.4x Morphine. RC.
W-18 - 10,000x potency of M, structure abstract from any other drug. These super potent opioids are used in vetenarian practice for tranquilising elephants.
OPIOID ANTAGONISTS AND INVERSE AGONISTS
(selective δ antagonists may reduce physical addiction without causing w/d if attatched to an opioid)

Chlornaltrexamine - Irreversible mixed ant.-ag. at μ opioid. 22x more potent than M
Cyprodime - Selective μ opioid antagonist with no affinity for κ or δ receptors
Diprenorphine - Strongest opiate antagonist available. 100x potency of Nalorphine. Used to reverse effects of super-potent opioids.
Levallorphan - μ opioid antagonist, when used with opiate, it potentiates it and removes addiction potential or induces withdrawal in addicts.
Nalbuphine - mixed ant.-ag. as is common with this class, there occurs analgesia with no addictive properties.
Naloxazone - Irreversible μ opioid receptor antagonist
Naloxonazine - Very Potent Irreversible μ opioid antagonist. dimerizes from Naloxazone under acidic conditions
Naltrexone - Competitive antagonist at μ & κ receptors, and to a lesser extent, δ. Modulation of the dopaminergic mesolimbic pathway makes it good for countering alcohol dependance as well as Opiate addiction. Blocks the euphoric effects of opioids and is used in rapid detoxification and attenuation of withdrawal. If opiates are used simultaneously, oD may occur.
Samidorphan - selective μ antagonist. potential for addiction treatment.

UNCATEGORISED OPIOIDS
FE 200665 - Is an all D-Amino acid peptide that acts as a restucted K-opioid receptor agnoist. Was dosed at 0.36mg/kg IV. Was compared to 15mg oxycodone. Slightly less than the potency of hydrocodone. Caused Hyperalgesic response in a skin pinch test. Also known as CR665.
SoRI-9409 - mixed μ agonist & δ antagonist. moderate analgesia without development of tolerance. Anti-addictive effects for all dopaminergic drugs.
Synthetic Conotoxin - Snail toxin derived painkiller 1000x potency of morphine. Non-addictive
RELATED COMPOUNDS
Amiphenazole - treatment for OD. counteracts respiratory depression. If Morphine-N-oxide is taken on this, M's potency will increase.
Chitosan - linear polysaccharide that can give Morphine up to 60% BA intranasally. Powdered & the ratio is 1.3g : 6.7g (morpine : chitosan)
BIMU-8 - NOOTROPIC
NMDA antagonists - Inhibit development of tolerance to morphine
Tezampanel - ANXIOLYTIC
Ibudilast - NOOTROPIC
Nuciferine
Tetrahydropalmatine - ANXIOLYTIC
Lofexidine - ANXIOLYTIC
d & l Phenylalanine (DLPA) - Increases dopamine and endorphin levels, reducing opiate tolerance and even providing an analgesic effect of it's own.

CCK ANTAGONISTS
Proglumide - Acts as a d opioid agonist and non selective CCK antagonist. Enhances analgesia produced by opioids and can prevent or even reverse the development of tolerance
Devazepide - No affinity for GABAa, selective CCKa antagonist.
Lorglumide - Selective CCKa antagonist for treatment of gastrointestinal problems and some forms of cancer as well as Opioid interacting properties.

NOCICEPTINERGIC DRUGS
(ORL-1 ant. & ag.'s)

J-113,397 - Highly selective ORL-1 antagonist. Prevents development of opiate tolerance, stimulates dopamine release, cognitive enhancer
SB-612,111 - Selective ORL-1 antagonist but several times the potency of ^^
MCOPPB - Potent, selective ORL-1 agonist with only moderate affinity for μ, even less for δ & κ. Anxiolytic with no inhibition of memory, motor function or sedation
NNC 63-0532 - Potent, selective ORL-1 agonist.
Ro64-6198 - Potent, selective ORL-1 agonist with 100x selectivity over others. In rats produced anxiolytic but no anticonvulsant effects. Impairs Short term memory & increases appetite. Reduces analgesic effects of M but no preventing tolerance. In primates it showed analgesic behaviour without respiratory depression.
Menabitan - potent cannabinoid receptor agonist with anti-nociceptive effects
ENKEPHALIN PROTEASE INHIBITORS
RB-101*** - Inhibits enzymes responsible for breaking down enkephalin (regulates nociceptin). Weak μ & δ affinity and slight σ1. Potentiates opiates, stops withdrawal symptoms, no addiction potential, produces no respiratory depression. Also exerts very potent antidepressant and anxiolytic effects. Not orally active so analogues vv were developed.
RB-120 - Orally active version of ^^. This is best atm.
RB-3007 - Another Enkeph. PI & Nociceptin antagonist
-->

Overdose

2015-10-20T23:37:05Z

GrimReaper:

== General Information ==

'''If you think you or a friend is overdosing, seek immediate medical attention. When in doubt, it is better to contact emergency services than to be responsible for bodily harm or death.'''

Furthermore, it is important not to misrepresent your situation to paramedics. Tell the paramedics and emergency personnel the truth about what you have ingested. A majority of overdose situations are caused by unsafe drug combinations; when considering a drug combination, check for any [Drug Combinations], avoid dangerous combinations and start with a lower dose of each drug.

=== The difference between a panic attack and a seizure ===

When a person has taken mind altering substances, especially with a history of anxiety, they may become hysterical and believe they are having a seizure. It can be difficult to diagnose a seizure for physicians because often it is over before the patient can be seen. Panic attacks however can present similarly to seizures and confirmation must be done through an EEG to confirm if there was in fact a seizure.

Seizures can commonly be caused by alcohol withdrawal, Benzodiazepine withdrawal, cocaine usage, MDMA usage, or even infection secondary to improper/unsanitary drug usage such as using old used needles.
* Sometimes partial seizures present themselves as panic attacks
* Some seizures are caused by conditions such as low blood sugar (hypoglycaemia) or a temporary change to the way the heart is working.
What seizures depending on their origin and type commanly can be sudden, short, and cause a change in the person’s awareness of where they are, what they are doing, what they are thinking or what they are feeling and even cause memory loss. It is also possible for stroke symptoms to present after a seizure in what is called the "post ictal" phase.

A concern when dealing with seizures is status epilepticus. Status epilepticus (SE) is an epileptic seizure of greater than five minutes or more than one seizure within a five-minute period without the person returning to normal between them

Benzodiazepines are indicated as treatment for seizures as they raise the seizure threshold; Contact Emergency medical services

=== The difference between a panic attack and a heart attack ===
*Panic attacks are again usually triggered by something
*Panic attacks and heart attacks can feel frighteningly similar: shortness of breath, palpitations, chest pain, dizziness, vertigo, feelings of unreality, numbness of hands and feet, sweating, fainting, and trembling.
Physical symptoms of a panic attack are triggered by an offset in breathing (usually hyperventilation). Your heart isn’t being strained; it’s being thrown into a natural fight or flight response. Also, your heart isn’t what’s causing the panic attack – your mind is. During a panic attack, chest pain is localized over the heart and described as "sharp, and comes and goes. The pain usually intensifies with breathing in and out, and pressing on the center of the chest. Panic attack may cause nausea, but vomiting is very rare. If tingling is present, the entire body tingles. Hyperventilation almost always precedes panic attack symptoms. If the location of the pain moves to the center of the chest, doesn't go away within 10 minutes, is accompanied by more than one incident of vomiting or diarrhea, or goes away and returns a few minutes later, you should immediately get medical attention.

Heart attacks, also known as Acute Myocardial Infarctions or AMI's are extremely deadly and anyone suspecting an AMI should err on the side of caution.

A heart attack can be caused my multitudes of things and the chance of something being a heart attack versus a panic attack can possibly be narrowed down through medical history current drug use and risk factors but the two can be hard to distinguish at times.

==== Classic signs of a heart attack include ====
* Sweating perfusely
* Chest pain (squeezing tight pain is typical, usually severe as well, but not all heart attacks present the same way)
* Cold skin
* Pale skin
* heart rate below 60 or above 100 beats per minute
* Difficulty breathing
* Pain radiating to the left shoulder or left arm (due to the heart being on the left side of the body)
* Pain radiating to the jaw or neck or chin
* Rapid breathing, possibly shallow as well
* Altered mental status
* Pain lasting longer than 20 minutes not relieved by rest!

If you suspect you are having a heart attack do not hesitate to contact emergency services

=== How To Check Your Heartrate and Pulse ===

http://onlineheartrate.com/
A normal resting heart rate for adults ranges from 60 to 100 beats a minute.

==== Tips to lower heartrate ====
The carotid artery runs down your throat next to the vagal nerve. Give the artery a gentle massage with your fingertips to help stimulate the neighboring nerve into slowing your heart rate down. This triggers the vagal nerve which is responsible for controlling your heart rate. To do the valsalva maneuver, after taking a deep breath, strain the muscles in your abdomen the same way you would to give a bowel movement. Hold the pressure for five seconds, and then let go. You may have to do this multiple times to get the desired effect.

== Serotonin Syndrome ==

Serotonin syndrome is a potentially life threatening drug reaction that causes the body to have too much serotonin, a chemical produced by nerve cells. Serotonin syndrome can happen as the result of taking many different drugs and taking different types of drugs together, including psychedelics, anti-depressants, CNS stimulants, opiods, 5-HT1 antagonists. some herbs, and others.

Symptom onset is usually rapid, often occurring within minutes. Serotonin syndrome encompasses a wide range of clinical findings. Mild symptoms may only consist of increased heart rate, shivering, sweating, dilated pupils,myoclonus (intermittent tremor or twitching), as well as overresponsive reflexes. Moderate intoxication includes additional abnormalities such as hyperactive bowel sounds, high blood pressure and hyperthermia; a temperature as high as 40 °C (104 °F) is common in moderate intoxication.

The combination of MAOIs, alcohol or other serotonin agonists or precursors pose a particularly severe risk of a life-threatening serotonin syndrome.

Treatment consists of discontinuing medications which may contribute and in moderate to severe cases administering a serotonin antagonist. An important adjunct treatment includes controlling agitation with benzodiazepine sedation.

If you think you have serotonin syndrome, it is best to seek medical advice.

== Opioid overdose ==

Naloxone is an opioid antagonist drug developed by Sankyo in the 1960s. Naloxone is a drug used to counter the effects of opioid overdose, for example heroin or morphine overdose. Naloxone is specifically used to counteract life-threatening depression of the central nervous system and respiratory system. Always have naloxone on you if you plan on taking opiates; many ambulances and hospitals also carry the drug.

== Stimulant overdose ==

In case of amphetamine psychosis

Antipsychotics such as Risperidone; or Haldol (Haloperidol lactate)

[[Benzodiazepines]] such as Lorazepam, Diazepam (EMS uses often), Midazolam

Benzodiazepines also raise the seizure threshold and are the drug class of choice in stimulant, primarily cocaine, overdose including if there is a cocaine or stimulant induced seizure

As mentioned above seizures may also occur due to stimulant usage, primarily with cocaine or MDMA

The use of cocaine is associated with the occurrence of seizures frequently, up to 40% in some case studies

Amphetamines and related drugs rarely induce epileptic seizures at therapeutic doses, but seizures may occur after the first dosing.

Caffeine at high doses may induce epileptic seizures because of its adenosine receptor-antagonizing properties.

Marijuana, at variance with other psychostimulants, owing to its serotonin-mediated anticonvulsant action, could have a medical use for the treatment of epilepsy.

Psychedelic compounds rarely induce epileptic seizures, but the most common clinical CNS complication after ingestion of ecstasy is the occurrence of. seizures

Possible hospitalisation

Seroquel (2x 50mg, 200mg max) If seroquel were to be used for a stimulant overdose it should be noted that benzodiazepine treatment of acute stimulant overdose will be amplified by seroquel. This drug interaction may cause CNS depression.

== Depressant Overdose ==

Depressants slow the central nervous system, and depress breathing and heart rate. In the case of an overdose caused by excess consumption or combination of depressants, effects can range from unrousable consciousness to possible coma or death.

Symptoms:

*Shallow breathing
*Unresponsive, unrousable unconsciousness
*Low body temperature
*Blue tinged skin, particularly on the fingertips or lips

In the case of these symptoms, it is important to seek medical attention immediately. In general, such overdoses must be treated in a hospital by supplementing oxygen, or through manual respiration. Certain drugs, such as opioids (mentioned above), may respond to individual treatments to reverse the depressant effects.

== Dissociative Overdose ==

Dissociative overdose can have long lasting psychological effects.

With an overdose of dissociatives, emergency care, such as 911, should be contacted immediately. There is no antidote for ketamine. Overdose situations with ketamine are treated with symptomatic and supportive care in the hospital setting. Benzodiazepines may be used if needed for seizures or excitation. Respiratory support is rarely needed, but assisted ventilation or supplemental oxygen may be required.

'Tussin syrup may contain potentially deadly active ingredients such as paracetamol (acetaminophen), chlorpheniramine, and phenylephrine. Never take more than 4g of acetaminophen in a day, which may cause liver damage. In case of overdose, you will want to see medical attention.

Combining dissociatives with stimulants can cause a dangerous rise in blood pressure and heart rate. CNS depressants such as ethanol (drinking alcohol) will have a combined depressant effect, which can cause a decreased respiratory rate.

Combining dextromethorphan with other serotonergic drugs could possibly cause serotonin toxicity, an excess of serotonergic activity in the central nervous system (CNS) and peripheral nervous system (PNS).

== Psychedelic Overdose ==

Most psychedelics are relatively safe, and won't put a user in a physically endangered state through psychedelic actions alone. However, many psychedelics are also stimulating and serotonergic, so overdoses may result in issues with stimulant overdose or serotonin syndrome.

In case of a NBOMe overdose, seek medical attention immediately.

== Other ==

Many Over The Counter drugs also contain APAP (acetaminophen/paracetamol). Never take more than 4g of acetaminophen in a day. Overdoses of APAP take place over several days with a slow onset, and damage the liver - possibly causing liver failure or death. In the case of such an overdose, seek medical attention.

== Emergency numbers ==

USA
Emergencies: 911
Poison Control Hotline 1-800-222-1222

Australia
Emergencies: 000 (112 from cell phones)
Poison Control: 13 11 26

United Kingdom
Emergencies: 999
Poison Control: 0845 4647
NHS non-emergency: 111

Germany
Emergencies: 112
49 30 3068 6711

Most of Europe:
Emergencies: 112

[[Category:Guides]]

File:Combo 2.png

2015-10-17T21:13:55Z

GrimReaper: GrimReaper uploaded a new version of "File:Combo 2.png"

File:Combo 2.png

2015-10-14T20:50:00Z

GrimReaper: GrimReaper uploaded a new version of "File:Combo 2.png"

File:Combo 2.png

2015-10-14T18:46:42Z

GrimReaper: GrimReaper uploaded a new version of "File:Combo 2.png"

File:Combo 2.png

2015-10-14T18:25:25Z

GrimReaper: GrimReaper uploaded a new version of "File:Combo 2.png"

File:Combo 2.png

2015-10-14T18:04:30Z

GrimReaper: GrimReaper uploaded a new version of "File:Combo 2.png"

File:Combo 2.png

2015-10-14T18:02:34Z

GrimReaper: GrimReaper uploaded a new version of "File:Combo 2.png"

Drug combinations

2015-10-14T18:01:02Z

GrimReaper:

'''WARNING! For educational purposes: We do not endorse any of these combinations. This page will always be 'work in progress'. It is extremely important to be safe at all times! '''

[[File:Combo_2.png|1000px|center]]

== Overview ==
If you want to give us some feedback/recommendation/comment on the chart, you can contact us:

[http://chat.tripsit.me/?nick=AskContent?#content Join #content channel on IRC]

Email: '''content@tripsit.me''', or email GrimReaper directly at '''grimreaper@tripsit.me'''

== Chart versions ==

'''[http://wiki.tripsit.me/images/d/d6/TripSitDrugComboChart.gif English]'''

'''[http://wiki.tripsit.me/images/5/5b/TripSitDrugComboChart-Portuguese.png Portuguese]'''

'''[http://wiki.tripsit.me/images/d/d4/TripSitDrugComboChart-German.png German]'''

'''[http://wiki.tripsit.me/wiki/File:TripSitDrugComboChart-Polish.gif Polish]'''

== Specific Combinations ==

=== Amphetamine & Mescaline ===

The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops

=== Cocaine & Mescaline ===

The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops

=== Caffeine & Mescaline ===

High doses of caffeine are uncomfortable and this will be magnified by psychedelics

=== 5-meo-xxt & Mescaline ===

The 5-MeO class of tryptamines can be unpredictable in their interactions

=== Tramadol & Mescaline ===

This combination can cause seizures due to the lowering of the threshold by tramadol and the potential of mescaline to cause seziures.

=== 5-meo-xxt & Dox ===

The 5-MeO class of tryptamines can be unpredictable in their interactions, particularly increasing the risk of unpleasant physical side effects.

=== Ketamine & Dox ===

Ketamine and psychedelics tend to potentiate each other - go slowly.

=== MXE & Dox ===

As an NMDA antagonist MXE potentiates DOx which can be unpleasantly intense

=== DXM & Dox ===

The DOx class as psychedelic stimulants have the potential to mask the effects of DXM and could lead to redosing to an unsafe level. DXM can also potentiate DOx resulting in an unpleasantly intense experience.

=== PCP & Dox ===

Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

=== Amphetamine & Dox ===

The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of amphetamine can easily lead to thought loops. Coming down from amphetamines while the DOx is still active can be quite anxiogenic.

=== MDMA & Dox ===

The combined stimulating effects of the two can be uncomfortable. Coming down on the MDMA while the DOx is still active can be quite anxiogenic.

=== Cocaine & Dox ===
The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of cocaine can easily lead to thought loops. Coming down from cocaine while the DOx is still active can be quite anxiogenic

=== Caffeine & Dox ===

High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating it may cause some physical discomfort.

=== Alcohol & Dox ===

Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk.

=== Opioids & Dox ===

No unexpected interactions.

=== Tramadol & Dox ===

Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

=== 5-meo-xxt & Nbomes ===

The 5-MeO class of tryptamines can be unpredictable in their interactions and the NBOMes are known to be unpredictable even alone. This combination is best avoided

=== Amphetamine & Nbomes ===

Amphetamines and NBOMes both provide considerable stimulation. When combined they can result in tachycardia, hypertension, vasoconstriction and in extreme cases heart failure. The anxiogenic and focusing effects of stimulants are also not good in combination with psychedelics as they can lead to unpleasant thought loops. NBOMes are known to cause seizures and stimulants can increase this risk.

=== Cocaine & Nbomes ===

Cocaine and NBOMes both provide considerable stimulation. When combined they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.

=== Caffeine & Nbomes ===

Caffiene can bring out the natural stimulation from psychedelic drugs to make it uncomfortable. High doses can cause anxiety which is hard to handle while tripping

=== Tramadol & Nbomes ===

Tramadol is well known to lower seizure threshold and NBOMes have also shown a tendency to cause severe seizures

=== 5-meo-xxt & 2c-x ===

The 5-MeO psychedelics can interact unpredictably to potentiate other psychedelics

=== Amphetamine & 2c-x ===

The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally uneccessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

=== Cocaine & 2c-x ===

The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

=== Caffeine & 2c-x ===

High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== Tramadol & 2c-x ===

Tramadol is well known to lower seizure threshold and psychedelics raise the risk of seizures.

=== Caffeine & 2c-t-x ===

High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== Alcohol & 2c-t-x ===

Both these classes of compound can interact unpredictably. Caution should be exercised.

=== Opioids & 2c-t-x ===

No expected interactions, some Opioids have Serotonin action, and could lead to Serotonin Syndrome or a seizure. These are pretty much only to Pentazocine, Methadone, Tramadol, Tapenatdol.

=== Caffeine & αMT ===

High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== Alcohol & αMT ===

aMT has a broad mechanism of action in the brain and so does alcohol so the combination can be unpredictable

=== Opioids & αMT ===

No unexpected interactions

=== Amphetamine & 5-meo-xxt ===

The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

=== MDMA & 5-meo-xxt ===

Some of the 5-MeO tryptamines are a bit unpredictable and should be mixed with MDMA with care

=== Cocaine & 5-meo-xxt ===

The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

=== Amphetamine & Ketamine ===

No unexpected interactions. Likely to increase blood pressure but not an issue with sensible doses

=== Caffeine & Ketamine ===

No unexpected interactions.

=== Alcohol & Ketamine ===

Both substances cause ataxia and bring a very high risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

=== Ghb/gbl & Ketamine ===

Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

=== Opioids & Ketamine ===

Both substances bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

=== Tramadol & Ketamine ===

No unexpected interactions

=== Benzodiazepines & Ketamine ===

Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

=== Amphetamine & MXE ===

Risk of tachycardia, hypertension, and manic states

=== MDMA & MXE ===

There have been reports of risky serotonergic interactions when the two are taken at the same time, but MXE taken to the end of an MDMA experience does not appear to cause the same issues.

=== Cocaine & MXE ===

Stimulants taken with MXE can lead to hypermanic states much more easily, especially if sleep is avoided.

=== Caffeine & MXE ===

No likely interactions
=== Alcohol & MXE ===

There is a high risk of memory loss, vomiting and severe ataxia from this combination.

=== Ghb/gbl & MXE ===

Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

=== Opioids & MXE ===

This combination can potentiate the effects of the opioid

=== Benzodiazepines & MXE ===

Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess.

=== Ssris & MXE ===

Depending on the SSRI this combination can be unpredictable

=== Amphetamine & DXM ===

Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.

=== Maois & DXM ===

High risk of serotonin syndrome

=== Cocaine & DXM ===

Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues

=== Ssris & DXM ===

High risk of serotonin syndrome.

=== Caffeine & DXM ===

High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== Alcohol & DXM ===

Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Additionally CNS depression can lead to difficulty breathing. Avoid on anything higher than 1st plateau.

=== Ghb/gbl & DXM ===

Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position. This combination is hard to predict

=== Opioids & DXM ===
CNS depression, difficult breathing, heart issues, hepatoxic, just very unsafe combination all around. Additionally, there is a reverse cross tolerance between opiates/dxm. I.E. if one takes dxm, their tolerance of opiates goes down slightly, thus causing additional synergistic effects.

=== Benzodiazepines & DXM ===

Small doses of benzos can end a bad trip, but both substances potentiate the ataxia and sedation caused by the other and this can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

=== Amphetamine & PCP ===

This combination can easily lead to hypermanic states

=== MDMA & PCP ===

This combination can easily lead to hypermanic states

=== Cocaine & PCP ===

This combination can easily lead to hypermanic states

=== Caffeine & PCP ===

Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

=== Alcohol & PCP ===

Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

=== Ghb/gbl & PCP ===

Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

=== Opioids & PCP ===

PCP can reduce opioid tolerance, increasing the risk of overdose

=== Benzodiazepines & PCP ===

Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely

=== Ssris & PCP ===

Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

=== Alcohol & N2O ===

This combination can lead to vomiting

=== Ghb/gbl & N2O ===
=== MDMA & Amphetamine ===

Amphetamines increase the neurotoxic effects of MDMA

=== Cocaine & Amphetamine ===

This combination of stimulants will increase strain on the heart. It is not generally worth it as cocaine has a mild blocking effect on dopamine releasers like amphetamine

=== Caffeine & Amphetamine ===

This combination of stimulants is not generally necessary and may increase strain on the heart, as well as potentially causing anxiety and greater physical discomfort.

=== Alcohol & Amphetamine ===

Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel the alcohol and the stimulant less. Extended release formulations may severely impede sleep, further worsening the hangover.

=== Ghb/gbl & Amphetamine ===

Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

=== Opioids & Amphetamine ===

Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

=== Tramadol & Amphetamine ===

Tramadol and stimulants both increase the risk of seizures.

=== Cocaine & MDMA ===

Cocaine blocks some of the desirable effects of MDMA while increasing the risk of heart attack.

=== Caffeine & MDMA ===

Caffiene is not really necessary with MDMA and increases any neurotoxic effects from MDMA

=== Alcohol & MDMA ===

Both MDMA and alcohol cause severe dehydration. Approach this combination with caution, moderation and sufficient hydration.

=== Tramadol & MDMA ===

Tramadol and stimulants both increase the risk of seizures.

=== Caffeine & Cocaine ===

Both stimulants, risk of tachycardia, hypertension, and in extreme cases heart failure.
=== Alcohol & Cocaine ===

Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel he alcohol less. Cocaine is potentiated somewhat by alcohol because of the formation of cocaethylene.

=== Ghb/gbl & Cocaine ===

Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest. Likewise the G can wear off and leave a dangerous concentration of cocaine behind

=== Opioids & Cocaine ===

Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

=== Tramadol & Cocaine ===

Tramadol and stimulants both increase the risk of seizures.

=== Ssris & Cocaine ===

Risk of serotonin syndrome, Likely to make the SSRI's innefective with regular cocaine use. The SSRIs may also make the cocaine less effective. Mental stability and cocaine don't go together

=== Ghb/gbl & Alcohol ===

Even in very low doses this combination rapidly leads to memory loss, severe ataxia and unconsciousness. There is a high risk of vomit aspiration while unconscious.

=== Opioids & Alcohol ===

Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely

=== Tramadol & Alcohol ===

Heavy CNS depressants, risk of seizures. Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely.

=== Benzodiazepines & Alcohol ===

Ethanol ingestion may potentiate the CNS effects of many benzodiazepines. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Blacking out and memory loss is almost certain.

=== MAOIs & Alcohol ===

The chemical tyramine in alcoholic beverages can have dangerous reactions with MAOIs, causing an increase in blood pressure.

=== Ssris & Alcohol ===

Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

=== Opioids & Ghb/gbl ===

The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position

=== Tramadol & Ghb/gbl ===

The sedative effects of this combination can lead to dangerous respiratory depression.

=== Benzodiazepines & Ghb/gbl ===

The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

=== Tramadol & Opioids ===

Concomitant use of tramadol increases the seizure risk in patients taking other opioids. These agents are often individually epileptogenic and may have additive effects on seizure threshold during coadministration. Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present

=== Benzodiazepines & Opioids ===

Central nervous system and/or respiratory-depressant effects may be additively or synergistically present. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position Blackouts/memory loss likely

=== Maois & Opioids ===

Coadministration of monoamine oxidase inhibitors (MAOIs) with certain opioids has been associated with rare reports of severe and fatal adverse reactions. There appear to be two types of interaction, an excitatory and a depressive one. Symptoms of the excitatory reaction may include agitation, headache, diaphoresis, hyperpyrexia, flushing, shivering, myoclonus, rigidity, tremor, diarrhea, hypertension, tachycardia, seizures, and coma. Death has occurred in some cases.

=== Benzodiazepines & Tramadol ===

Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present. Vomit aspiration a risk when passed out, lay down in recovery position if ingested.

== References ==

=== LSD & DMT ===

http://www.ncbi.nlm.nih.gov/pubmed/3006089
http://deepblue.lib.umich.edu/bitstream/handle/2027.42/26285/0000370.pdf

===LSD & GHB/GBL===

http://www.ncbi.nlm.nih.gov/pubmed/16483730

===LSD & Opioids===

http://www.ncbi.nlm.nih.gov/pubmed/547279

http://www.ncbi.nlm.nih.gov/pubmed/3006089

"Low doses antagonized the effects of both hallucinogens, whereas larger doses enhanced their effects."

http://www.ncbi.nlm.nih.gov/pubmed/3006089

http://deepblue.lib.umich.edu/bitstream/handle/2027.42/26285/0000370.pdf

===LSD & Tramadol===

http://www.ncbi.nlm.nih.gov/pubmed/3006089

===LSD & MAOIs===

http://www.ncbi.nlm.nih.gov/pubmed/8788508

http://www.ncbi.nlm.nih.gov/pubmed/108709

https://www.erowid.org/references/refs_view.php?A=ShowDocPartFrame&ID=2439&DocPartID=2199

===LSD & SSRIs===

http://www.nature.com/npp/journal/v14/n6/full/1380431a.html

http://www.ncbi.nlm.nih.gov/pubmed/8726753

===DMT & Opioids===

http://www.ncbi.nlm.nih.gov/pubmed/3006089

===DMT & Tramadol===

http://www.ncbi.nlm.nih.gov/pubmed/3006089

===MDMA & GHB/GBL===

http://www.ncbi.nlm.nih.gov/pubmed/16234132

http://www.ncbi.nlm.nih.gov/pubmed/22554869

http://www.ncbi.nlm.nih.gov/pubmed/20730418

http://www.ncbi.nlm.nih.gov/pubmed/16483730

===DOx & Amphetamines===

http://www.ncbi.nlm.nih.gov/pubmed/1208759

===Ketamine & Caffeine===

http://onlinelibrary.wiley.com/doi/10.1111/j.1742-7843.2009.00382.x/full

===Ketamine & Alcohol===

http://onlinelibrary.wiley.com/doi/10.1002/jemt.22045/abstract

===Ketamine & GHB/GBL===

http://www.ncbi.nlm.nih.gov/pubmed/16483730

===Ketamine & Opioids===

http://www.ncbi.nlm.nih.gov/pubmed/21224020

===Tramadol & SSRIs===

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2714818/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750095/

===MXE & DXM===

http://i.imgur.com/zmqaw.jpg

http://www.sciencedirect.com/science/article/pii/S0014488607002543

===MXE & Amphetamines===

http://www.ncbi.nlm.nih.gov/pubmed/25060403

===DXM & PCP===

http://i.imgur.com/zmqaw.jpg

http://www.sciencedirect.com/science/article/pii/S0014488607002543

===PCP & SSRIs===

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1224745/

===Amphetamines & Benzodiazepines===

http://www.ncbi.nlm.nih.gov/pubmed/17320309

===MDMA & Caffeine===

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3492978/

http://link.springer.com/article/10.1007/s00213-010-1864-1

http://www.sciencedirect.com/science/article/pii/S0028390805003114

http://www.ncbi.nlm.nih.gov/pubmed/24211539

===MDMA & Alcohol===

http://www.ncbi.nlm.nih.gov/pubmed/21040238

http://www.ncbi.nlm.nih.gov/pubmed/21756931

===Cocaine & SSRIs===

http://www.ncbi.nlm.nih.gov/pubmed/23761390

http://www.ncbi.nlm.nih.gov/pubmed/20195220

===Caffeine & Alcohol===

http://www.ncbi.nlm.nih.gov/pubmed/20001110

===Caffeine & Tramadol===

http://www.ncbi.nlm.nih.gov/pubmed/20837047

===Caffeine & SSRIs===

http://journals.lww.com/jpharmacogenetics/abstract/1996/06000/a_fluvoxamine_caffeine_interaction_study.3.aspx

===Alcohol & GHB/GBL===

http://www.ncbi.nlm.nih.gov/pubmed/15274975

===Alcohol & SSRIs===

http://www.ncbi.nlm.nih.gov/pubmed/15739105

===GHB/GBL & Opioids===

http://www.ncbi.nlm.nih.gov/pubmed/7782758

===GHB/GBL & Tramadol===

http://www.ncbi.nlm.nih.gov/pubmed/7782758

===GHB/GBL & Benzodiazepines===

http://www.ncbi.nlm.nih.gov/pubmed/16483730

===GHB/GBL & MAOIs===

No study, but MAO B inhibitors should enhance the effects, no interaction with MAO A.

===Opioids & Benzodiazepines===

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3454351/

===Opioids & MAOIs===

http://www.ncbi.nlm.nih.gov/pubmed/17157368 (?)

http://www.ncbi.nlm.nih.gov/pubmed/2891392

http://www.if-pan.krakow.pl/pjp/pdf/2013/3_593.pdf

===Opioids & SSRIs===

http://www.ncbi.nlm.nih.gov/pubmed/23391344

http://www.ncbi.nlm.nih.gov/pubmed/20513454

http://www.ncbi.nlm.nih.gov/pubmed/16005413

http://www.ncbi.nlm.nih.gov/pubmed/18676387

http://www.ncbi.nlm.nih.gov/pubmed/17381671

===Tramadol & Benzodiazepines===

http://www.ncbi.nlm.nih.gov/pubmed/12842359

===Tramadol & MAOIs===

http://www.ncbi.nlm.nih.gov/pubmed/16051647

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750095/

===Benzodiazepines & SSRIs===

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446479/

http://www.ncbi.nlm.nih.gov/pubmed/9435993

===MAOIs & SSRIs===

http://www.ncbi.nlm.nih.gov/pubmed/24577320

[[Category:Guides]]

Drug combinations

2015-10-14T18:00:25Z

GrimReaper:

'''WARNING! For educational purposes: We do not endorse any of these combinations. This page will always be 'work in progress'. It is extremely important to be safe at all times! '''

[[File:File:Combo_2.png|1000px|center]]

== Overview ==
If you want to give us some feedback/recommendation/comment on the chart, you can contact us:

[http://chat.tripsit.me/?nick=AskContent?#content Join #content channel on IRC]

Email: '''content@tripsit.me''', or email GrimReaper directly at '''grimreaper@tripsit.me'''

== Chart versions ==

'''[http://wiki.tripsit.me/images/d/d6/TripSitDrugComboChart.gif English]'''

'''[http://wiki.tripsit.me/images/5/5b/TripSitDrugComboChart-Portuguese.png Portuguese]'''

'''[http://wiki.tripsit.me/images/d/d4/TripSitDrugComboChart-German.png German]'''

'''[http://wiki.tripsit.me/wiki/File:TripSitDrugComboChart-Polish.gif Polish]'''

== Specific Combinations ==

=== Amphetamine & Mescaline ===

The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops

=== Cocaine & Mescaline ===

The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops

=== Caffeine & Mescaline ===

High doses of caffeine are uncomfortable and this will be magnified by psychedelics

=== 5-meo-xxt & Mescaline ===

The 5-MeO class of tryptamines can be unpredictable in their interactions

=== Tramadol & Mescaline ===

This combination can cause seizures due to the lowering of the threshold by tramadol and the potential of mescaline to cause seziures.

=== 5-meo-xxt & Dox ===

The 5-MeO class of tryptamines can be unpredictable in their interactions, particularly increasing the risk of unpleasant physical side effects.

=== Ketamine & Dox ===

Ketamine and psychedelics tend to potentiate each other - go slowly.

=== MXE & Dox ===

As an NMDA antagonist MXE potentiates DOx which can be unpleasantly intense

=== DXM & Dox ===

The DOx class as psychedelic stimulants have the potential to mask the effects of DXM and could lead to redosing to an unsafe level. DXM can also potentiate DOx resulting in an unpleasantly intense experience.

=== PCP & Dox ===

Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

=== Amphetamine & Dox ===

The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of amphetamine can easily lead to thought loops. Coming down from amphetamines while the DOx is still active can be quite anxiogenic.

=== MDMA & Dox ===

The combined stimulating effects of the two can be uncomfortable. Coming down on the MDMA while the DOx is still active can be quite anxiogenic.

=== Cocaine & Dox ===
The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of cocaine can easily lead to thought loops. Coming down from cocaine while the DOx is still active can be quite anxiogenic

=== Caffeine & Dox ===

High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating it may cause some physical discomfort.

=== Alcohol & Dox ===

Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk.

=== Opioids & Dox ===

No unexpected interactions.

=== Tramadol & Dox ===

Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

=== 5-meo-xxt & Nbomes ===

The 5-MeO class of tryptamines can be unpredictable in their interactions and the NBOMes are known to be unpredictable even alone. This combination is best avoided

=== Amphetamine & Nbomes ===

Amphetamines and NBOMes both provide considerable stimulation. When combined they can result in tachycardia, hypertension, vasoconstriction and in extreme cases heart failure. The anxiogenic and focusing effects of stimulants are also not good in combination with psychedelics as they can lead to unpleasant thought loops. NBOMes are known to cause seizures and stimulants can increase this risk.

=== Cocaine & Nbomes ===

Cocaine and NBOMes both provide considerable stimulation. When combined they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.

=== Caffeine & Nbomes ===

Caffiene can bring out the natural stimulation from psychedelic drugs to make it uncomfortable. High doses can cause anxiety which is hard to handle while tripping

=== Tramadol & Nbomes ===

Tramadol is well known to lower seizure threshold and NBOMes have also shown a tendency to cause severe seizures

=== 5-meo-xxt & 2c-x ===

The 5-MeO psychedelics can interact unpredictably to potentiate other psychedelics

=== Amphetamine & 2c-x ===

The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally uneccessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

=== Cocaine & 2c-x ===

The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

=== Caffeine & 2c-x ===

High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== Tramadol & 2c-x ===

Tramadol is well known to lower seizure threshold and psychedelics raise the risk of seizures.

=== Caffeine & 2c-t-x ===

High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== Alcohol & 2c-t-x ===

Both these classes of compound can interact unpredictably. Caution should be exercised.

=== Opioids & 2c-t-x ===

No expected interactions, some Opioids have Serotonin action, and could lead to Serotonin Syndrome or a seizure. These are pretty much only to Pentazocine, Methadone, Tramadol, Tapenatdol.

=== Caffeine & αMT ===

High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== Alcohol & αMT ===

aMT has a broad mechanism of action in the brain and so does alcohol so the combination can be unpredictable

=== Opioids & αMT ===

No unexpected interactions

=== Amphetamine & 5-meo-xxt ===

The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

=== MDMA & 5-meo-xxt ===

Some of the 5-MeO tryptamines are a bit unpredictable and should be mixed with MDMA with care

=== Cocaine & 5-meo-xxt ===

The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

=== Amphetamine & Ketamine ===

No unexpected interactions. Likely to increase blood pressure but not an issue with sensible doses

=== Caffeine & Ketamine ===

No unexpected interactions.

=== Alcohol & Ketamine ===

Both substances cause ataxia and bring a very high risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

=== Ghb/gbl & Ketamine ===

Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

=== Opioids & Ketamine ===

Both substances bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

=== Tramadol & Ketamine ===

No unexpected interactions

=== Benzodiazepines & Ketamine ===

Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

=== Amphetamine & MXE ===

Risk of tachycardia, hypertension, and manic states

=== MDMA & MXE ===

There have been reports of risky serotonergic interactions when the two are taken at the same time, but MXE taken to the end of an MDMA experience does not appear to cause the same issues.

=== Cocaine & MXE ===

Stimulants taken with MXE can lead to hypermanic states much more easily, especially if sleep is avoided.

=== Caffeine & MXE ===

No likely interactions
=== Alcohol & MXE ===

There is a high risk of memory loss, vomiting and severe ataxia from this combination.

=== Ghb/gbl & MXE ===

Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

=== Opioids & MXE ===

This combination can potentiate the effects of the opioid

=== Benzodiazepines & MXE ===

Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess.

=== Ssris & MXE ===

Depending on the SSRI this combination can be unpredictable

=== Amphetamine & DXM ===

Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.

=== Maois & DXM ===

High risk of serotonin syndrome

=== Cocaine & DXM ===

Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues

=== Ssris & DXM ===

High risk of serotonin syndrome.

=== Caffeine & DXM ===

High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== Alcohol & DXM ===

Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Additionally CNS depression can lead to difficulty breathing. Avoid on anything higher than 1st plateau.

=== Ghb/gbl & DXM ===

Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position. This combination is hard to predict

=== Opioids & DXM ===
CNS depression, difficult breathing, heart issues, hepatoxic, just very unsafe combination all around. Additionally, there is a reverse cross tolerance between opiates/dxm. I.E. if one takes dxm, their tolerance of opiates goes down slightly, thus causing additional synergistic effects.

=== Benzodiazepines & DXM ===

Small doses of benzos can end a bad trip, but both substances potentiate the ataxia and sedation caused by the other and this can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

=== Amphetamine & PCP ===

This combination can easily lead to hypermanic states

=== MDMA & PCP ===

This combination can easily lead to hypermanic states

=== Cocaine & PCP ===

This combination can easily lead to hypermanic states

=== Caffeine & PCP ===

Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

=== Alcohol & PCP ===

Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

=== Ghb/gbl & PCP ===

Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

=== Opioids & PCP ===

PCP can reduce opioid tolerance, increasing the risk of overdose

=== Benzodiazepines & PCP ===

Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely

=== Ssris & PCP ===

Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

=== Alcohol & N2O ===

This combination can lead to vomiting

=== Ghb/gbl & N2O ===
=== MDMA & Amphetamine ===

Amphetamines increase the neurotoxic effects of MDMA

=== Cocaine & Amphetamine ===

This combination of stimulants will increase strain on the heart. It is not generally worth it as cocaine has a mild blocking effect on dopamine releasers like amphetamine

=== Caffeine & Amphetamine ===

This combination of stimulants is not generally necessary and may increase strain on the heart, as well as potentially causing anxiety and greater physical discomfort.

=== Alcohol & Amphetamine ===

Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel the alcohol and the stimulant less. Extended release formulations may severely impede sleep, further worsening the hangover.

=== Ghb/gbl & Amphetamine ===

Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

=== Opioids & Amphetamine ===

Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

=== Tramadol & Amphetamine ===

Tramadol and stimulants both increase the risk of seizures.

=== Cocaine & MDMA ===

Cocaine blocks some of the desirable effects of MDMA while increasing the risk of heart attack.

=== Caffeine & MDMA ===

Caffiene is not really necessary with MDMA and increases any neurotoxic effects from MDMA

=== Alcohol & MDMA ===

Both MDMA and alcohol cause severe dehydration. Approach this combination with caution, moderation and sufficient hydration.

=== Tramadol & MDMA ===

Tramadol and stimulants both increase the risk of seizures.

=== Caffeine & Cocaine ===

Both stimulants, risk of tachycardia, hypertension, and in extreme cases heart failure.
=== Alcohol & Cocaine ===

Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel he alcohol less. Cocaine is potentiated somewhat by alcohol because of the formation of cocaethylene.

=== Ghb/gbl & Cocaine ===

Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest. Likewise the G can wear off and leave a dangerous concentration of cocaine behind

=== Opioids & Cocaine ===

Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

=== Tramadol & Cocaine ===

Tramadol and stimulants both increase the risk of seizures.

=== Ssris & Cocaine ===

Risk of serotonin syndrome, Likely to make the SSRI's innefective with regular cocaine use. The SSRIs may also make the cocaine less effective. Mental stability and cocaine don't go together

=== Ghb/gbl & Alcohol ===

Even in very low doses this combination rapidly leads to memory loss, severe ataxia and unconsciousness. There is a high risk of vomit aspiration while unconscious.

=== Opioids & Alcohol ===

Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely

=== Tramadol & Alcohol ===

Heavy CNS depressants, risk of seizures. Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely.

=== Benzodiazepines & Alcohol ===

Ethanol ingestion may potentiate the CNS effects of many benzodiazepines. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Blacking out and memory loss is almost certain.

=== MAOIs & Alcohol ===

The chemical tyramine in alcoholic beverages can have dangerous reactions with MAOIs, causing an increase in blood pressure.

=== Ssris & Alcohol ===

Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

=== Opioids & Ghb/gbl ===

The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position

=== Tramadol & Ghb/gbl ===

The sedative effects of this combination can lead to dangerous respiratory depression.

=== Benzodiazepines & Ghb/gbl ===

The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

=== Tramadol & Opioids ===

Concomitant use of tramadol increases the seizure risk in patients taking other opioids. These agents are often individually epileptogenic and may have additive effects on seizure threshold during coadministration. Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present

=== Benzodiazepines & Opioids ===

Central nervous system and/or respiratory-depressant effects may be additively or synergistically present. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position Blackouts/memory loss likely

=== Maois & Opioids ===

Coadministration of monoamine oxidase inhibitors (MAOIs) with certain opioids has been associated with rare reports of severe and fatal adverse reactions. There appear to be two types of interaction, an excitatory and a depressive one. Symptoms of the excitatory reaction may include agitation, headache, diaphoresis, hyperpyrexia, flushing, shivering, myoclonus, rigidity, tremor, diarrhea, hypertension, tachycardia, seizures, and coma. Death has occurred in some cases.

=== Benzodiazepines & Tramadol ===

Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present. Vomit aspiration a risk when passed out, lay down in recovery position if ingested.

== References ==

=== LSD & DMT ===

http://www.ncbi.nlm.nih.gov/pubmed/3006089
http://deepblue.lib.umich.edu/bitstream/handle/2027.42/26285/0000370.pdf

===LSD & GHB/GBL===

http://www.ncbi.nlm.nih.gov/pubmed/16483730

===LSD & Opioids===

http://www.ncbi.nlm.nih.gov/pubmed/547279

http://www.ncbi.nlm.nih.gov/pubmed/3006089

"Low doses antagonized the effects of both hallucinogens, whereas larger doses enhanced their effects."

http://www.ncbi.nlm.nih.gov/pubmed/3006089

http://deepblue.lib.umich.edu/bitstream/handle/2027.42/26285/0000370.pdf

===LSD & Tramadol===

http://www.ncbi.nlm.nih.gov/pubmed/3006089

===LSD & MAOIs===

http://www.ncbi.nlm.nih.gov/pubmed/8788508

http://www.ncbi.nlm.nih.gov/pubmed/108709

https://www.erowid.org/references/refs_view.php?A=ShowDocPartFrame&ID=2439&DocPartID=2199

===LSD & SSRIs===

http://www.nature.com/npp/journal/v14/n6/full/1380431a.html

http://www.ncbi.nlm.nih.gov/pubmed/8726753

===DMT & Opioids===

http://www.ncbi.nlm.nih.gov/pubmed/3006089

===DMT & Tramadol===

http://www.ncbi.nlm.nih.gov/pubmed/3006089

===MDMA & GHB/GBL===

http://www.ncbi.nlm.nih.gov/pubmed/16234132

http://www.ncbi.nlm.nih.gov/pubmed/22554869

http://www.ncbi.nlm.nih.gov/pubmed/20730418

http://www.ncbi.nlm.nih.gov/pubmed/16483730

===DOx & Amphetamines===

http://www.ncbi.nlm.nih.gov/pubmed/1208759

===Ketamine & Caffeine===

http://onlinelibrary.wiley.com/doi/10.1111/j.1742-7843.2009.00382.x/full

===Ketamine & Alcohol===

http://onlinelibrary.wiley.com/doi/10.1002/jemt.22045/abstract

===Ketamine & GHB/GBL===

http://www.ncbi.nlm.nih.gov/pubmed/16483730

===Ketamine & Opioids===

http://www.ncbi.nlm.nih.gov/pubmed/21224020

===Tramadol & SSRIs===

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2714818/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750095/

===MXE & DXM===

http://i.imgur.com/zmqaw.jpg

http://www.sciencedirect.com/science/article/pii/S0014488607002543

===MXE & Amphetamines===

http://www.ncbi.nlm.nih.gov/pubmed/25060403

===DXM & PCP===

http://i.imgur.com/zmqaw.jpg

http://www.sciencedirect.com/science/article/pii/S0014488607002543

===PCP & SSRIs===

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1224745/

===Amphetamines & Benzodiazepines===

http://www.ncbi.nlm.nih.gov/pubmed/17320309

===MDMA & Caffeine===

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3492978/

http://link.springer.com/article/10.1007/s00213-010-1864-1

http://www.sciencedirect.com/science/article/pii/S0028390805003114

http://www.ncbi.nlm.nih.gov/pubmed/24211539

===MDMA & Alcohol===

http://www.ncbi.nlm.nih.gov/pubmed/21040238

http://www.ncbi.nlm.nih.gov/pubmed/21756931

===Cocaine & SSRIs===

http://www.ncbi.nlm.nih.gov/pubmed/23761390

http://www.ncbi.nlm.nih.gov/pubmed/20195220

===Caffeine & Alcohol===

http://www.ncbi.nlm.nih.gov/pubmed/20001110

===Caffeine & Tramadol===

http://www.ncbi.nlm.nih.gov/pubmed/20837047

===Caffeine & SSRIs===

http://journals.lww.com/jpharmacogenetics/abstract/1996/06000/a_fluvoxamine_caffeine_interaction_study.3.aspx

===Alcohol & GHB/GBL===

http://www.ncbi.nlm.nih.gov/pubmed/15274975

===Alcohol & SSRIs===

http://www.ncbi.nlm.nih.gov/pubmed/15739105

===GHB/GBL & Opioids===

http://www.ncbi.nlm.nih.gov/pubmed/7782758

===GHB/GBL & Tramadol===

http://www.ncbi.nlm.nih.gov/pubmed/7782758

===GHB/GBL & Benzodiazepines===

http://www.ncbi.nlm.nih.gov/pubmed/16483730

===GHB/GBL & MAOIs===

No study, but MAO B inhibitors should enhance the effects, no interaction with MAO A.

===Opioids & Benzodiazepines===

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3454351/

===Opioids & MAOIs===

http://www.ncbi.nlm.nih.gov/pubmed/17157368 (?)

http://www.ncbi.nlm.nih.gov/pubmed/2891392

http://www.if-pan.krakow.pl/pjp/pdf/2013/3_593.pdf

===Opioids & SSRIs===

http://www.ncbi.nlm.nih.gov/pubmed/23391344

http://www.ncbi.nlm.nih.gov/pubmed/20513454

http://www.ncbi.nlm.nih.gov/pubmed/16005413

http://www.ncbi.nlm.nih.gov/pubmed/18676387

http://www.ncbi.nlm.nih.gov/pubmed/17381671

===Tramadol & Benzodiazepines===

http://www.ncbi.nlm.nih.gov/pubmed/12842359

===Tramadol & MAOIs===

http://www.ncbi.nlm.nih.gov/pubmed/16051647

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750095/

===Benzodiazepines & SSRIs===

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446479/

http://www.ncbi.nlm.nih.gov/pubmed/9435993

===MAOIs & SSRIs===

http://www.ncbi.nlm.nih.gov/pubmed/24577320

[[Category:Guides]]

File:Combo 2.png

2015-10-14T17:59:21Z

GrimReaper: GrimReaper uploaded a new version of "File:Combo 2.png"

Drug combinations

2015-10-14T17:57:26Z

GrimReaper:

'''WARNING! For educational purposes: We do not endorse any of these combinations. This page will always be 'work in progress'. It is extremely important to be safe at all times! '''

[[File:TripSitDrugComboChart.gif|1000px|center]]

== Overview ==
If you want to give us some feedback/recommendation/comment on the chart, you can contact us:

[http://chat.tripsit.me/?nick=AskContent?#content Join #content channel on IRC]

Email: '''content@tripsit.me''', or email GrimReaper directly at '''grimreaper@tripsit.me'''

== Chart versions ==

'''[http://wiki.tripsit.me/images/d/d6/TripSitDrugComboChart.gif English]'''

'''[http://wiki.tripsit.me/images/5/5b/TripSitDrugComboChart-Portuguese.png Portuguese]'''

'''[http://wiki.tripsit.me/images/d/d4/TripSitDrugComboChart-German.png German]'''

'''[http://wiki.tripsit.me/wiki/File:TripSitDrugComboChart-Polish.gif Polish]'''

== Specific Combinations ==

=== Amphetamine & Mescaline ===

The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops

=== Cocaine & Mescaline ===

The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops

=== Caffeine & Mescaline ===

High doses of caffeine are uncomfortable and this will be magnified by psychedelics

=== 5-meo-xxt & Mescaline ===

The 5-MeO class of tryptamines can be unpredictable in their interactions

=== Tramadol & Mescaline ===

This combination can cause seizures due to the lowering of the threshold by tramadol and the potential of mescaline to cause seziures.

=== 5-meo-xxt & Dox ===

The 5-MeO class of tryptamines can be unpredictable in their interactions, particularly increasing the risk of unpleasant physical side effects.

=== Ketamine & Dox ===

Ketamine and psychedelics tend to potentiate each other - go slowly.

=== MXE & Dox ===

As an NMDA antagonist MXE potentiates DOx which can be unpleasantly intense

=== DXM & Dox ===

The DOx class as psychedelic stimulants have the potential to mask the effects of DXM and could lead to redosing to an unsafe level. DXM can also potentiate DOx resulting in an unpleasantly intense experience.

=== PCP & Dox ===

Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

=== Amphetamine & Dox ===

The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of amphetamine can easily lead to thought loops. Coming down from amphetamines while the DOx is still active can be quite anxiogenic.

=== MDMA & Dox ===

The combined stimulating effects of the two can be uncomfortable. Coming down on the MDMA while the DOx is still active can be quite anxiogenic.

=== Cocaine & Dox ===
The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of cocaine can easily lead to thought loops. Coming down from cocaine while the DOx is still active can be quite anxiogenic

=== Caffeine & Dox ===

High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating it may cause some physical discomfort.

=== Alcohol & Dox ===

Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk.

=== Opioids & Dox ===

No unexpected interactions.

=== Tramadol & Dox ===

Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

=== 5-meo-xxt & Nbomes ===

The 5-MeO class of tryptamines can be unpredictable in their interactions and the NBOMes are known to be unpredictable even alone. This combination is best avoided

=== Amphetamine & Nbomes ===

Amphetamines and NBOMes both provide considerable stimulation. When combined they can result in tachycardia, hypertension, vasoconstriction and in extreme cases heart failure. The anxiogenic and focusing effects of stimulants are also not good in combination with psychedelics as they can lead to unpleasant thought loops. NBOMes are known to cause seizures and stimulants can increase this risk.

=== Cocaine & Nbomes ===

Cocaine and NBOMes both provide considerable stimulation. When combined they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.

=== Caffeine & Nbomes ===

Caffiene can bring out the natural stimulation from psychedelic drugs to make it uncomfortable. High doses can cause anxiety which is hard to handle while tripping

=== Tramadol & Nbomes ===

Tramadol is well known to lower seizure threshold and NBOMes have also shown a tendency to cause severe seizures

=== 5-meo-xxt & 2c-x ===

The 5-MeO psychedelics can interact unpredictably to potentiate other psychedelics

=== Amphetamine & 2c-x ===

The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally uneccessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

=== Cocaine & 2c-x ===

The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

=== Caffeine & 2c-x ===

High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== Tramadol & 2c-x ===

Tramadol is well known to lower seizure threshold and psychedelics raise the risk of seizures.

=== Caffeine & 2c-t-x ===

High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== Alcohol & 2c-t-x ===

Both these classes of compound can interact unpredictably. Caution should be exercised.

=== Opioids & 2c-t-x ===

No expected interactions, some Opioids have Serotonin action, and could lead to Serotonin Syndrome or a seizure. These are pretty much only to Pentazocine, Methadone, Tramadol, Tapenatdol.

=== Caffeine & αMT ===

High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== Alcohol & αMT ===

aMT has a broad mechanism of action in the brain and so does alcohol so the combination can be unpredictable

=== Opioids & αMT ===

No unexpected interactions

=== Amphetamine & 5-meo-xxt ===

The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

=== MDMA & 5-meo-xxt ===

Some of the 5-MeO tryptamines are a bit unpredictable and should be mixed with MDMA with care

=== Cocaine & 5-meo-xxt ===

The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

=== Amphetamine & Ketamine ===

No unexpected interactions. Likely to increase blood pressure but not an issue with sensible doses

=== Caffeine & Ketamine ===

No unexpected interactions.

=== Alcohol & Ketamine ===

Both substances cause ataxia and bring a very high risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

=== Ghb/gbl & Ketamine ===

Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

=== Opioids & Ketamine ===

Both substances bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

=== Tramadol & Ketamine ===

No unexpected interactions

=== Benzodiazepines & Ketamine ===

Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

=== Amphetamine & MXE ===

Risk of tachycardia, hypertension, and manic states

=== MDMA & MXE ===

There have been reports of risky serotonergic interactions when the two are taken at the same time, but MXE taken to the end of an MDMA experience does not appear to cause the same issues.

=== Cocaine & MXE ===

Stimulants taken with MXE can lead to hypermanic states much more easily, especially if sleep is avoided.

=== Caffeine & MXE ===

No likely interactions
=== Alcohol & MXE ===

There is a high risk of memory loss, vomiting and severe ataxia from this combination.

=== Ghb/gbl & MXE ===

Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

=== Opioids & MXE ===

This combination can potentiate the effects of the opioid

=== Benzodiazepines & MXE ===

Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess.

=== Ssris & MXE ===

Depending on the SSRI this combination can be unpredictable

=== Amphetamine & DXM ===

Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.

=== Maois & DXM ===

High risk of serotonin syndrome

=== Cocaine & DXM ===

Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues

=== Ssris & DXM ===

High risk of serotonin syndrome.

=== Caffeine & DXM ===

High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== Alcohol & DXM ===

Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Additionally CNS depression can lead to difficulty breathing. Avoid on anything higher than 1st plateau.

=== Ghb/gbl & DXM ===

Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position. This combination is hard to predict

=== Opioids & DXM ===
CNS depression, difficult breathing, heart issues, hepatoxic, just very unsafe combination all around. Additionally, there is a reverse cross tolerance between opiates/dxm. I.E. if one takes dxm, their tolerance of opiates goes down slightly, thus causing additional synergistic effects.

=== Benzodiazepines & DXM ===

Small doses of benzos can end a bad trip, but both substances potentiate the ataxia and sedation caused by the other and this can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

=== Amphetamine & PCP ===

This combination can easily lead to hypermanic states

=== MDMA & PCP ===

This combination can easily lead to hypermanic states

=== Cocaine & PCP ===

This combination can easily lead to hypermanic states

=== Caffeine & PCP ===

Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

=== Alcohol & PCP ===

Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

=== Ghb/gbl & PCP ===

Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

=== Opioids & PCP ===

PCP can reduce opioid tolerance, increasing the risk of overdose

=== Benzodiazepines & PCP ===

Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely

=== Ssris & PCP ===

Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

=== Alcohol & N2O ===

This combination can lead to vomiting

=== Ghb/gbl & N2O ===
=== MDMA & Amphetamine ===

Amphetamines increase the neurotoxic effects of MDMA

=== Cocaine & Amphetamine ===

This combination of stimulants will increase strain on the heart. It is not generally worth it as cocaine has a mild blocking effect on dopamine releasers like amphetamine

=== Caffeine & Amphetamine ===

This combination of stimulants is not generally necessary and may increase strain on the heart, as well as potentially causing anxiety and greater physical discomfort.

=== Alcohol & Amphetamine ===

Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel the alcohol and the stimulant less. Extended release formulations may severely impede sleep, further worsening the hangover.

=== Ghb/gbl & Amphetamine ===

Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

=== Opioids & Amphetamine ===

Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

=== Tramadol & Amphetamine ===

Tramadol and stimulants both increase the risk of seizures.

=== Cocaine & MDMA ===

Cocaine blocks some of the desirable effects of MDMA while increasing the risk of heart attack.

=== Caffeine & MDMA ===

Caffiene is not really necessary with MDMA and increases any neurotoxic effects from MDMA

=== Alcohol & MDMA ===

Both MDMA and alcohol cause severe dehydration. Approach this combination with caution, moderation and sufficient hydration.

=== Tramadol & MDMA ===

Tramadol and stimulants both increase the risk of seizures.

=== Caffeine & Cocaine ===

Both stimulants, risk of tachycardia, hypertension, and in extreme cases heart failure.
=== Alcohol & Cocaine ===

Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel he alcohol less. Cocaine is potentiated somewhat by alcohol because of the formation of cocaethylene.

=== Ghb/gbl & Cocaine ===

Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest. Likewise the G can wear off and leave a dangerous concentration of cocaine behind

=== Opioids & Cocaine ===

Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

=== Tramadol & Cocaine ===

Tramadol and stimulants both increase the risk of seizures.

=== Ssris & Cocaine ===

Risk of serotonin syndrome, Likely to make the SSRI's innefective with regular cocaine use. The SSRIs may also make the cocaine less effective. Mental stability and cocaine don't go together

=== Ghb/gbl & Alcohol ===

Even in very low doses this combination rapidly leads to memory loss, severe ataxia and unconsciousness. There is a high risk of vomit aspiration while unconscious.

=== Opioids & Alcohol ===

Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely

=== Tramadol & Alcohol ===

Heavy CNS depressants, risk of seizures. Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely.

=== Benzodiazepines & Alcohol ===

Ethanol ingestion may potentiate the CNS effects of many benzodiazepines. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Blacking out and memory loss is almost certain.

=== MAOIs & Alcohol ===

The chemical tyramine in alcoholic beverages can have dangerous reactions with MAOIs, causing an increase in blood pressure.

=== Ssris & Alcohol ===

Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

=== Opioids & Ghb/gbl ===

The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position

=== Tramadol & Ghb/gbl ===

The sedative effects of this combination can lead to dangerous respiratory depression.

=== Benzodiazepines & Ghb/gbl ===

The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

=== Tramadol & Opioids ===

Concomitant use of tramadol increases the seizure risk in patients taking other opioids. These agents are often individually epileptogenic and may have additive effects on seizure threshold during coadministration. Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present

=== Benzodiazepines & Opioids ===

Central nervous system and/or respiratory-depressant effects may be additively or synergistically present. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position Blackouts/memory loss likely

=== Maois & Opioids ===

Coadministration of monoamine oxidase inhibitors (MAOIs) with certain opioids has been associated with rare reports of severe and fatal adverse reactions. There appear to be two types of interaction, an excitatory and a depressive one. Symptoms of the excitatory reaction may include agitation, headache, diaphoresis, hyperpyrexia, flushing, shivering, myoclonus, rigidity, tremor, diarrhea, hypertension, tachycardia, seizures, and coma. Death has occurred in some cases.

=== Benzodiazepines & Tramadol ===

Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present. Vomit aspiration a risk when passed out, lay down in recovery position if ingested.

== References ==

=== LSD & DMT ===

http://www.ncbi.nlm.nih.gov/pubmed/3006089
http://deepblue.lib.umich.edu/bitstream/handle/2027.42/26285/0000370.pdf

===LSD & GHB/GBL===

http://www.ncbi.nlm.nih.gov/pubmed/16483730

===LSD & Opioids===

http://www.ncbi.nlm.nih.gov/pubmed/547279

http://www.ncbi.nlm.nih.gov/pubmed/3006089

"Low doses antagonized the effects of both hallucinogens, whereas larger doses enhanced their effects."

http://www.ncbi.nlm.nih.gov/pubmed/3006089

http://deepblue.lib.umich.edu/bitstream/handle/2027.42/26285/0000370.pdf

===LSD & Tramadol===

http://www.ncbi.nlm.nih.gov/pubmed/3006089

===LSD & MAOIs===

http://www.ncbi.nlm.nih.gov/pubmed/8788508

http://www.ncbi.nlm.nih.gov/pubmed/108709

https://www.erowid.org/references/refs_view.php?A=ShowDocPartFrame&ID=2439&DocPartID=2199

===LSD & SSRIs===

http://www.nature.com/npp/journal/v14/n6/full/1380431a.html

http://www.ncbi.nlm.nih.gov/pubmed/8726753

===DMT & Opioids===

http://www.ncbi.nlm.nih.gov/pubmed/3006089

===DMT & Tramadol===

http://www.ncbi.nlm.nih.gov/pubmed/3006089

===MDMA & GHB/GBL===

http://www.ncbi.nlm.nih.gov/pubmed/16234132

http://www.ncbi.nlm.nih.gov/pubmed/22554869

http://www.ncbi.nlm.nih.gov/pubmed/20730418

http://www.ncbi.nlm.nih.gov/pubmed/16483730

===DOx & Amphetamines===

http://www.ncbi.nlm.nih.gov/pubmed/1208759

===Ketamine & Caffeine===

http://onlinelibrary.wiley.com/doi/10.1111/j.1742-7843.2009.00382.x/full

===Ketamine & Alcohol===

http://onlinelibrary.wiley.com/doi/10.1002/jemt.22045/abstract

===Ketamine & GHB/GBL===

http://www.ncbi.nlm.nih.gov/pubmed/16483730

===Ketamine & Opioids===

http://www.ncbi.nlm.nih.gov/pubmed/21224020

===Tramadol & SSRIs===

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2714818/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750095/

===MXE & DXM===

http://i.imgur.com/zmqaw.jpg

http://www.sciencedirect.com/science/article/pii/S0014488607002543

===MXE & Amphetamines===

http://www.ncbi.nlm.nih.gov/pubmed/25060403

===DXM & PCP===

http://i.imgur.com/zmqaw.jpg

http://www.sciencedirect.com/science/article/pii/S0014488607002543

===PCP & SSRIs===

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1224745/

===Amphetamines & Benzodiazepines===

http://www.ncbi.nlm.nih.gov/pubmed/17320309

===MDMA & Caffeine===

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3492978/

http://link.springer.com/article/10.1007/s00213-010-1864-1

http://www.sciencedirect.com/science/article/pii/S0028390805003114

http://www.ncbi.nlm.nih.gov/pubmed/24211539

===MDMA & Alcohol===

http://www.ncbi.nlm.nih.gov/pubmed/21040238

http://www.ncbi.nlm.nih.gov/pubmed/21756931

===Cocaine & SSRIs===

http://www.ncbi.nlm.nih.gov/pubmed/23761390

http://www.ncbi.nlm.nih.gov/pubmed/20195220

===Caffeine & Alcohol===

http://www.ncbi.nlm.nih.gov/pubmed/20001110

===Caffeine & Tramadol===

http://www.ncbi.nlm.nih.gov/pubmed/20837047

===Caffeine & SSRIs===

http://journals.lww.com/jpharmacogenetics/abstract/1996/06000/a_fluvoxamine_caffeine_interaction_study.3.aspx

===Alcohol & GHB/GBL===

http://www.ncbi.nlm.nih.gov/pubmed/15274975

===Alcohol & SSRIs===

http://www.ncbi.nlm.nih.gov/pubmed/15739105

===GHB/GBL & Opioids===

http://www.ncbi.nlm.nih.gov/pubmed/7782758

===GHB/GBL & Tramadol===

http://www.ncbi.nlm.nih.gov/pubmed/7782758

===GHB/GBL & Benzodiazepines===

http://www.ncbi.nlm.nih.gov/pubmed/16483730

===GHB/GBL & MAOIs===

No study, but MAO B inhibitors should enhance the effects, no interaction with MAO A.

===Opioids & Benzodiazepines===

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3454351/

===Opioids & MAOIs===

http://www.ncbi.nlm.nih.gov/pubmed/17157368 (?)

http://www.ncbi.nlm.nih.gov/pubmed/2891392

http://www.if-pan.krakow.pl/pjp/pdf/2013/3_593.pdf

===Opioids & SSRIs===

http://www.ncbi.nlm.nih.gov/pubmed/23391344

http://www.ncbi.nlm.nih.gov/pubmed/20513454

http://www.ncbi.nlm.nih.gov/pubmed/16005413

http://www.ncbi.nlm.nih.gov/pubmed/18676387

http://www.ncbi.nlm.nih.gov/pubmed/17381671

===Tramadol & Benzodiazepines===

http://www.ncbi.nlm.nih.gov/pubmed/12842359

===Tramadol & MAOIs===

http://www.ncbi.nlm.nih.gov/pubmed/16051647

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750095/

===Benzodiazepines & SSRIs===

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446479/

http://www.ncbi.nlm.nih.gov/pubmed/9435993

===MAOIs & SSRIs===

http://www.ncbi.nlm.nih.gov/pubmed/24577320

[[Category:Guides]]

Mescaline

2015-10-02T20:56:49Z

GrimReaper:

[[File:Mescaline.jpg|thumb|200px|Mescaline vial and powder]]

'''Mescaline''' is a [[Psychedelics|psychedelic]] phenethylamine derived from several ancient species of cactus, which have been used ritualistically for thousands of years. It continues to be used for spiritual, religious and recreational purposes today.

== History ==

Mescaline is thought to be one of the oldest psychedelics used by humans, evidence suggesting Native Americans in Mexico consumed it ceremonially over 5700 years ago. However, it wasn't until 1919 that it was first synthesised by Ernst Spath. Eight years later, an extensive study of mescaline's effects was published in 'Der Meskalunraush', meaning 'The Mesacline High.' Then, in 1952 Dr. Humphry Osmond began working with psychedelics at the Weyburn Mental Hospital in Saskatchewan, Canada. Dr. Osmond was studying the similarities between Mescaline and the adrenaline molecule.

The following year, in 1953, Aldous Huxley consumed 400mg of mescaline under Dr. Osmond's direct supervision, recounting and publishing his first experience in the book The Doors of Perception in 1954. The Doors of Perception went on to catch the attention of many prominent psychedelic researchers and became one of the most referenced pieces of literature in the psychedelic community. The psychedelic rock band The Doors took its name from the title of the book.
Among the many researchers who took notice of Huxley's work was Alexander Shulgin, who went on to test mescaline on himself in 1960 at a 350mg dose. This experience sparked an interest in phenethylamines that persisted for the rest of his career as a chemist.[https://www.erowid.org/library/books_online/shulgin_labbooks/ Detailed in Shulgin's Lab Notebook #4 on page 471].

In 1961, Shulgin proposed the 'mescaline unit' (ED mescaline divided by ED analog) as a measure of relative potency of mescaline analogs. In this calculation the effective dose represents the average of ED1 and ED100 (ED50 or 'median effective dose'). The 'mescaline-unit' (M.U.) was used in studies of many psychoactive compounds by many prominent chemical researchers, including the U.S. Army Medical Research Institute of Chemical Defense. However, it is no longer used.

On October 27 of 1970, the Comprehensive Drug Abuse Prevention and Control Act was passed in the USA. Part II of this is the Controlled Substances Act (CSA), which defines a scheduling system for drugs. Under this act, mescaline, along with LSD, psilocybin, psylocin, peyote, cannabis and MDA were all listed under Schedule I.
In 1991, Alexander and Ann Shulgin first published their book called [https://www.erowid.org/library/books_online/pihkal/pihkal.shtml Phenethylamines I Have Known and Loved], a collection of years' worth of work documenting in detail the synthesis and subjective effects of over 250 phenethylamines, including mescaline. This book is now widely considered to be one of the single most important pieces of literature in the history of pharmacology and chemistry. However, because it provided detailed information on the synthesis of hundreds of drugs, the book also led to their widespread clandestine production and distribution in the years following its release.

== Usage ==

The drinking of teas made from mescaline containing cacti is one of the oldest known instances of psychedelic drug use. Europeans noted use of peyote in Native American religious ceremonies upon early contact, notably by the Huichols in Mexico. Other mescaline-containing cacti such as the San Pedro have a long history of use in South America, from Peru to Ecuador.

Mescaline was used by Native American cultures for spiritual purposes and usually were either consumed dried or in a tea. The nausea and vomiting associated with consuming the cactus itself was thought to be an inherent as well as important part of the experience. It was considered to have a cleansing effect on the mind and body.

In the 60s, mescaline along with [[LSD]] and several other psychedelics were researched for the treatment of select mental illnesses, notably alcoholism and depression.
In modern times, mescaline continues to be used recreationally - though is somewhat more uncommon than other psychedelics such as the [[2C-X]] series, which are very similar in effects, presumably due to its relatively low potency and difficulty in production.

== Dosage ==

{| class="wikitable"
|+ Oral
|-
| Threshold ||100mg
|-
| Light ||100-200 mg
|-
| Common ||200-300 mg
|-
| Strong ||300-500 mg
|-
| Heavy ||500-1000mg+
|}

== Duration ==

Note: Duration can be significantly longer with higher doses. Onset can vary, Avoid redosing.

{| class="wikitable"
|+ Oral
| Onset ||60-180+ Minutes
|-
| Duration ||6-12 Hours
|-
| After Effects || 3-5 Hours
|-
| Total ||10-20 Hours
|}

== Effects ==

Note: The prevalence of negative effects increases with higher doses.

=== Positive ===
* Feelings of interconnectedness
* Spiritual events
* Euphoria
* Increased sensitivity to touch
* Music enhancement

=== Neutral ===

* Altered thinking processes
* An altered sense of time and self-awareness
* Closed and open-eye visual phenomena
* Synesthesia (especially in conjunction with music)
* Peripheral stimulation
* Increased cardiovascular activity
* Increased Perspiration

=== Negative ===

* Nausea
* Vomiting
* Unwanted spiritual experiences
* Tension
* Anxiety
* Intense feelings of dread and doom

(Note: Nausea and vomiting are extremely common with mescaline, particularly when consumed in the form of a cactus tea. Simple A/B extraction techniques can be applied to mescaline containing cacti. Both the literature and anecdotal evidence suggest that nausea is less common with the pure salts of mescaline.)

== Harm Reduction ==

As with all psychedelic drugs, mescaline carries within it the potential for a very powerful experience, and as such has the potential to result a very difficult experience ('bad' trip). Mindset and setting play important roles in governing the nature of a psychedelic experience, among other things.

See [[Psychedelics#Harm_Reduction|Psychedelic Harm Reduction]] and [[How To Deal With A Bad Trip]] for more information.

=== Interactions ===

Due to the illicit nature of mescaline, little empirical data is available regarding its interaction profile. It's pharmacology however is fairly well understood and based on this it would not be advisable to mix mescaline with irreversible MAOIs and lithium. Always exercise extreme caution when mixing any medications or drugs that do not have well established interaction profiles.

There are a significant amount of anecdotal reports that involve mixing mescaline with reversible inhibitors of monoamine oxidase (RIMAs) both as extracted salts and ayahuasca style brews from harmaline/harmine containing plants. Caution is advised if one intends to attempt this. It can result in a significant alteration of the intensity and character of a mescaline trip. Note: Tyramine is a biosynthetic precursor of mescaline in some species of mescaline containing cacti. Harmful interactions between tyramine and irreversible MAOIs (such as isocarboxazid) are well established in medical literature so combining mescaline with this particular class of MAOI is strongly discouraged.

See the [[Drug combinations]] chart for more information.

== Chemistry and Pharmacology ==

=== Chemistry ===

3,4,5-Trimethoxybenzeneethanamine (also referred to as 3,4,5-trimethoxyphenethylamine) or mescaline freebase, is a white crystalline odorless solid at room temperature. Its chemical formula is C11H17NO3 and it is soluble in alcohol, chloroform, benzene, xylene, toluene, acetone, dichloromethane, highly soluble in isopropyl alcohol, soluble in d-limonene and moderately soluble in water. It is practically insoluble in ether or petroleum ether and has melting/boiling points of 35-36°C and 180°C (12 mmHg) respectively. The freebase has a molecular weight of 211.26.

Note: Mescaline freebase will form mescaline carbonate upon prolonged exposure with air.

The hydrochloric salt of mescaline is the most common form by far. It has a melting point of 184° C according to the Merck Index. It has the appearance of needle-like clear/whitish crystals and is moderately soluble in water, alcohol, methanol. (at least 1.0 mg/ml) (Merck Index) In contrast to the freebase it is practically insoluble in toluene and acetone, insoluble in isopropyl alcohol, diethyl ether, and d-limonene. The hydrochloric salt has a molecular weight of 247.72.
The second most common salt of mescaline seems to be the sulfate dihydrate. It also appears as a whitish crystaline solid, retaining the whitish color albeit somewhat brighter, but losing the needle like structure in favour of a more rock like appearance. It is soluble in hot water, methanol and insoluble in near freezing water, alcohol and acetone. The sulphate has a melting point of 183–186 °C and a molecular weight of 309.33606.

Many salts of mescaline are attainable and all have different physical properties and solubilty profiles. Here we cover the two most commonly explored salts. For some more information on the salts not covered here, check out the links section at the bottom of the page.

=== Pharmacology ===

Mescaline shares structural similarities with Serotonin and Dopamine. Mescaline acts similarly to other psychedelics by binding to and activating the serotonin 5-HT2A receptor with low affinity and high efficacy. Mescaline is also known to bind to and activate the serotonin 5-HT2C receptor.
Tolerance builds with repeated usage, lasting for a few days. Mescaline causes cross-tolerance with other serotonergic psychedelics such as LSD, psilocin and 2C-x compounds.

Some studies have concluded that mescaline goes through the body nearly unchanged. Six hours after dosing half of dose has been excreted and of between 20% and 50% of it is unchanged. The rest is the carboxylic acid, most likely degraded by MAO.

=== LD50 ===

The LD50 is unknown in humans. In experiments with rats, the LD50 for mescaline has been established in the range of 800-1200mg/kg orally. [https://www.erowid.org/chemicals/mescaline/mescaline_datasheet1.shtml See Mescaline MSDS via hazard.com]
Considering the human dose range is about 100-1000mg, it would be very difficult to consume enough Mescaline to kill a human. As such, there are no recorded human deaths from the ingestion of mescaline. With that said, caution is still advised when consuming high doses.

== Legal status ==

* In Australia, the peyote cacti and other mescaline-containing plants such as San Pedro are illegal in Western Australia, Queensland and the Norther Territory, whilst in other states such as Victoria and New South Wales, they are legal for ornamental and gardening purposes.
* In Canada, The Netherlands, and Germany, mescaline in raw form and dried mescaline-containing cacti are considered an illegal drug, however anyone may grow and use peyote, or Lophophora williamsii, along with Echinopsis Panchanoi and Echinopsis Peruviana without restriction, as it is specifically exempt from legislation. In Canada, mescaline is classified as a schedule III drug under the Controlled Drugs and Substances Act, whereas peyote is exempt.
* In the United Kingdom, mescaline in purified powder form is a Class A drug, however dried cactus can be bought and sold legally.
* In the United States, mescaline was made illegal in 1970 by the Comprehensive Drug Abuse Prevention and Control Act. The drug was prohibited internationally by the * 1971 Convention on Psychotropic Substances and is categorized as a Schedule I 'hallucinogen' by the CSA. Mescaline is legal only for certain groups (such as the Native American Church) and in scientific and medical research. The current state of the law is that while the federal government may not restrict use of peyote in ceremony, individual states do have a right to restrict its use/ Many states, including Utah have legalized peyote usage with 'sincere religious intent', or within a religious organization regardless of race.

== Links ==

* [https://www.erowid.org/chemicals/mescaline/mescaline_journal7.shtml Mescaline: The Chemistry and Pharmacology of its Analogs]
* [https://www.erowid.org/library/books_online/shulgin_labbooks/ Dr. Shulgin's Lab Notes]
* [https://www.erowid.org/library/books_online/pihkal/pihkal096.shtml PiHKAL Entry]
* [https://www.erowid.org/chemicals/mescaline/ Erowid Entry]
* [https://www.wikipedia.org/wiki/Mescaline Wikipedia Entry]
* [http://deepblue.lib.umich.edu/bitstream/handle/2027.42/33868/0000129.pdf?sequence=1 'Relationship of the Structure of Mescaline and Seven Analogs to Toxicity and Behavior of Five Species of Labratory Animals' (full text)]
* [https://wiki.dmt-nexus.me/Psychedelic_Compounds_Chemical_and_Physical_Properties#Freebase_Mescaline Physical and Chemical Properties of Various Mescaline Salts]

[[Category:Stimulant]]
[[Category:Psychedelic]]
[[Category:Drugs]]

File:Combo 2.png

2015-08-04T22:54:51Z

GrimReaper: GrimReaper uploaded a new version of "File:Combo 2.png"

Main Page

2015-05-25T22:23:28Z

GrimReaper:

{{DISPLAYTITLE:Welcome to TripSit Wiki!}}
<table style="display:block;" cellpadding=0>
<tr>
<td valign=top width=30% bgcolor=#f1f1f1>
== Drug Knowledge ==
*'''List of [[:Category:Drugs|Psychoactive Substances]]'''
*Main pages for drug classes:
**[[Psychedelics]]
**[[Dissociatives]]
**[[Stimulants]]
**[[Depressants]]
***[[Opioids]]
***[[Benzodiazepines]]
**[[Antidepressants]]
**[[Deliriants]]
**[[:Category:Ethnobotanical|Ethnobotanicals]]
**[[Research Chemicals]]

* [[Drug combinations]]
* [http://factsheet.tripsit.me/factsheet Factsheets]
* [[Glossary]]

== [[Guides]] ==

* [[Addiction]]
* [[Overdose]]
* [[Panic Attacks]]
* [[How To Deal With A Bad Trip]]
* [[Common Misconceptions About Psychedelics]]
* [[Quick Guide to Plugging]]
* [[Quick Guide to Stimulant Comedowns]]
* [[Quick Guide to Volumetric Dosing]]
* [[Cold Water Extraction]]

== Tripsitting ==
* [[How_To_Tripsit_Online|How to Tripsit online]]
* [[How_To_Tripsit_In_Real_Life|How to Tripsit in real life]]

== Harm Reduction Supplies & Testing ==
* [[Scales]]
* [[Test Kits]]
* [[Sources for Laboratory Analysis]]

</td>
<td valign=top width=30% bgcolor=#f1f1f1>
== [[:Category:Common Drugs|Common Drugs]] ==

* '''[[:Category:Psychedelic|Psychedelics]]'''
** [[Mushrooms]]
** [[DMT]]
** [[LSD]]
** [[LSA]]
** [[Mescaline]]
** [[2C-X|2C-X series]]
** [[NBOMes|NBOMe series]]
** [[DOx|DOx series]]
** [[AMT|αMT]]
** [[Cannabis]]

* '''[[:Category:Dissociative|Dissociatives]]'''
** [[PCP]]
** [[3-MeO-PCP]]
** [[Ketamine]]
** [[MXE]]
** [[DXM]]
** [[Diphenidine]]
** [[Salvia]]
** [[Nitrous Oxide]]

* '''[[:Category:Stimulant|Stimulants]]'''
** [[Adderall]]
** [[Amphetamine]]
** [[Methamphetamine]]
** [[MDMA]]
** [[MDA]]
** [[Mephedrone]]
** [[Cocaine]]
** [[Methylphenidate]]

* '''[[:Category:Depressant|Depressants]]'''
** [[Alcohol]]
** [[Etizolam]]
** [[GHB]]
** [[Kava]]
** [[Zolpidem]]

* '''[[:Category:Opioid|Opioids]]'''
** [[Kratom]]
** [[Morphine]]
** [[Heroin]]
** [[Codeine]]
** [[Tramadol]]
** [[Hydrocodone]]
** [[Oxycodone]]
** [[Buprenorphine]]
</td>

<td valign=top width=20%>
== Community ==
=== Important Pages ===
* [[TripSit Rules]]
* [[Network Terms of Service]]
* [[List of staff and their roles]]
* [[TripSit's Plans]]

=== IRC ===
* [[IRC_User_Guide|'''New user guide''']]
* [http://tripsit.me/tripsitapp/ Tripsit's portable IRC distribution]
* [[Channels]]
** [http://chat.tripsit.me/?nick=Social?#tripsit #tripsit]
** [http://chat.tripsit.me/?nick=Social?#home #home]
** [http://chat.tripsit.me/?nick=Social?#drugs #drugs]
* [[How_to_connect_through_Tor|How to Connect through Tor]]
* [[List of IRC bot commands]]
* Moderation [[Commands reference]]

=== TripRadio ===
* [http://radio.tripsit.me Listen Now]

* [[Radio|General info]]
* [[DJ Application|We need DJs!]]
* [[How to DJ|How to setup DJ software]]
</td>

</tr>
</table>

[[About|About Tripsit wiki]]

TripSit wiki currently has [[Special:Statistics|{{NUMBEROFPAGES}} pages]].

View a [[Special:AllPages|list of all pages]].

User talk:Laika

2015-05-12T22:18:06Z

GrimReaper: Welcome!

'''Welcome to ''TripSit wiki''!'''
We hope you will contribute much and well.
You will probably want to read the [[https://www.mediawiki.org/wiki/Special:MyLanguage/Help:Contents|help pages]].
Again, welcome and have fun! [[User:GrimReaper|GrimReaper]] ([[User talk:GrimReaper|talk]]) 22:18, 12 May 2015 (UTC)

User:Laika

2015-05-12T22:18:06Z

GrimReaper: Creating user page for new user.

I am a tripsitter on the network and my interest in pharmacology has helped me gain important harm reduction information regarding drug use. I'm always learning and I hope to help improve necessary content so that harm reduction information is accessible for people.

I am a computer science student on track to graduate in the summer of 2016, so I believe some of my programming knowledge can be useful.

I have worked two summers as a maintenance worker, chef, and camp counselor at a camp for inner-city Detroit (Michigan) children. This experience has helped me understand conflict resolution, managing panic in others, and community building.

Buprenorphine

2015-04-13T15:30:32Z

GrimReaper: /* Dosage */

[[File:Suboxone.jpg|350px|right]]

'''Buprenorphine''' is a semi-synthetic opioid derived from thebaine which is typically used for treatment of opioid addiction. It is an analgesic, and has gained notoriety for its ability to successfully interrupt severe opiate addictions. Buprenorphine has a higher affinity for μ-opioid receptors compared to full opioid agonists. Because of this, buprenorphine can block the effects of other opioid agonists in a dose-dependent fashion. By its dual effects of reducing craving and attenuating the response to administered heroin, buprenorphine reduces the self-administration of heroin. Methadone, a full opioid agonist, also reduces the impact of additional heroin, but the effect of methadone is primarily due to the induction of cross-tolerance which is dose dependent. In contrast buprenorphine achieves its effect primarily by prolonged occupancy of a high proportion of opioid receptors, blocking the action of heroin and other opioid receptor agonists.

== History ==

Addiction therapeutics arose within the historical context of efforts to develop a non-addicting analgesic that began in the United States in the early 1920s. Early 20th century efforts to respond to the “opium problem,” through regulation and control at the source of supply and to address public health concerns through innovation in the research laboratory set the stage for the gradual shift in researchers’ interests toward developing a treatment for addiction therapeutics.

The solution to the “opium problem” was first sought at the laboratory bench at a time when the United States was becoming a major player within the evolving international drug control framework. For such a narrowly tailored goal to be understood as meeting a broad social problem of unclear etimology, it had to be translated into a feasible research program. Reliable methods to test compounds in animals and human beings had to be developed and validated. In the CDA’s first decade, some 150 compounds were produced and evaluated; all but one - Metopon (5-methylhydromorphone) - demonstrated the elusiveness of the goal.

Methadone was introduced into the United States in 1947 by Eli Lilly and Company, however, researchers opposed using methadone for maintenance given the results of studies on former morphine and/or heroin addicts in the late 1940s indicating that the subjects expressed increased satisfaction as dosage increased. They concluded that “narcotic drug addicts would abuse methadone and would become habituated to it if it were freely available and not controlled”. They also noted that methadone “completely alleviated the morphine abstinence syndrome in man,” yet itself exhibited a mild abstinence syndrome.

In 1974, Congress became concerned with methadone diversion and amended the Controlled Substances Act (CSA), in 1970 to give DEA considerable powers despite the inception of the National Institute on Drug Abuse (NIDA) and sunset of SAODAP in 1973. Many clinicians came to view the methadone regulations as government interference with the practice of medicine. The restrictive climate had led SAODAP to prioritize development of narcotic antagonists.

Buprenorphine was discovered in 1966, at the research labs of a home products company, Reckitt & Colman (hereafter Reckitts), in Hull, England.

The story of the development of buprenorphine as an "addict treatment" began in 1975, when Lexington Addiction Research Center (ARC) scientist Jasinski countered growing opposition to using prisoners as clinical research subjects by arguing that many prisoners were addicts and the pharmacology of buprenorphine made it such an “attractive candidate" as a treatment for opiate dependence that its human abuse potential was in urgent need of study.

Jasinski singled out buprenorphine as having an “especially unique pharmacology in man” because it produced “very little physical dependence”, even with chronic administration. Citing his 1978 study, he speculated that buprenorphine “would not only have a therapeutic application as an analgesic of low abuse potential but also as a new type of drug treatment of narcotic addiction."

Jasinski heralded buprenorphine’s unique potential because it alone produced long-lasting “changes in feelings that are acceptable to addicts,” and was “less toxic than methadone,” declaring that the committee’s 50-year project to “potentially utilize narcotics therapeutically to both relieve pain and treat addiction without the production of physical dependence” had yielded buprenorphine, which “appears to have the advantage of both methadone and naltrexone but without the major disadvantage of each”.

In 1979, following the ban on use of federal prisoners as research subjects, NIDA had moved the ARC’s Clinical Research Program, now under the direction of Jasinski, to the medical campus of The Johns Hopkins University (JHU) in Baltimore, Maryland; the preclinical program followed in 1981. The JHU site was chosen partly because Baltimore provided a suitable source of research subjects: inner-city heroin addicts. Addiction researchers considered it unethical and unwise to carry out research involving addictive substances on people who were not or had not been addicted.

By 1985, injectable buprenorphine had been marketed for analgesic applications in 29 countries and the sublingual tablet in 16 countries. In the United Kingdom, Reckitts had launched injectable buprenorphine for severe pain in 1978,with the sublingual analgesic following in 1982. It licensed Norwich–Eaton to distribute buprenorphine hydrochloride (Buprenex) in the United States, where the analgesic was launched in 1985, after FDA approval.

The difficulties of coordinating public and private interests, local and global effects, changes in domestic regulatory mechanisms, and perceptions of addiction and its treatment charted buprenorphine’s tortuous, 30-year path to FDA approval and market. Buprenorphine arose as a maintenance therapy at a time when addicts - like other citizens - were expected to take personal responsibility for health and healthcare, and where such decisions were seen as individual matters of choice and political entitlement.

== Uses ==

Buprenorphine is usually sold in the form of sublingual tablets (Suboxone), or transdermal patches (Butrans). Patches can be attached to skin for long release as treatment for opioid withdrawal, or cut and chewed for recreational use. Usual (30 minutes) sub-lingual use of patches is not 100% effective, so patches can be re-used. Buprenorphine is water-soluble, and can be extracted with a [[Cold Water Extraction]] (takes more time, usually 24 hours, or around 4 hours with few drops of strong alcohol). Since buprenorphine is a long acting opioid antagonist, other opioids won't work for at least 36 hours after dosing buprenorphine (though some negative effects will be garnered).

Buprenorphine will cause withdrawal if you have an opioid tolerance and don't wait long enough (typically 48~ hours) before taking it.

Respiratory depression from buprenorphine (or buprenorphine/naloxone) overdose is less likely than from other opioids. There is no evidence of organ damage with chronic use of buprenorphine, although increases in liver enzymes are sometimes seen. Likewise, there is no evidence of significant disruption of cognitive or psychomotor performance with buprenorphine maintenance dosing.

== Dosage ==

Dosage is usually 2-3mg (assuming 100% effectiveness), and most users don't feel the need to take more. Ceiling effect is 16-32mg, and redosing is not effective.

600µg is considered equivalent to 10 mg morphine for pain relief.

{| class="wikitable"
|+ Sublingual
|-
| Light || 1-2mg
|-
| Common || 3-6mg
|-
| Strong || 6-8mg
|-
| Heavy || 8mg+
|-
| Ceiling || 16-32mg
|}

== Duration ==

{| class="wikitable"
|+ Sublingual
|-
| Onset || 30-60 minutes
|-
| Peak || 1-4 hours
|-
| Total (low dose) || 8-12 hours
|-
| Total (high dose) || 24-72 hours
|}

== Effects ==

Because of its ceiling effect and poor bio-availability, buprenorphine is safer in high doses compared to full opioid agonists. The maximal effects of buprenorphine appear to occur in the 16–32 mg dose range for sublingual tablets. Higher doses are unlikely to produce greater effects.

=== Positive ===

* Euphoria

* Sedation

* Pain relief

* Elevated mood

* Overall feeling of contentedness

=== Neutral ===

* Pupillary dilation

=== Negative ===

* Dysphoric mood

* Piloerection

* Nausea or vomiting

* Diarrhea

* Muscle aches/cramps

* Yawning

* Lacrimation

* Mild fever

* Rhinorrhea

* Insomnia

* Craving

* Sweating

* Distress/irritability

== Harm Reduction ==

Unlike methadone, the effect of buprenorphine on respiratory depression reaches a ceiling, therefore higher doses do not increase risk of respiratory depression to a significant degree.

However, if buprenorphine is used in combination with other central nervous system depressants, such as benzodiazepines and other CNS [[Depressants]], the combined effect on respiration can be life threatening.

=== Interactions ===

[[Drug Combinations]]

Combination of buprenorphine and SSRIs [http://www.ncbi.nlm.nih.gov/pubmed/18774063 can cause] Serotonin Syndrome.

== Chemistry and Pharmacology ==

Buprenorphine is a derivative of the opioid alkaloid thebaine that is a more potent (25 – 40 times) and longer lasting analgesic than morphine. It appears to act as a partial agonist at the μ- and κ-opioid receptors and as an antagonist at δ-opioid-receptors. The lack of δ-opioid agonism has been suggested to account for the observation that buprenorphine tolerance may not develop with chronic use.

Buprenorphine is metabolised by the liver, via CYP3A4 (also CYP2C8 seems to be involved) isozymes of the cytochrome P450 enzyme system, into norbuprenorphine (by N-dealkylation).

== Links ==

[https://en.wikipedia.org/wiki/Buprenorphine Wikipedia]

[https://erowid.org/pharms/buprenorphine/buprenorphine.shtml Erowid]

http://buprenorphine.samhsa.gov/about.html

[http://www.ncbi.nlm.nih.gov/pubmed/22256949 The history of the development of buprenorphine as an addiction therapeutic.]

http://www.nationaldrugstrategy.gov.au/internet/drugstrategy/publishing.nsf/content/9011C92D2F6E1FC5CA2575B4001353B6/$File/bupren1.pdf

[http://www.reddit.com/r/opiates/comments/1f3ak7/suboxone_faq/ /r/opiates Suboxone FAQ]

[[Category:Drugs]]

[[Category:Depressant]]

[[Category:Opioid]]

5-MeO-DMT

2015-04-03T17:52:08Z

GrimReaper: /* Effects */

[[File:Bufo-alvarius.jpg|250px|right]]
'''5-MeO-DMT''' was first discovered in ''Dictyoloma incanescens'' and later was isolated from ''Anadenanthera peregrina'' as well. It occurs in a very large number of plants, often in association with [[N,N-DMT]]. Its effects are somewhat more potent than those of N,N-DMT. When the two are administered simultaneously, 5-MeO-DMT more quickly occupies the specific receptors. 5-MeO-DMT is a natural neurotransmitter in the human nervous system. When 5-MeO-DMT (10 to 20 mg) is smoked or vaporized and inhaled, the effects are almost immediately apparent, are incredibly extreme, and last about ten minutes. Many people report having shamanic experiences with this substance as well as experiencing states of enlightenment and the clear light of nirvana (Metzner 1988). The Colorado River toad (''Bufo alvarius'') is native to the area around Tucson, Arizona. These toads spend nine months of the year underground, buried in the mud that keeps them protected from the burning desert sun. The toads emerge from their hiding places with the first rains and begin their courtship (Smith 1982,97-100). They remain visible for only three months. Like all toads, Bufo alvarius develops mucous secretions in two glands that are located on the neck The secretions of the Colorado River toad, however, do not contain bufotoxine, the toxic substance that is found in the secretions of most other toads. Instead, the dried mass contains 15% 5-MeO-DMT (Erspamer et al. 1965, 1967). The native tribes that lived in the North American Southwest made fetishes of this Bufo alvarius. However, it was only in recent times that the toad's cultural importance and its psychedelic use were discovered, or more likely rediscovered (cf. Davis and Weil 1992). The toad is "milked" by being held firmly without being crushed. Both glands are then massaged gently until a fat stream of the secretion squirts out. The secretion is caught on a piece of glass, where it is allowed to dry and crystallize. The yellowish crystalline mass then can be scraped off, mixed with different herbs (such as damiana [Turnera diffusa] ), and smoked. The toad, which is released unharmed, is quickly able to replenish the loss in its secretions. When taken orally, Bufo alvarius secretions are apparently toxic, whereas they are not poisonous when smoked (Weil and Davis 1994). Davis and Weil have suggested that the dried secretions of Bufo alvarius were traded to Mexico in preColumbian times and that the priests and shamans there smoked or used it in some other manner (Davis and Weil1992; cf. balche', bufotenine). In Arizona, there is now a Church of the Toad of Light, which uses the secretions of Bufo alvarius as a sacrament (Most 1984; Ott 1993,396*).

== Dosage ==
{| class="wikitable"
|+ Smoked/Vaporized
|-
| Light || 2-5 mg
|-
| Common || 5-10 mg
|-
| Strong || 10-20 mg
|}

{| class="wikitable"
|+ Insufflated
|-
| Light || 3-5 mg
|-
| Common || 5-10 mg
|-
| Strong || 8-15 mg
|}

== Duration ==

{| class="wikitable"
|+ Smoked/Vaporized
|-
| Onset || 0-1 minutes
|-
| Total || 5-15 hours
|-
| After-effects || 15-60 hours (dose-dependent)
|}

{| class="wikitable"
|+ Insufflated
|-
| Onset || 1-5 minutes
|-
| Total || 15-45 hours
|-
| After-effects || 1-3 hours (dose-dependent)
|}

== Effects ==
=== Postive ===

*Immersive experiences
*Profound life-changing spiritual experiences
*Occasional euphoria
*Sensual enhancement

=== Neutral ===

*Short Duration
*Abnormal vocalizations
*Dissociation
*Muscle jerking

=== Negative ===

*Fear
*Panic
*Overly-intense experiences
*Hard on the lungs to smoke

== Harm Reduction ==
=== Interactions ===
Check out our [[Drug Combinations]] page and chart for interactions and combinations of common drugs.

== Chemistry and Pharmacology ==

=== LD50 ===
115 mg/kg in mice

== Links ==
[https://www.erowid.org/chemicals/5meo_dmt/5meo_dmt.shtml Erowid]

[http://en.wikipedia.org/wiki/5-MeO-DMT Wikipedia]

[[Category:Drugs]]
[[Category:Psychedelic]]
[[Category:Research Chemical]]

5-MeO-DMT

2015-04-03T17:51:54Z

GrimReaper:

[[File:Bufo-alvarius.jpg|250px|right]]
'''5-MeO-DMT''' was first discovered in ''Dictyoloma incanescens'' and later was isolated from ''Anadenanthera peregrina'' as well. It occurs in a very large number of plants, often in association with [[N,N-DMT]]. Its effects are somewhat more potent than those of N,N-DMT. When the two are administered simultaneously, 5-MeO-DMT more quickly occupies the specific receptors. 5-MeO-DMT is a natural neurotransmitter in the human nervous system. When 5-MeO-DMT (10 to 20 mg) is smoked or vaporized and inhaled, the effects are almost immediately apparent, are incredibly extreme, and last about ten minutes. Many people report having shamanic experiences with this substance as well as experiencing states of enlightenment and the clear light of nirvana (Metzner 1988). The Colorado River toad (''Bufo alvarius'') is native to the area around Tucson, Arizona. These toads spend nine months of the year underground, buried in the mud that keeps them protected from the burning desert sun. The toads emerge from their hiding places with the first rains and begin their courtship (Smith 1982,97-100). They remain visible for only three months. Like all toads, Bufo alvarius develops mucous secretions in two glands that are located on the neck The secretions of the Colorado River toad, however, do not contain bufotoxine, the toxic substance that is found in the secretions of most other toads. Instead, the dried mass contains 15% 5-MeO-DMT (Erspamer et al. 1965, 1967). The native tribes that lived in the North American Southwest made fetishes of this Bufo alvarius. However, it was only in recent times that the toad's cultural importance and its psychedelic use were discovered, or more likely rediscovered (cf. Davis and Weil 1992). The toad is "milked" by being held firmly without being crushed. Both glands are then massaged gently until a fat stream of the secretion squirts out. The secretion is caught on a piece of glass, where it is allowed to dry and crystallize. The yellowish crystalline mass then can be scraped off, mixed with different herbs (such as damiana [Turnera diffusa] ), and smoked. The toad, which is released unharmed, is quickly able to replenish the loss in its secretions. When taken orally, Bufo alvarius secretions are apparently toxic, whereas they are not poisonous when smoked (Weil and Davis 1994). Davis and Weil have suggested that the dried secretions of Bufo alvarius were traded to Mexico in preColumbian times and that the priests and shamans there smoked or used it in some other manner (Davis and Weil1992; cf. balche', bufotenine). In Arizona, there is now a Church of the Toad of Light, which uses the secretions of Bufo alvarius as a sacrament (Most 1984; Ott 1993,396*).

== Dosage ==
{| class="wikitable"
|+ Smoked/Vaporized
|-
| Light || 2-5 mg
|-
| Common || 5-10 mg
|-
| Strong || 10-20 mg
|}

{| class="wikitable"
|+ Insufflated
|-
| Light || 3-5 mg
|-
| Common || 5-10 mg
|-
| Strong || 8-15 mg
|}

== Duration ==

{| class="wikitable"
|+ Smoked/Vaporized
|-
| Onset || 0-1 minutes
|-
| Total || 5-15 hours
|-
| After-effects || 15-60 hours (dose-dependent)
|}

{| class="wikitable"
|+ Insufflated
|-
| Onset || 1-5 minutes
|-
| Total || 15-45 hours
|-
| After-effects || 1-3 hours (dose-dependent)
|}

== Effects ==

=== Postive ===

*Immersive experiences
*Profound life-changing spiritual experiences
*Occasional euphoria
*Sensual enhancement

=== Neutral ===

*Short Duration
*Abnormal vocalizations
*Dissociation
*Muscle jerking

=== Negative ===

*Fear
*Panic
*Overly-intense experiences
*Hard on the lungs to smoke

== Harm Reduction ==
=== Interactions ===
Check out our [[Drug Combinations]] page and chart for interactions and combinations of common drugs.

== Chemistry and Pharmacology ==

=== LD50 ===
115 mg/kg in mice

== Links ==
[https://www.erowid.org/chemicals/5meo_dmt/5meo_dmt.shtml Erowid]

[http://en.wikipedia.org/wiki/5-MeO-DMT Wikipedia]

[[Category:Drugs]]
[[Category:Psychedelic]]
[[Category:Research Chemical]]

5-MeO-DMT

2015-04-03T17:51:30Z

GrimReaper:

[[File:Bufo-alvarius.jpg|250px|right]]
'''5-MeO-DMT''' was first discovered in ''Dictyoloma incanescens'' and later was isolated from ''Anadenanthera peregrina'' as well. It occurs in a very large number of plants, often in association with [[N,N-DMT]]. Its effects are somewhat more potent than those of N,N-DMT. When the two are administered simultaneously, 5-MeO-DMT more quickly occupies the specific receptors. 5-MeO-DMT is a natural neurotransmitter in the human nervous system. When 5-MeO-DMT (10 to 20 mg) is smoked or vaporized and inhaled, the effects are almost immediately apparent, are incredibly extreme, and last about ten minutes. Many people report having shamanic experiences with this substance as well as experiencing states of enlightenment and the clear light of nirvana (Metzner 1988). The Colorado River toad (''Bufo alvarius'') is native to the area around Tucson, Arizona. These toads spend nine months of the year underground, buried in the mud that keeps them protected from the burning desert sun. The toads emerge from their hiding places with the first rains and begin their courtship (Smith 1982,97-100). They remain visible for only three months. Like all toads, Bufo alvarius develops mucous secretions in two glands that are located on the neck The secretions of the Colorado River toad, however, do not contain bufotoxine, the toxic substance that is found in the secretions of most other toads. Instead, the dried mass contains 15% 5-MeO-DMT (Erspamer et al. 1965, 1967). The native tribes that lived in the North American Southwest made fetishes of this Bufo alvarius. However, it was only in recent times that the toad's cultural importance and its psychedelic use were discovered, or more likely rediscovered (cf. Davis and Weil 1992). The toad is "milked" by being held firmly without being crushed. Both glands are then massaged gently until a fat stream of the secretion squirts out. The secretion is caught on a piece of glass, where it is allowed to dry and crystallize. The yellowish crystalline mass then can be scraped off, mixed with different herbs (such as damiana [Turnera diffusa] ), and smoked. The toad, which is released unharmed, is quickly able to replenish the loss in its secretions. When taken orally, Bufo alvarius secretions are apparently toxic, whereas they are not poisonous when smoked (Weil and Davis 1994). Davis and Weil have suggested that the dried secretions of Bufo alvarius were traded to Mexico in preColumbian times and that the priests and shamans there smoked or used it in some other manner (Davis and Weil1992; cf. balche', bufotenine). In Arizona, there is now a Church of the Toad of Light, which uses the secretions of Bufo alvarius as a sacrament (Most 1984; Ott 1993,396*).

== Dosage ==
{| class="wikitable"
|+ Smoked/Vaporized
|-
| Light || 2-5 mg
|-
| Common || 5-10 mg
|-
| Strong || 10-20 mg
|}

{| class="wikitable"
|+ Insufflated
|-
| Light || 3-5 mg
|-
| Common || 5-10 mg
|-
| Strong || 8-15 mg
|}

== Duration ==

{| class="wikitable"
|+ Smoked/Vaporized
|-
| Onset || 0-1 minutes
|-
| Total || 5-15 hours
|-
| After-effects || 15-60 hours (dose-dependent)
|}

{| class="wikitable"
|+ Insufflated
|-
| Onset || 1-5 minutes
|-
| Total || 15-45 hours
|-
| After-effects || 1-3 hours (dose-dependent)
|}

== Effects ==

=== Postive ===

*Immersive experiences
*Profound life-changing spiritual experiences
*Occasional euphoria
*Sensual enhancement

=== Neutral ===

*Short Duration
*Abnormal vocalizations
*Dissociation
*Muscle jerking

=== Negative ===

*Fear
*Panic
*Overly-intense experiences
*Hard on the lungs to smoke

== Images ==
<gallery>
File:Example.jpg| ''Example image 1''
File:Example.jpg| ''Example image with link: [[TripSit Rules]]''
</gallery>

== Harm Reduction ==
=== Interactions ===
Check out our [[Drug Combinations]] page and chart for interactions and combinations of common drugs.

== Chemistry and Pharmacology ==

=== LD50 ===
115 mg/kg in mice

== Links ==
[https://www.erowid.org/chemicals/5meo_dmt/5meo_dmt.shtml Erowid]

[http://en.wikipedia.org/wiki/5-MeO-DMT Wikipedia]

[[Category:Drugs]]
[[Category:Psychedelic]]
[[Category:Research Chemical]]

File:Bufo-alvarius.jpg

2015-04-03T17:51:04Z

GrimReaper:

5-MeO-DMT

2015-04-03T17:48:34Z

GrimReaper:

[[File:Example.jpg|thumb|250px|right]]
'''5-MeO-DMT''' was first discovered in ''Dictyoloma incanescens'' and later was isolated from ''Anadenanthera peregrina'' as well. It occurs in a very large number of plants, often in association with [[N,N-DMT]]. Its effects are somewhat more potent than those of N,N-DMT. When the two are administered simultaneously, 5-MeO-DMT more quickly occupies the specific receptors. 5-MeO-DMT is a natural neurotransmitter in the human nervous system. When 5-MeO-DMT (10 to 20 mg) is smoked or vaporized and inhaled, the effects are almost immediately apparent, are incredibly extreme, and last about ten minutes. Many people report having shamanic experiences with this substance as well as experiencing states of enlightenment and the clear light of nirvana (Metzner 1988). The Colorado River toad (''Bufo alvarius'') is native to the area around Tucson, Arizona. These toads spend nine months of the year underground, buried in the mud that keeps them protected from the burning desert sun. The toads emerge from their hiding places with the first rains and begin their courtship (Smith 1982,97-100). They remain visible for only three months. Like all toads, Bufo alvarius develops mucous secretions in two glands that are located on the neck The secretions of the Colorado River toad, however, do not contain bufotoxine, the toxic substance that is found in the secretions of most other toads. Instead, the dried mass contains 15% 5-MeO-DMT (Erspamer et al. 1965, 1967). The native tribes that lived in the North American Southwest made fetishes of this Bufo alvarius. However, it was only in recent times that the toad's cultural importance and its psychedelic use were discovered, or more likely rediscovered (cf. Davis and Weil 1992). The toad is "milked" by being held firmly without being crushed. Both glands are then massaged gently until a fat stream of the secretion squirts out. The secretion is caught on a piece of glass, where it is allowed to dry and crystallize. The yellowish crystalline mass then can be scraped off, mixed with different herbs (such as damiana [Turnera diffusa] ), and smoked. The toad, which is released unharmed, is quickly able to replenish the loss in its secretions. When taken orally, Bufo alvarius secretions are apparently toxic, whereas they are not poisonous when smoked (Weil and Davis 1994). Davis and Weil have suggested that the dried secretions of Bufo alvarius were traded to Mexico in preColumbian times and that the priests and shamans there smoked or used it in some other manner (Davis and Weil1992; cf. balche', bufotenine). In Arizona, there is now a Church of the Toad of Light, which uses the secretions of Bufo alvarius as a sacrament (Most 1984; Ott 1993,396*).

== Dosage ==
{| class="wikitable"
|+ Smoked/Vaporized
|-
| Light || 2-5 mg
|-
| Common || 5-10 mg
|-
| Strong || 10-20 mg
|}

{| class="wikitable"
|+ Insufflated
|-
| Light || 3-5 mg
|-
| Common || 5-10 mg
|-
| Strong || 8-15 mg
|}

== Duration ==

{| class="wikitable"
|+ Smoked/Vaporized
|-
| Onset || 0-1 minutes
|-
| Total || 5-15 hours
|-
| After-effects || 15-60 hours (dose-dependent)
|}

{| class="wikitable"
|+ Insufflated
|-
| Onset || 1-5 minutes
|-
| Total || 15-45 hours
|-
| After-effects || 1-3 hours (dose-dependent)
|}

== Effects ==

=== Postive ===

*Immersive experiences
*Profound life-changing spiritual experiences
*Occasional euphoria
*Sensual enhancement

=== Neutral ===

*Short Duration
*Abnormal vocalizations
*Dissociation
*Muscle jerking

=== Negative ===

*Fear
*Panic
*Overly-intense experiences
*Hard on the lungs to smoke

== Images ==
<gallery>
File:Example.jpg| ''Example image 1''
File:Example.jpg| ''Example image with link: [[TripSit Rules]]''
</gallery>

== Harm Reduction ==
=== Interactions ===
Check out our [[Drug Combinations]] page and chart for interactions and combinations of common drugs.

== Chemistry and Pharmacology ==

=== LD50 ===
115 mg/kg in mice

== Links ==
[https://www.erowid.org/chemicals/5meo_dmt/5meo_dmt.shtml Erowid]

[http://en.wikipedia.org/wiki/5-MeO-DMT Wikipedia]

[[Category:Drugs]]
[[Category:Psychedelic]]
[[Category:Research Chemical]]

DXM

2015-03-31T21:23:45Z

GrimReaper: /* Second Plateau */

[[File:Romilarad.jpg|thumb|right|200px|Romilar 1968 Ad]]

'''Dextromethorphan''' (also known as 'DXM', 'DM' or 'robo') is an over-the-counter antitussive (cough treatment) which when taken at doses exceeding the recommended therapeutic range becomes a powerful [[Dissociatives|dissociative]] drug which also has some psychedelic properties.

While DXM can be used safely it is not an inherently safe drug. Repeated use within a short period of time, combination with certain types of drugs, certain genetic factors and the prevalence of other active ingredients which become harmful at needed doses found in many brands of cough medication make for a chemical which must be used with caution.

The high is not for everyone; it is said to loosely follow the rule of thirds: one third hates it, one third doesn't care, and one third like it. It should not be underestimated as a hallucinogenic, at higher dosages mimic high doses of ketamine but with more psychedelic properties.

DXM manifests its effects in a series of plateaus, with dose determining which plateau (and subsequently which effects) one will experience. Lower dose plateaus can be well suited to relaxation, light social interaction and listening to music, however higher doses result in a more encompassing dissociative experience which does not lend itself to attentive presence. At high doses it's common to have strong hallucinations, experiences of detachment, depersonalization, and out-of-body experiences. These all-encompassing states are startling and uncomfortable for some.

It's mechanism of action is via multiple effects, including actions as a nonselective serotonin reuptake inhibitor and a sigma-1 receptor agonist. DXM and it's major metabolite, dextrorphan, also act as an NMDA receptor antagonist at high doses, which produces effects similar to, yet distinct from, the dissociative states created by other dissociative anaesthetics such as [[Ketamine]] and [[PCP]].

DXM does not typically show up in normal drug tests however it can produce false positive results for PCP and/or Opioids in extended or specialized drug tests. Proper occasional use should not produce these false-positive results after a couple days have passed.

== History ==

The racemic parent compound racemorphan was first described in a Swiss and US patent application from Hoffmann-La Roche in 1946 and 1947, respectively; a patent was granted in 1950. A resolution of the two isomers of racemorphan with tartaric acid was published in 1952, and DXM was successfully tested in 1954 as part of US Navy and CIA-funded research on nonaddictive substitutes for codeine.

The FDA approved DXM in 1958 after research supported its legitimacy and effectiveness as a cough suppressant. After its approval, it was introduced as an OTC medication under the name Romilar, which was introduced as a replacement for codeine containing cough remedies in an effort to cut down on abuse. In early 1960s Beat poets Allen Ginsberg and Peter Orlovsky, musicians such as Daevid Allen Soft Machine, and alternative authors such as Jack Kerouac known to have used DXM in the form of Romilar. In 1973, Romilar was taken off the shelves after a burst in sales because of frequent misuse, and was replaced by cough syrup in an attempt to cut down on abuse. In 1975, the popularity and extensive abuse of DXM was recognized, and Romilar was removed from the OTC market. However, DXM was specifically excluded from the Controlled Substances Act (CSA) of 1970, therefore, it was still legal to produce and use.

A few years after its removal from OTC, companies began introducing refined DXM products (e.g., Robitussin, Vicks-44, Dextrotussion) that were designed to limit recreational use by creating an unpleasant taste if consumed in large quantities. Within a short time those same manufactures began to produce forms of DXM with "some appealing flavoring," which led at least one researcher to suggest that the cycle of recreational abuse may be repeated. In 1996, DXM HBr powder could be purchased in bulk from online retailers, allowing users to avoid consuming DXM in syrup preparations.

== Different Forms ==

DXM is widely available in over-the-counter cough treatments which appear in different forms including gelcaps, lozenges and syrups. DXM is also less commonly found in a more pure form, either extracted or bought directly from a chemical manufacturer.

While there are some products available which contain only DXM as active medical ingredients it is common to find products which contain DXM but also contain enough of another active ingredient to pose a serious risk to the user's health.

=== Extracted ===

The ideal source of DXM would be an extraction, but that requires time and a chemical procedure which most people are not equipped to do. It's not a complicated process however it does carry some risks in itself. There is a technique known as the 'Agent Lemon extraction'.

===Gel Caps===

DXM Gelcaps such as RobitussinDM Gelcaps or other no-name brand products containing only DXM encased in a gelcap are often the preferred source for DXM users. For most users gelcaps which contain only DXM produce a more clear headed high in lower doses. Most users experience fewer side effects from gelcaps than from syrup however some users report an upset stomach from the gelcaps, indicating that some users may have a sensitivity to the edible plastics used to make the gelcaps.

===Lozenges===

There are also sore-throat and cough medications containing DXM which exist in the form of a hard-candy like lozenge. These sometimes contain only DXM, however most brands of DXM lozenges also contain analgesics such as acetaminophen or benzocaine. Some brands such as '''Cordicin Cough and Cold''' (also known as '''CCC''') have a variety of products, most of which contain other active ingredients such as antihistamines or CPM (Chlorpheniramine Maleate) and may have one or two products which contain only DXM.

'''WARNING''': Cordicin Cough & Cold is one of the most commonly used sources of DXM, and also one of the most dangerous. Nearly every single CCC product contains other active ingredients such as CPM, which can cause severe and life-threatening symptoms including seizures, shortness of breath or troubled breathing, weakness, loss of consciousness, severe dryness of the mouth, nose or throat, bleeding from the skin, mouth, eyes, rectum and vagina, and possibly death.

https://www.erowid.org/chemicals/dxm/dxm_info2.shtml

As always when using lozenges always choose a product which only has DXM in it.

=== Syrup ===

Cough syrup is the most common source for DXM users. While there are many brand name and no-name syrups which only contain DXM as an active ingredient there are many active and "inactive" ingredients commonly found in cough syrups which can cause negative effects ranging in severity. See [[DXM#HarmReduction|Harm Reduction]] for more information.

Some say the high produced from syrup is mostly sedating. You may feel sluggish when using it to get high on DXM, possibly as a result of other ingredients found in syrup however because of the even dispersion of DXM throughout the syrup it is said to produce a more 'solid' trip.

===Delsym===

Delsym is brand with many formulations which contain Dextromethorphan Polistrex.

This is an extended release form of DXM which produced a longer lasting trip with weaker effects. It is said to be very difficult to reach the third plateau using DXM which may be preferable for this reason to beginners or users who would prefer a longer and weaker trip.

== Dosage ==

The dosage below refers to an "average" 180lbs / 80kg person taking DXM HBR. Before dosing it's important to note a few things:

* HBR and Polistirex doses vary significantly due to polistirex slow absorbsion rate (1mg of DXM polistirex is equivalent to about 6mg DXM HBR).

* '''DXM doses are affected by weight'''. For more accurate dosage information, see the following resources:

* For a graphical chart of the dosage ranges [http://taimapedia.org/images/4/46/DXMDosingChart.png this chart] is helpful.

* For an easy calculator that does the math for you, [http://dxm.darkridge.com/calc.html this page] can be helpful.

'''Before dosing, be sure to read the Plateaus section to know which level you want to dose for.'''

{| class="wikitable"

|+ Plateau range dosage for a 80kg (180lb) person.

|-

| First || 122-200mg

|-

| Second || 200-600mg

|-

| Third || 600-1200mg

|-

| Fourth || 1200-1600mg

|-

| Risk of death || 2.2g+

|}

== Duration ==

{| class="wikitable"

|+ Oral HBR

|-

| Total || 6-8 hours

|}

{| class="wikitable"

|+ Oral Polistirex

|-

| Total || 8-12 hours

|}

=== Redosing ===

Redosing is not advised.

It's better to know how much you've taken at the start of the trip, rather than guestimate how much you're on as you keep dosing. The effects will start to come in waves and may not be pleasant. If you feel the need, it's recommended to take a high initial dose and a lower dose 1-2 hours in.

=== Predosing ===

One should make sure there is only DXM in the product they are taking. Grapefruit juice can potentiate dxm due to intactions with cytochrome P450.<ref>http://medicine.iupui.edu/clinpharm/ddis/2d6references/#dextromethorphanSub</ref>

== Effects ==

The high is not for everyone; it is said to loosely follow the rule of thirds: one third hates it, one third doesn't care, and one third like it.

=== Positive ===

* Euphoria, mood lift

* Increased giggling and laughing

* Dissociation of mind from body (positive when sought)

* Creative dream-like experiences

* Increased tactile sensation

* Some users report empathy and forgiveness towards other people

=== Neutral ===

* Pupil dilation

* Visual stop motion effect (flanging or strobing)

* Visual and aural (auditory) hallucinations

* Decreased sexual functioning (difficulty achieving orgasm)

* Confusion, disorientation

* Skin sensitivity, alters tactile (touch) and skin sensations

* Robotic, zombie-like walking, "robo-walk"

* Discoordination, reduced agility

* Loss of appetite

* Involuntary flexing of muscles

* Feelings of merging with adjacent objects like a couch or bed (with higher doses)

=== Negative ===

* Vomiting

* Dizzyness

* Body itching

* Rash, red blotchy skin

* Diarrhea

* Fever

* Tachycardia (racing, pounding heart)

* Some users report feeling disconnected, isolated from others

=== After-Effects ===

Some users report hangover or depression that might last up to a few days.

=== Robo-Walk ===

The robo-walk feels like all of the muscles in your body are activated at once and while strange to the observer is not painful to the individual. You can still walk but detailed coordination such as running, jumping, or maneuvering around furniture becomes much harder if not impossible. However, when you you start getting the effects of robo-walk, you really wouldn't want to be moving around anyway. The best thing to do is get a good pair of headphones, turn off the lights, close your eyes and let your mind wander.

== Plateaus ==

There are various 'stages' to DXM trips called ''plateaus''. Traditionally, there are only four plateaus that someone should try to aim for. All of them share general feelings of dissociation, but the strength and effects of these feelings are more pronounced in the later two plateaus.

There are two plateaus are commonly associated with a mix of being high on THC and drunk on alcohol. If you take a first or second plateau dose, it's totally possible to socialize. Lower plateau doses are relatively easy to hide compared to higher plateau doses and talking with others becomes a lot easier while under the influence of DXM. It would also be fun to chill in your room alone and do whatever you normally do for fun, but it's suggested to try something that will take up most of your attention but allow your mind to wander at the same time. Something like playing a casual video game, or drawing whatever comes to mind.

If you take a third or fourth plateau dose, it's recommend to trip alone or with a close friend, as it's not a social drug at this dose. The best way to enjoy it is to lay back and listen to music with your eyes closed.

Choosing your destination plateau will depend a lot on what other drugs you've done and how comfortable you are with your mind. People who have never tried any hallucinogen other than THC should start at First, while everyone else could start at Second. '''It is not advised to start at the third or fourth''' unless you have extensive experience with other dissociatives.

=== First Plateau ===

The first plateau is the lightest in effect. It feels a bit 'off', and is often likened to something of a cross between the effects of [[MDA]] and Alcohol. First plateau is usually slightly stimulating.

Effects commonly experienced at the first plateau level

* A shift in thinking perspective; things look and feel 'different'

* Increased tactile sensation

* Increased appreciation of music

* Feeling heavy, sensation of increased body weight

* Enhanced emotional response & sensitivity

* Some dizziness or vertigo

'''First Plateau dose: 1-2mg/lb.'''

=== Second Plateau ===

This pleatau is a bit more intense. You may feel like your stoned and movement may become difficult. The second is supposed to be fun and disorienting. Music is awesome to listen to and you can walk outside and perhaps hallucinate a small-mild amount. You can socialize with friends and you could say you're slightly drunk.

'''Second Plateau dose: 2-5mg/lb.'''

'''Transitional'''

Most people stop their DXM journey here, as the final two plateaus are not really 'fun' but 'enlightening'. We don't recommend crossing this threshold until you're ready to move on from games of the mind to exercises of the consciousness. Enjoy the 2nd plat as long as you can because it's more of a fun experience and there is no going back once you've been past it. "Once you see what's behind the curtain, you can't enjoy the show" so they say.

=== Third Plateau ===

Third plateau is a full on dissociative experience. You cannot ignore the feeling inside of you and at this point its no longer a social drug and should be done by yourself or with a sitter. The third plateau isn't 'party-mode' or even 'socialize-mode'. Its more like 'alone-and-tripping-mode'. This is most akin to a "k-hole" that people experience after taking large amounts of ketamine. A lot of dissociation happens at this level, and the internal thoughts can be quite interesting. Using CEV's, DXM users have been known to have extremely vivid, controllable hallucinations and out of body experiences.

'''Third Plateau dose: 5-7.5mg/lb.'''

=== Fourth Plateau ===

This is the deep meditative state. Few people enjoy going this far, as all you can really do (or want to do) is sit, listen to music, close your eyes, and become a god. You can create universes in your mind just by thinking of them.

'''Fourth Plateau dose: 7.5-10mg/lb.'''

=== Fifth Plateau ===
Increasing the dosage above forth plateau will lead to level that some people refer to as Sigma Plateau. Keep in mind that this is dangerous, and very unpleasant most of the time, so TripSit is discouraging it.

== Harm Reduction ==

See [[Dissociatives#Harm_Reduction|Dissociative Harm Reduction]] for general information.

=== Dangerous Ingredients Commonly Used in DXM Products ===

Many products which contain DXM also contain other medication or otherwise non-medically-active ingredients that can cause serious harm in the doses found in DXM containing products. If a user intends to use an OTC cough medication in order to get high on DXM they almost always will have to consume a dangerous quantity of other dangerous ingredients if they are present in the medication. For this reason it is strongly recommended to find a source which contains /only/ DXM.

The following is a summary of other ingredients commonly found in DXM products.

* : Acetaminophen/Paracetamol/APAP is a painkiller commonly found in over the counter flu medication, and is used in many Tylenol and Panadol brand products.

: Acetaminophen/paracetamol/APAP is hepatoxic in high doses. This means it will damage your liver if taken in high doses.

:: Your body can only process a certain amount of APAP at once before it the normal pathways become saturated.

:: Once the regular pathways used for metabolizing APAP have been saturated the remaining APAP gets broken down in the liver by an enzyme called

:: cytochrome P450. ::: '''When forced to break down APAP this enzyme produces toxic metabolites!'''

The effects of an acetaminophen overdose may not be apparent for up to sixteen hours after the user has ingested the APAP! This makes APAP overdose even more dangerous because of the chance that a user might take more or not take notice after thinking they are 'in the clear'.

'''Under no circumstances should anyone attempt to use any DXM product containing 'Paracetamol', also known as 'APAP' & 'Acetaminophen'!'''

* '''Guaifenesin''' is an expectorant. It works by causing the lungs to produce more fluid, making it easier to cough up phlegm.

: Guaifenesin is added to many OTC cough, cold and flu medications to help treat the 'stuffed up' feeling which often found in viruses and colds.

: Guaifenesin overdoses cause severe nausea and vomiting in most users. Some users report being able to use products which contain some guaifensin and

: other users report no negative effects from guaifenesin containing products.

: '''It is strongly recommended to avoid products which contain Guaifenesin when using DXM!'''

* '''Antihistamines''' such as '''[[DPH|Diphenhydramine]]''' are often found in sleep-aids, night-time formulations of cold medications and allergy medications.

: Antihistamines are sometimes found with DXM in night or 'PM' versions of products, and should generally be avoided when using DXM. When taken in

: high doses antihistamines can cause dizzyness, nausea, a strong dysphoria, paranoia, delirium and hallucinations. Many antihistamines, OTC or prescription

: can also have a dangerous synergy with some of the effects produced by DXM.

* '''Food Coloring & other "Inactive" Ingredients'''

: Many DXM products contain dyes which can cause allergic reactions in some users. Usually these dyes are not harmful in low doses however in doses which may be

: required for DXM's effects they can become problematic. '''Tartrazine (FD&C Yellow #5)''' is one of the most notable coloring ingredients to cause reactions.

: Cough syrups usually contain one or more chemical used to make them taste sweet.

: '''Glucose, sucrose, invert sugar, and fructose''' are commonly used sweetening agents. These sweeteners pose an obvious risk to people with blood sugar conditions

: such as diabetes or hypoglycemia.

: Thickening agents such as '''propylene glycol''' or '''polyethylene glycol''' are found in most cough syrups. These are not toxic but may cause an upset stomach

: when consumed in large doses.

=== Interactions ===

DXM has several potentially dangerous interactions with pharmaceutical and recreational drugs including some analgesics (painkillers), antihistamines, antidepressants and stimulants.

DXM has the potential to cause [[Serotonin Syndrome]] if mixed with other serotonergic drugs such as [[Antidepressants|antidepressants]], MAOIs, empathogens which affect serotonin release such as [[MDMA]], [[MDA]], [[Mephedrone]], etc. Serotonin Syndrome causes discomfort, excitability, irritability, and can be deadly <ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464814/</ref> if not treated.

* See [[Drug_Combinations|Drug combinations]] and [[Dissociatives#Interactions|Dissociative Interactions]] for more information.

== Chemistry and Pharmacology ==

IUPAC:(4bS,8aR,9S)-3-Methoxy-11-methyl-6,7,8,8a,9,10-hexahydro-5H-9,4b-(epiminoethano)phenanthrene.

Dextromethorphan is the dextrorotartory enantiomer of levomethophan, which is the methyl ether of levophanol, both opioid analgesics.

=== Pharmacodynamics ===

{| class="wikitable"

|+ Binding receptors

|-

| NMDA - 7253

|-

| SERT - 2015

|-

| NET - 110606

|-

| Sigma-1 - 23

|-

| Sigma-2 - 240

|}

=== Pharmacokinectics ===

Following oral dosing, DXM is rapidly absorbed from the GI tract. Where it enters the bloodstream, and crosses the blood-brain barrier.

At therapeutic doses, DXM acts centrally (brain) as opposed to locally (Respiratory tract). It's rapidly absorbed from the GI tract into the active metabolite Dextrophan (DXO) in the liver by the cytochrome P450 enzyme CYP2D6.

Around one in 10 of the Caucasian population has little or no CYP2D6 enzyme activity, leading to long-lived high drug levels.

== Images ==

<gallery mode="packed-hover">

Image:Dxm1.jpg|''Robitussin brand DXM Gel Caps''

Image:Dxm_gelcap.jpg

</gallery>

== Links ==

[http://www.erowid.org/chemicals/dxm/faq/dxm_faq.shtml DXM FAQ]

[https://www.erowid.org/chemicals/dxm/dxm_timeline.php DXM timeline on Erowid]

[http://en.wikipedia.org/wiki/Dextromethorphan Wikipedia]

== References ==

<references />

[[Category:Dissociative]]

[[Category:Drugs]]

DXM

2015-03-31T13:45:19Z

GrimReaper:

[[File:Romilarad.jpg|thumb|right|200px|Romilar 1968 Ad]]

'''Dextromethorphan''' (also known as 'DXM', 'DM' or 'robo') is an over-the-counter antitussive (cough treatment) which when taken at doses exceeding the recommended therapeutic range becomes a powerful [[Dissociatives|dissociative]] drug which also has some psychedelic properties.

While DXM can be used safely it is not an inherently safe drug. Repeated use within a short period of time, combination with certain types of drugs, certain genetic factors and the prevalence of other active ingredients which become harmful at needed doses found in many brands of cough medication make for a chemical which must be used with caution.

The high is not for everyone; it is said to loosely follow the rule of thirds: one third hates it, one third doesn't care, and one third like it. It should not be underestimated as a hallucinogenic, at higher dosages mimic high doses of ketamine but with more psychedelic properties.

DXM manifests its effects in a series of plateaus, with dose determining which plateau (and subsequently which effects) one will experience. Lower dose plateaus can be well suited to relaxation, light social interaction and listening to music, however higher doses result in a more encompassing dissociative experience which does not lend itself to attentive presence. At high doses it's common to have strong hallucinations, experiences of detachment, depersonalization, and out-of-body experiences. These all-encompassing states are startling and uncomfortable for some.

It's mechanism of action is via multiple effects, including actions as a nonselective serotonin reuptake inhibitor and a sigma-1 receptor agonist. DXM and it's major metabolite, dextrorphan, also act as an NMDA receptor antagonist at high doses, which produces effects similar to, yet distinct from, the dissociative states created by other dissociative anaesthetics such as [[Ketamine]] and [[PCP]].

DXM does not typically show up in normal drug tests however it can produce false positive results for PCP and/or Opioids in extended or specialized drug tests. Proper occasional use should not produce these false-positive results after a couple days have passed.

== History ==

The racemic parent compound racemorphan was first described in a Swiss and US patent application from Hoffmann-La Roche in 1946 and 1947, respectively; a patent was granted in 1950. A resolution of the two isomers of racemorphan with tartaric acid was published in 1952, and DXM was successfully tested in 1954 as part of US Navy and CIA-funded research on nonaddictive substitutes for codeine.

The FDA approved DXM in 1958 after research supported its legitimacy and effectiveness as a cough suppressant. After its approval, it was introduced as an OTC medication under the name Romilar, which was introduced as a replacement for codeine containing cough remedies in an effort to cut down on abuse. In early 1960s Beat poets Allen Ginsberg and Peter Orlovsky, musicians such as Daevid Allen Soft Machine, and alternative authors such as Jack Kerouac known to have used DXM in the form of Romilar. In 1973, Romilar was taken off the shelves after a burst in sales because of frequent misuse, and was replaced by cough syrup in an attempt to cut down on abuse. In 1975, the popularity and extensive abuse of DXM was recognized, and Romilar was removed from the OTC market. However, DXM was specifically excluded from the Controlled Substances Act (CSA) of 1970, therefore, it was still legal to produce and use.

A few years after its removal from OTC, companies began introducing refined DXM products (e.g., Robitussin, Vicks-44, Dextrotussion) that were designed to limit recreational use by creating an unpleasant taste if consumed in large quantities. Within a short time those same manufactures began to produce forms of DXM with "some appealing flavoring," which led at least one researcher to suggest that the cycle of recreational abuse may be repeated. In 1996, DXM HBr powder could be purchased in bulk from online retailers, allowing users to avoid consuming DXM in syrup preparations.

== Different Forms ==

DXM is widely available in over-the-counter cough treatments which appear in different forms including gelcaps, lozenges and syrups. DXM is also less commonly found in a more pure form, either extracted or bought directly from a chemical manufacturer.

While there are some products available which contain only DXM as active medical ingredients it is common to find products which contain DXM but also contain enough of another active ingredient to pose a serious risk to the user's health.

=== Extracted ===

The ideal source of DXM would be an extraction, but that requires time and a chemical procedure which most people are not equipped to do. It's not a complicated process however it does carry some risks in itself. There is a technique known as the 'Agent Lemon extraction'.

===Gel Caps===

DXM Gelcaps such as RobitussinDM Gelcaps or other no-name brand products containing only DXM encased in a gelcap are often the preferred source for DXM users. For most users gelcaps which contain only DXM produce a more clear headed high in lower doses. Most users experience fewer side effects from gelcaps than from syrup however some users report an upset stomach from the gelcaps, indicating that some users may have a sensitivity to the edible plastics used to make the gelcaps.

===Lozenges===

There are also sore-throat and cough medications containing DXM which exist in the form of a hard-candy like lozenge. These sometimes contain only DXM, however most brands of DXM lozenges also contain analgesics such as acetaminophen or benzocaine. Some brands such as '''Cordicin Cough and Cold''' (also known as '''CCC''') have a variety of products, most of which contain other active ingredients such as antihistamines or CPM (Chlorpheniramine Maleate) and may have one or two products which contain only DXM.

'''WARNING''': Cordicin Cough & Cold is one of the most commonly used sources of DXM, and also one of the most dangerous. Nearly every single CCC product contains other active ingredients such as CPM, which can cause severe and life-threatening symptoms including seizures, shortness of breath or troubled breathing, weakness, loss of consciousness, severe dryness of the mouth, nose or throat, bleeding from the skin, mouth, eyes, rectum and vagina, and possibly death.

https://www.erowid.org/chemicals/dxm/dxm_info2.shtml

As always when using lozenges always choose a product which only has DXM in it.

=== Syrup ===

Cough syrup is the most common source for DXM users. While there are many brand name and no-name syrups which only contain DXM as an active ingredient there are many active and "inactive" ingredients commonly found in cough syrups which can cause negative effects ranging in severity. See [[DXM#HarmReduction|Harm Reduction]] for more information.

Some say the high produced from syrup is mostly sedating. You may feel sluggish when using it to get high on DXM, possibly as a result of other ingredients found in syrup however because of the even dispersion of DXM throughout the syrup it is said to produce a more 'solid' trip.

===Delsym===

Delsym is brand with many formulations which contain Dextromethorphan Polistrex.

This is an extended release form of DXM which produced a longer lasting trip with weaker effects. It is said to be very difficult to reach the third plateau using DXM which may be preferable for this reason to beginners or users who would prefer a longer and weaker trip.

== Dosage ==

The dosage below refers to an "average" 180lbs / 80kg person taking DXM HBR. Before dosing it's important to note a few things:

* HBR and Polistirex doses vary significantly due to polistirex slow absorbsion rate (1mg of DXM polistirex is equivalent to about 6mg DXM HBR).

* '''DXM doses are affected by weight'''. For more accurate dosage information, see the following resources:

* For a graphical chart of the dosage ranges [http://taimapedia.org/images/4/46/DXMDosingChart.png this chart] is helpful.

* For an easy calculator that does the math for you, [http://dxm.darkridge.com/calc.html this page] can be helpful.

'''Before dosing, be sure to read the Plateaus section to know which level you want to dose for.'''

{| class="wikitable"

|+ Plateau range dosage for a 80kg (180lb) person.

|-

| First || 122-200mg

|-

| Second || 200-600mg

|-

| Third || 600-1200mg

|-

| Fourth || 1200-1600mg

|-

| Risk of death || 2.2g+

|}

== Duration ==

{| class="wikitable"

|+ Oral HBR

|-

| Total || 6-8 hours

|}

{| class="wikitable"

|+ Oral Polistirex

|-

| Total || 8-12 hours

|}

=== Redosing ===

Redosing is not advised.

It's better to know how much you've taken at the start of the trip, rather than guestimate how much you're on as you keep dosing. The effects will start to come in waves and may not be pleasant. If you feel the need, it's recommended to take a high initial dose and a lower dose 1-2 hours in.

=== Predosing ===

One should make sure there is only DXM in the product they are taking. Grapefruit juice can potentiate dxm due to intactions with cytochrome P450.<ref>http://medicine.iupui.edu/clinpharm/ddis/2d6references/#dextromethorphanSub</ref>

== Effects ==

The high is not for everyone; it is said to loosely follow the rule of thirds: one third hates it, one third doesn't care, and one third like it.

=== Positive ===

* Euphoria, mood lift

* Increased giggling and laughing

* Dissociation of mind from body (positive when sought)

* Creative dream-like experiences

* Increased tactile sensation

* Some users report empathy and forgiveness towards other people

=== Neutral ===

* Pupil dilation

* Visual stop motion effect (flanging or strobing)

* Visual and aural (auditory) hallucinations

* Decreased sexual functioning (difficulty achieving orgasm)

* Confusion, disorientation

* Skin sensitivity, alters tactile (touch) and skin sensations

* Robotic, zombie-like walking, "robo-walk"

* Discoordination, reduced agility

* Loss of appetite

* Involuntary flexing of muscles

* Feelings of merging with adjacent objects like a couch or bed (with higher doses)

=== Negative ===

* Vomiting

* Dizzyness

* Body itching

* Rash, red blotchy skin

* Diarrhea

* Fever

* Tachycardia (racing, pounding heart)

* Some users report feeling disconnected, isolated from others

=== After-Effects ===

Some users report hangover or depression that might last up to a few days.

=== Robo-Walk ===

The robo-walk feels like all of the muscles in your body are activated at once and while strange to the observer is not painful to the individual. You can still walk but detailed coordination such as running, jumping, or maneuvering around furniture becomes much harder if not impossible. However, when you you start getting the effects of robo-walk, you really wouldn't want to be moving around anyway. The best thing to do is get a good pair of headphones, turn off the lights, close your eyes and let your mind wander.

== Plateaus ==

There are various 'stages' to DXM trips called ''plateaus''. Traditionally, there are only four plateaus that someone should try to aim for. All of them share general feelings of dissociation, but the strength and effects of these feelings are more pronounced in the later two plateaus.

There are two plateaus are commonly associated with a mix of being high on THC and drunk on alcohol. If you take a first or second plateau dose, it's totally possible to socialize. Lower plateau doses are relatively easy to hide compared to higher plateau doses and talking with others becomes a lot easier while under the influence of DXM. It would also be fun to chill in your room alone and do whatever you normally do for fun, but it's suggested to try something that will take up most of your attention but allow your mind to wander at the same time. Something like playing a casual video game, or drawing whatever comes to mind.

If you take a third or fourth plateau dose, it's recommend to trip alone or with a close friend, as it's not a social drug at this dose. The best way to enjoy it is to lay back and listen to music with your eyes closed.

Choosing your destination plateau will depend a lot on what other drugs you've done and how comfortable you are with your mind. People who have never tried any hallucinogen other than THC should start at First, while everyone else could start at Second. '''It is not advised to start at the third or fourth''' unless you have extensive experience with other dissociatives.

=== First Plateau ===

The first plateau is the lightest in effect. It feels a bit 'off', and is often likened to something of a cross between the effects of [[MDA]] and Alcohol. First plateau is usually slightly stimulating.

Effects commonly experienced at the first plateau level

* A shift in thinking perspective; things look and feel 'different'

* Increased tactile sensation

* Increased appreciation of music

* Feeling heavy, sensation of increased body weight

* Enhanced emotional response & sensitivity

* Some dizziness or vertigo

'''First Plateau dose: 1-2mg/lb.'''

=== Second Plateau ===

This pleatu is a bit more intense. You may feel like your stoned and movement may become difficult. The second is supposed to be fun and disorienting. Music is awesome to listen to and you can walk outside and perhaps hallucinate a small-mild amount. You can socialize with friends and you could say you're slightly drunk.

'''Second Plateau dose: 2-5mg/lb.'''

'''Transitional'''

Most people stop their DXM journey here, as the final two plateaus are not really 'fun' but 'enlightening'. We don't recommend crossing this threshold until you're ready to move on from games of the mind to exercises of the consciousness. Enjoy the 2nd plat as long as you can because it's more of a fun experience and there is no going back once you've been past it. "Once you see what's behind the curtain, you can't enjoy the show" so they say.

=== Third Plateau ===

Third plateau is a full on dissociative experience. You cannot ignore the feeling inside of you and at this point its no longer a social drug and should be done by yourself or with a sitter. The third plateau isn't 'party-mode' or even 'socialize-mode'. Its more like 'alone-and-tripping-mode'. This is most akin to a "k-hole" that people experience after taking large amounts of ketamine. A lot of dissociation happens at this level, and the internal thoughts can be quite interesting. Using CEV's, DXM users have been known to have extremely vivid, controllable hallucinations and out of body experiences.

'''Third Plateau dose: 5-7.5mg/lb.'''

=== Fourth Plateau ===

This is the deep meditative state. Few people enjoy going this far, as all you can really do (or want to do) is sit, listen to music, close your eyes, and become a god. You can create universes in your mind just by thinking of them.

'''Fourth Plateau dose: 7.5-10mg/lb.'''

=== Fifth Plateau ===
Increasing the dosage above forth plateau will lead to level that some people refer to as Sigma Plateau. Keep in mind that this is dangerous, and very unpleasant most of the time, so TripSit is discouraging it.

== Harm Reduction ==

See [[Dissociatives#Harm_Reduction|Dissociative Harm Reduction]] for general information.

=== Dangerous Ingredients Commonly Used in DXM Products ===

Many products which contain DXM also contain other medication or otherwise non-medically-active ingredients that can cause serious harm in the doses found in DXM containing products. If a user intends to use an OTC cough medication in order to get high on DXM they almost always will have to consume a dangerous quantity of other dangerous ingredients if they are present in the medication. For this reason it is strongly recommended to find a source which contains /only/ DXM.

The following is a summary of other ingredients commonly found in DXM products.

* : Acetaminophen/Paracetamol/APAP is a painkiller commonly found in over the counter flu medication, and is used in many Tylenol and Panadol brand products.

: Acetaminophen/paracetamol/APAP is hepatoxic in high doses. This means it will damage your liver if taken in high doses.

:: Your body can only process a certain amount of APAP at once before it the normal pathways become saturated.

:: Once the regular pathways used for metabolizing APAP have been saturated the remaining APAP gets broken down in the liver by an enzyme called

:: cytochrome P450. ::: '''When forced to break down APAP this enzyme produces toxic metabolites!'''

The effects of an acetaminophen overdose may not be apparent for up to sixteen hours after the user has ingested the APAP! This makes APAP overdose even more dangerous because of the chance that a user might take more or not take notice after thinking they are 'in the clear'.

'''Under no circumstances should anyone attempt to use any DXM product containing 'Paracetamol', also known as 'APAP' & 'Acetaminophen'!'''

* '''Guaifenesin''' is an expectorant. It works by causing the lungs to produce more fluid, making it easier to cough up phlegm.

: Guaifenesin is added to many OTC cough, cold and flu medications to help treat the 'stuffed up' feeling which often found in viruses and colds.

: Guaifenesin overdoses cause severe nausea and vomiting in most users. Some users report being able to use products which contain some guaifensin and

: other users report no negative effects from guaifenesin containing products.

: '''It is strongly recommended to avoid products which contain Guaifenesin when using DXM!'''

* '''Antihistamines''' such as '''[[DPH|Diphenhydramine]]''' are often found in sleep-aids, night-time formulations of cold medications and allergy medications.

: Antihistamines are sometimes found with DXM in night or 'PM' versions of products, and should generally be avoided when using DXM. When taken in

: high doses antihistamines can cause dizzyness, nausea, a strong dysphoria, paranoia, delirium and hallucinations. Many antihistamines, OTC or prescription

: can also have a dangerous synergy with some of the effects produced by DXM.

* '''Food Coloring & other "Inactive" Ingredients'''

: Many DXM products contain dyes which can cause allergic reactions in some users. Usually these dyes are not harmful in low doses however in doses which may be

: required for DXM's effects they can become problematic. '''Tartrazine (FD&C Yellow #5)''' is one of the most notable coloring ingredients to cause reactions.

: Cough syrups usually contain one or more chemical used to make them taste sweet.

: '''Glucose, sucrose, invert sugar, and fructose''' are commonly used sweetening agents. These sweeteners pose an obvious risk to people with blood sugar conditions

: such as diabetes or hypoglycemia.

: Thickening agents such as '''propylene glycol''' or '''polyethylene glycol''' are found in most cough syrups. These are not toxic but may cause an upset stomach

: when consumed in large doses.

=== Interactions ===

DXM has several potentially dangerous interactions with pharmaceutical and recreational drugs including some analgesics (painkillers), antihistamines, antidepressants and stimulants.

DXM has the potential to cause [[Serotonin Syndrome]] if mixed with other serotonergic drugs such as [[Antidepressants|antidepressants]], MAOIs, empathogens which affect serotonin release such as [[MDMA]], [[MDA]], [[Mephedrone]], etc. Serotonin Syndrome causes discomfort, excitability, irritability, and can be deadly <ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464814/</ref> if not treated.

* See [[Drug_Combinations|Drug combinations]] and [[Dissociatives#Interactions|Dissociative Interactions]] for more information.

== Chemistry and Pharmacology ==

IUPAC:(4bS,8aR,9S)-3-Methoxy-11-methyl-6,7,8,8a,9,10-hexahydro-5H-9,4b-(epiminoethano)phenanthrene.

Dextromethorphan is the dextrorotartory enantiomer of levomethophan, which is the methyl ether of levophanol, both opioid analgesics.

=== Pharmacodynamics ===

{| class="wikitable"

|+ Binding receptors

|-

| NMDA - 7253

|-

| SERT - 2015

|-

| NET - 110606

|-

| Sigma-1 - 23

|-

| Sigma-2 - 240

|}

=== Pharmacokinectics ===

Following oral dosing, DXM is rapidly absorbed from the GI tract. Where it enters the bloodstream, and crosses the blood-brain barrier.

At therapeutic doses, DXM acts centrally (brain) as opposed to locally (Respiratory tract). It's rapidly absorbed from the GI tract into the active metabolite Dextrophan (DXO) in the liver by the cytochrome P450 enzyme CYP2D6.

Around one in 10 of the Caucasian population has little or no CYP2D6 enzyme activity, leading to long-lived high drug levels.

== Images ==

<gallery mode="packed-hover">

Image:Dxm1.jpg|''Robitussin brand DXM Gel Caps''

Image:Dxm_gelcap.jpg

</gallery>

== Links ==

[http://www.erowid.org/chemicals/dxm/faq/dxm_faq.shtml DXM FAQ]

[https://www.erowid.org/chemicals/dxm/dxm_timeline.php DXM timeline on Erowid]

[http://en.wikipedia.org/wiki/Dextromethorphan Wikipedia]

== References ==

<references />

[[Category:Dissociative]]

[[Category:Drugs]]

DXM

2015-03-31T09:12:28Z

GrimReaper: /* Links */

[[File:Romilarad.jpg|thumb|right|200px|Romilar 1968 Ad]]

'''Dextromethorphan''' (also known as 'DXM', 'DM' or 'robo') is an over-the-counter antitussive (cough treatment) which when taken at doses exceeding the recommended therapeutic range becomes a powerful [[Dissociatives|dissociative]] drug which also has some psychedelic properties.

While DXM can be used safely it is not an inherently safe drug. Repeated use within a short period of time, combination with certain types of drugs, certain genetic factors and the prevalence of other active ingredients which become harmful at needed doses found in many brands of cough medication make for a chemical which must be used with caution.

The high is not for everyone; it is said to loosely follow the rule of thirds: one third hates it, one third doesn't care, and one third like it. It should not be underestimated as a hallucinogenic, at higher dosages mimic high doses of ketamine but with more psychedelic properties.

DXM manifests its effects in a series of plateaus, with dose determining which plateau (and subsequently which effects) one will experience. Lower dose plateaus can be well suited to relaxation, light social interaction and listening to music, however higher doses result in a more encompassing dissociative experience which does not lend itself to attentive presence. At high doses it's common to have strong hallucinations, experiences of detachment, depersonalization, and out-of-body experiences. These all-encompassing states are startling and uncomfortable for some.

It's mechanism of action is via multiple effects, including actions as a nonselective serotonin reuptake inhibitor and a sigma-1 receptor agonist. DXM and it's major metabolite, dextrorphan, also act as an NMDA receptor antagonist at high doses, which produces effects similar to, yet distinct from, the dissociative states created by other dissociative anaesthetics such as [[Ketamine]] and [[PCP]].

DXM does not typically show up in normal drug tests however it can produce false positive results for PCP and/or Opioids in extended or specialized drug tests. Proper occasional use should not produce these false-positive results after a couple days have passed.

== History ==

The racemic parent compound racemorphan was first described in a Swiss and US patent application from Hoffmann-La Roche in 1946 and 1947, respectively; a patent was granted in 1950. A resolution of the two isomers of racemorphan with tartaric acid was published in 1952, and DXM was successfully tested in 1954 as part of US Navy and CIA-funded research on nonaddictive substitutes for codeine.

The FDA approved DXM in 1958 after research supported its legitimacy and effectiveness as a cough suppressant. After its approval, it was introduced as an OTC medication under the name Romilar, which was introduced as a replacement for codeine containing cough remedies in an effort to cut down on abuse. In early 1960s Beat poets Allen Ginsberg and Peter Orlovsky, musicians such as Daevid Allen Soft Machine, and alternative authors such as Jack Kerouac known to have used DXM in the form of Romilar. In 1973, Romilar was taken off the shelves after a burst in sales because of frequent misuse, and was replaced by cough syrup in an attempt to cut down on abuse. In 1975, the popularity and extensive abuse of DXM was recognized, and Romilar was removed from the OTC market. However, DXM was specifically excluded from the Controlled Substances Act (CSA) of 1970, therefore, it was still legal to produce and use.

A few years after its removal from OTC, companies began introducing refined DXM products (e.g., Robitussin, Vicks-44, Dextrotussion) that were designed to limit recreational use by creating an unpleasant taste if consumed in large quantities. Within a short time those same manufactures began to produce forms of DXM with "some appealing flavoring," which led at least one researcher to suggest that the cycle of recreational abuse may be repeated. In 1996, DXM HBr powder could be purchased in bulk from online retailers, allowing users to avoid consuming DXM in syrup preparations.

== Different Forms ==

DXM is widely available in over-the-counter cough treatments which appear in different forms including gelcaps, lozenges and syrups. DXM is also less commonly found in a more pure form, either extracted or bought directly from a chemical manufacturer.

While there are some products available which contain only DXM as active medical ingredients it is common to find products which contain DXM but also contain enough of another active ingredient to pose a serious risk to the user's health.

=== Extracted ===

The ideal source of DXM would be an extraction, but that requires time and a chemical procedure which most people are not equipped to do. It's not a complicated process however it does carry some risks in itself. There is a technique known as the 'Agent Lemon extraction'.

===Gel Caps===

DXM Gelcaps such as RobitussinDM Gelcaps or other no-name brand products containing only DXM encased in a gelcap are often the preferred source for DXM users. For most users gelcaps which contain only DXM produce a more clear headed high in lower doses. Most users experience fewer side effects from gelcaps than from syrup however some users report an upset stomach from the gelcaps, indicating that some users may have a sensitivity to the edible plastics used to make the gelcaps.

===Lozenges===

There are also sore-throat and cough medications containing DXM which exist in the form of a hard-candy like lozenge. These sometimes contain only DXM, however most brands of DXM lozenges also contain analgesics such as acetaminophen or benzocaine. Some brands such as '''Cordicin Cough and Cold''' (also known as '''CCC''') have a variety of products, most of which contain other active ingredients such as antihistamines or CPM (Chlorpheniramine Maleate) and may have one or two products which contain only DXM.

'''WARNING''': Cordicin Cough & Cold is one of the most commonly used sources of DXM, and also one of the most dangerous. Nearly every single CCC product contains other active ingredients such as CPM, which can cause severe and life-threatening symptoms including seizures, shortness of breath or troubled breathing, weakness, loss of consciousness, severe dryness of the mouth, nose or throat, bleeding from the skin, mouth, eyes, rectum and vagina, and possibly death.

https://www.erowid.org/chemicals/dxm/dxm_info2.shtml

As always when using lozenges always choose a product which only has DXM in it.

=== Syrup ===

Cough syrup is the most common source for DXM users. While there are many brand name and no-name syrups which only contain DXM as an active ingredient there are many active and "inactive" ingredients commonly found in cough syrups which can cause negative effects ranging in severity. See [[DXM#HarmReduction|Harm Reduction]] for more information.

Some say the high produced from syrup is mostly sedating. You may feel sluggish when using it to get high on DXM, possibly as a result of other ingredients found in syrup however because of the even dispersion of DXM throughout the syrup it is said to produce a more 'solid' trip.

===Delsym===

Delsym is brand with many formulations which contain Dextromethorphan Polistrex.

This is an extended release form of DXM which produced a longer lasting trip with weaker effects. It is said to be very difficult to reach the third plateau using DXM which may be preferable for this reason to beginners or users who would prefer a longer and weaker trip.

== Dosage ==

The dosage below refers to an "average" 180lbs / 80kg person taking DXM HBR. Before dosing it's important to note a few things:

* HBR and Polistirex doses vary significantly due to polistirex slow absorbsion rate (1mg of DXM polistirex is equivalent to about 6mg DXM HBR).

* '''DXM doses are affected by weight'''. For more accurate dosage information, see the following resources:

* For a graphical chart of the dosage ranges [http://taimapedia.org/images/4/46/DXMDosingChart.png this chart] is helpful.

* For an easy calculator that does the math for you, [http://dxm.darkridge.com/calc.html this page] can be helpful.

'''Before dosing, be sure to read the Plateaus section to know which level you want to dose for.'''

{| class="wikitable"

|+ Plateau range dosage for a 80kg (180lb) person.

|-

| First || 122-200mg

|-

| Second || 200-600mg

|-

| Third || 600-1200mg

|-

| Fourth || 1200-1600mg

|-

| Risk of death || 2.2g+

|}

== Duration ==

{| class="wikitable"

|+ Oral HBR

|-

| Total || 6-8 hours

|}

{| class="wikitable"

|+ Oral Polistirex

|-

| Total || 8-12 hours

|}

=== Redosing ===

Redosing is not advised.

It's better to know how much you've taken at the start of the trip, rather than guestimate how much you're on as you keep dosing. The effects will start to come in waves and may not be pleasant. If you feel the need, it's recommended to take a high initial dose and a lower dose 1-2 hours in.

=== Predosing ===

One should make sure there is only DXM in the product they are taking. Grapefruit juice can potentiate dxm due to intactions with cytochrome P450.<ref>http://medicine.iupui.edu/clinpharm/ddis/2d6references/#dextromethorphanSub</ref>

== Effects ==

The high is not for everyone; it is said to loosely follow the rule of thirds: one third hates it, one third doesn't care, and one third like it.

=== Positive ===

* Euphoria, mood lift

* Increased giggling and laughing

* Dissociation of mind from body (positive when sought)

* Creative dream-like experiences

* Increased tactile sensation

* Some users report empathy and forgiveness towards other people

=== Neutral ===

* Pupil dilation

* Visual stop motion effect (flanging or strobing)

* Visual and aural (auditory) hallucinations

* Decreased sexual functioning (difficulty achieving orgasm)

* Confusion, disorientation

* Skin sensitivity, alters tactile (touch) and skin sensations

* Robotic, zombie-like walking, "robo-walk"

* Discoordination, reduced agility

* Loss of appetite

* Involuntary flexing of muscles

* Feelings of merging with adjacent objects like a couch or bed (with higher doses)

=== Negative ===

* Vomiting

* Dizzyness

* Body itching

* Rash, red blotchy skin

* Diarrhea

* Fever

* Tachycardia (racing, pounding heart)

* Some users report feeling disconnected, isolated from others

=== After-Effects ===

Some users report hangover or depression that might last up to a few days.

=== Robo-Walk ===

The robo-walk feels like all of the muscles in your body are activated at once and while strange to the observer is not painful to the individual. You can still walk but detailed coordination such as running, jumping, or maneuvering around furniture becomes much harder if not impossible. However, when you you start getting the effects of robo-walk, you really wouldn't want to be moving around anyway. The best thing to do is get a good pair of headphones, turn off the lights, close your eyes and let your mind wander.

== Plateaus ==

There are various 'stages' to DXM trips called ''plateaus''. Traditionally, there are only four plateaus that someone should try to aim for. All of them share general feelings of dissociation, but the strength and effects of these feelings are more pronounced in the later two plateaus.

There are two plateaus are commonly associated with a mix of being high on THC and drunk on alcohol. If you take a first or second plateau dose, it's totally possible to socialize. Lower plateau doses are relatively easy to hide compared to higher plateau doses and talking with others becomes a lot easier while under the influence of DXM. It would also be fun to chill in your room alone and do whatever you normally do for fun, but it's suggested to try something that will take up most of your attention but allow your mind to wander at the same time. Something like playing a casual video game, or drawing whatever comes to mind.

If you take a third or fourth plateau dose, it's recommend to trip alone or with a close friend, as it's not a social drug at this dose. The best way to enjoy it is to lay back and listen to music with your eyes closed.

Choosing your destination plateau will depend a lot on what other drugs you've done and how comfortable you are with your mind. People who have never tried any hallucinogen other than THC should start at First, while everyone else could start at Second. '''It is not advised to start at the third or fourth''' unless you have extensive experience with other dissociatives.

=== First Plateau ===

The first plateau is the lightest in effect. It feels a bit 'off', and is often likened to something of a cross between the effects of [[MDA]] and Alcohol. First plateau is usually slightly stimulating.

Effects commonly experienced at the first plateau level

* A shift in thinking perspective; things look and feel 'different'

* Increased tactile sensation

* Increased appreciation of music

* Feeling heavy, sensation of increased body weight

* Enhanced emotional response & sensitivity

* Some dizziness or vertigo

'''First Plateau dose: 1-2mg/lb.'''

=== Second Plateau ===

This pleatu is a bit more intense. You may feel like your stoned and movement may become difficult. The second is supposed to be fun and disorienting. Music is awesome to listen to and you can walk outside and perhaps hallucinate a small-mild amount. You can socialize with friends and you could say you're slightly drunk.

'''Second Plateau dose: 2-5mg/lb.'''

'''Transitional'''

Most people stop their DXM journey here, as the final two plateaus are not really 'fun' but 'enlightening'. We don't recommend crossing this threshold until you're ready to move on from games of the mind to exercises of the consciousness. Enjoy the 2nd plat as long as you can because it's more of a fun experience and there is no going back once you've been past it. "Once you see what's behind the curtain, you can't enjoy the show" so they say.

=== Third Plateau ===

Third plateau is a full on dissociative experience. You cannot ignore the feeling inside of you and at this point its no longer a social drug and should be done by yourself or with a sitter. The third plateau isn't 'party-mode' or even 'socialize-mode'. Its more like 'alone-and-tripping-mode'. This is most akin to a "k-hole" that people experience after taking large amounts of ketamine. A lot of dissociation happens at this level, and the internal thoughts can be quite interesting. Using CEV's, DXM users have been known to have extremely vivid, controllable hallucinations and out of body experiences.

'''Third Plateau dose: 5-7.5mg/lb.'''

=== Fourth Plateau ===

This is the deep meditative state. Few people enjoy going this far, as all you can really do (or want to do) is sit, listen to music, close your eyes, and become a god. You can create universes in your mind just by thinking of them.

'''Fourth Plateau dose: 7.5-10mg/lb.'''

== Harm Reduction ==

See [[Dissociatives#Harm_Reduction|Dissociative Harm Reduction]] for general information.

=== Dangerous Ingredients Commonly Used in DXM Products ===

Many products which contain DXM also contain other medication or otherwise non-medically-active ingredients that can cause serious harm in the doses found in DXM containing products. If a user intends to use an OTC cough medication in order to get high on DXM they almost always will have to consume a dangerous quantity of other dangerous ingredients if they are present in the medication. For this reason it is strongly recommended to find a source which contains /only/ DXM.

The following is a summary of other ingredients commonly found in DXM products.

* : Acetaminophen/Paracetamol/APAP is a painkiller commonly found in over the counter flu medication, and is used in many Tylenol and Panadol brand products.

: Acetaminophen/paracetamol/APAP is hepatoxic in high doses. This means it will damage your liver if taken in high doses.

:: Your body can only process a certain amount of APAP at once before it the normal pathways become saturated.

:: Once the regular pathways used for metabolizing APAP have been saturated the remaining APAP gets broken down in the liver by an enzyme called

:: cytochrome P450. ::: '''When forced to break down APAP this enzyme produces toxic metabolites!'''

The effects of an acetaminophen overdose may not be apparent for up to sixteen hours after the user has ingested the APAP! This makes APAP overdose even more dangerous because of the chance that a user might take more or not take notice after thinking they are 'in the clear'.

'''Under no circumstances should anyone attempt to use any DXM product containing 'Paracetamol', also known as 'APAP' & 'Acetaminophen'!'''

* '''Guaifenesin''' is an expectorant. It works by causing the lungs to produce more fluid, making it easier to cough up phlegm.

: Guaifenesin is added to many OTC cough, cold and flu medications to help treat the 'stuffed up' feeling which often found in viruses and colds.

: Guaifenesin overdoses cause severe nausea and vomiting in most users. Some users report being able to use products which contain some guaifensin and

: other users report no negative effects from guaifenesin containing products.

: '''It is strongly recommended to avoid products which contain Guaifenesin when using DXM!'''

* '''Antihistamines''' such as '''[[DPH|Diphenhydramine]]''' are often found in sleep-aids, night-time formulations of cold medications and allergy medications.

: Antihistamines are sometimes found with DXM in night or 'PM' versions of products, and should generally be avoided when using DXM. When taken in

: high doses antihistamines can cause dizzyness, nausea, a strong dysphoria, paranoia, delirium and hallucinations. Many antihistamines, OTC or prescription

: can also have a dangerous synergy with some of the effects produced by DXM.

* '''Food Coloring & other "Inactive" Ingredients'''

: Many DXM products contain dyes which can cause allergic reactions in some users. Usually these dyes are not harmful in low doses however in doses which may be

: required for DXM's effects they can become problematic. '''Tartrazine (FD&C Yellow #5)''' is one of the most notable coloring ingredients to cause reactions.

: Cough syrups usually contain one or more chemical used to make them taste sweet.

: '''Glucose, sucrose, invert sugar, and fructose''' are commonly used sweetening agents. These sweeteners pose an obvious risk to people with blood sugar conditions

: such as diabetes or hypoglycemia.

: Thickening agents such as '''propylene glycol''' or '''polyethylene glycol''' are found in most cough syrups. These are not toxic but may cause an upset stomach

: when consumed in large doses.

=== Interactions ===

DXM has several potentially dangerous interactions with pharmaceutical and recreational drugs including some analgesics (painkillers), antihistamines, antidepressants and stimulants.

DXM has the potential to cause [[Serotonin Syndrome]] if mixed with other serotonergic drugs such as [[Antidepressants|antidepressants]], MAOIs, empathogens which affect serotonin release such as [[MDMA]], [[MDA]], [[Mephedrone]], etc. Serotonin Syndrome causes discomfort, excitability, irritability, and can be deadly <ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464814/</ref> if not treated.

* See [[Drug_Combinations|Drug combinations]] and [[Dissociatives#Interactions|Dissociative Interactions]] for more information.

== Chemistry and Pharmacology ==

IUPAC:(4bS,8aR,9S)-3-Methoxy-11-methyl-6,7,8,8a,9,10-hexahydro-5H-9,4b-(epiminoethano)phenanthrene.

Dextromethorphan is the dextrorotartory enantiomer of levomethophan, which is the methyl ether of levophanol, both opioid analgesics.

=== Pharmacodynamics ===

{| class="wikitable"

|+ Binding receptors

|-

| NMDA - 7253

|-

| SERT - 2015

|-

| NET - 110606

|-

| Sigma-1 - 23

|-

| Sigma-2 - 240

|}

=== Pharmacokinectics ===

Following oral dosing, DXM is rapidly absorbed from the GI tract. Where it enters the bloodstream, and crosses the blood-brain barrier.

At therapeutic doses, DXM acts centrally (brain) as opposed to locally (Respiratory tract). It's rapidly absorbed from the GI tract into the active metabolite Dextrophan (DXO) in the liver by the cytochrome P450 enzyme CYP2D6.

Around one in 10 of the Caucasian population has little or no CYP2D6 enzyme activity, leading to long-lived high drug levels.

== Images ==

<gallery mode="packed-hover">

Image:Dxm1.jpg|''Robitussin brand DXM Gel Caps''

Image:Dxm_gelcap.jpg

</gallery>

== Links ==

[http://www.erowid.org/chemicals/dxm/faq/dxm_faq.shtml DXM FAQ]

[https://www.erowid.org/chemicals/dxm/dxm_timeline.php DXM timeline on Erowid]

[http://en.wikipedia.org/wiki/Dextromethorphan Wikipedia]

== References ==

<references />

[[Category:Dissociative]]

[[Category:Drugs]]

DXM

2015-03-28T17:58:53Z

GrimReaper:

[[File:Romilarad.jpg|thumb|right|200px|Romilar 1968 Ad]]

'''Dextromethorphan''' (also known as 'DXM', 'DM' or 'robo') is an over-the-counter antitussive (cough treatment) which when taken at doses exceeding the recommended therapeutic range becomes a powerful [[Dissociatives|dissociative]] drug which also has some psychedelic properties.

While DXM can be used safely it is not an inherently safe drug. Repeated use within a short period of time, combination with certain types of drugs, certain genetic factors and the prevalence of other active ingredients which become harmful at needed doses found in many brands of cough medication make for a chemical which must be used with caution.

It's mechanism of action is via multiple effects, including actions as a nonselective serotonin reuptake inhibitor and a sigma-1 receptor agonist. DXM and it's major metabolite, dextrorphan, also act as an NMDA receptor antagonist at high doses, which produces effects similar to, yet distinct from, the dissociative states created by other dissociative anaesthetics such as [[Ketamine]] and [[PCP]].

DXM does not typically show up in normal drug tests however it can produce false positive results for PCP and/or Opioids in extended or specialized drug tests. Proper occasional use should not produce these false-positive results after a couple days have passed.

== History ==
The racemic parent compound racemorphan was first described in a Swiss and US patent application from Hoffmann-La Roche in 1946 and 1947, respectively; a patent was granted in 1950. A resolution of the two isomers of racemorphan with tartaric acid was published in 1952, and DXM was successfully tested in 1954 as part of US Navy and CIA-funded research on nonaddictive substitutes for codeine. The FDA approved DXM in 1958 after research supported its legitimacy and effectiveness as a cough suppressant. After its approval, it was introduced as an OTC medication under the name Romilar, which was introduced as a replacement for codeine containing cough remedies in an effort to cut down on abuse. In early 1960s Beat poets Allen Ginsberg and Peter Orlovsky, musicians such as Daevid Allen Soft Machine, and alternative authors such as Jack Kerouac known to have used DXM in the form of Romilar. In 1973, Romilar was taken off the shelves after a burst in sales because of frequent misuse, and was replaced by cough syrup in an attempt to cut down on abuse. In 1975, the popularity and extensive abuse of DXM was recognized, and Romilar was removed from the OTC market. However, DXM was specifically excluded from the Controlled Substances Act (CSA) of 1970, therefore, it was still legal to produce and use. A few years after its removal from OTC, companies began introducing refined DXM products (e.g., Robitussin, Vicks-44, Dextrotussion) that were designed to limit recreational use by creating an unpleasant taste if consumed in large quantities. Within a short time those same manufactures began to produce forms of DXM with "some appealing flavoring," which led at least one researcher to suggest that the cycle of recreational abuse may be repeated. In 1996, DXM HBr powder could be purchased in bulk from online retailers, allowing users to avoid consuming DXM in syrup preparations.

== Different Forms ==

DXM is widely available in over-the-counter cough treatments which appear in different forms including gelcaps, lozenges and syrups. DXM is also less commonly found in a more pure form, either extracted or bought directly from a chemical manufacturer.

While there are some products available which contain only DXM as active medical ingredients it is common to find products which contain DXM but also contain enough of another active ingredient to pose a serious risk to the user's health.

=== Extracted ===

The ideal source of DXM would be an extraction, but that requires time and a chemical procedure which most people are not equipped to do. It's not a complicated process however it does carry some risks in itself. There is a technique known as the 'Agent Lemon extraction'.

=== Syrup ===

Cough syrup is the most common source for DXM users. While there are many brand name and no-name syrups which only contain DXM as an active ingredient there are many active and "inactive" ingredients commonly found in cough syrups which can cause negative effects ranging in severity. See [[DXM#HarmReduction|Harm Reduction]] for more information.

Some say the high produced from syrup is mostly sedating. You may feel sluggish when using it to get high on DXM, possibly as a result of other ingredients found in syrup however because of the even dispersion of DXM throughout the syrup it is said to produce a more 'solid' trip.

===Gel Caps===

DXM Gelcaps such as RobitussinDM Gelcaps or other no-name brand products containing only DXM encased in a gelcap are often the preferred source for DXM users. For most users gelcaps which contain only DXM produce a more clear headed high in lower doses. Most users experience fewer side effects from gelcaps than from syrup however some users report an upset stomach from the gelcaps, indicating that some users may have a sensitivity to the edible plastics used to make the gelcaps.

===Lozenges===

There are also sore-throat and cough medications containing DXM which exist in the form of a hard-candy like lozenge. These sometimes contain only DXM, however most brands of DXM lozenges also contain analgesics such as acetaminophen or benzocaine. Some brands such as '''Cordicin Cough and Cold''' (also known as '''CCC''') have a variety of products, most of which contain other active ingredients such as antihistamines or CPM (Chlorpheniramine Maleate) and may have one or two products which contain only DXM.

WARNING: Cordicin Cough & Cold is one of the most commonly used sources of DXM, and also one of the most dangerous. Nearly every single CCC product contains other active ingredients such as CPM, which can cause severe and life-threatening symptoms including seizures, shortness of breath or troubled breathing, weakness, loss of consciousness, severe dryness of the mouth, nose or throat, bleeding from the skin, mouth, eyes, rectum and vagina, and possibly death.

https://www.erowid.org/chemicals/dxm/dxm_info2.shtml

As always when using lozenges always choose a product which only has DXM in it.

===Delsym===

Delsym is brand with many formulations which contain Dextromethorphan Polistrex.

This is an extended release form of DXM which produced a longer lasting trip with weaker effects. It is said to be impossible to reach the third plateau using DXM which may be preferable for this reason to beginners or users who would prefer a longer and weaker trip.

== Dosage ==

'''DXM doses are affected by weight'''. See [http://taimapedia.org/images/4/46/DXMDosingChart.png this chart] for easy dosing.
Dosage refers to DXM HBR. HBR and Polistirex doses vary significantly due to polistirex slow absorbsion rate. (1mg of DXM polistirex is equivalent to about 6mg DXM HBR)

{| class="wikitable"
|+ Oral
|-
| Light || 100-200mg
|-
| Common || 200-400mg
|-
| Strong || 300-600mg
|-
| Heavy || 600-1500mg
|-
| Risk of death || 2.2g+
|}

== Duration ==

{| class="wikitable"
|+ Oral
|-
| Total || 6-8 hours
|}

=== Redosing ===

Redosing is not advised.

It's better to know how much you've taken at the start of the trip, rather than guestimate how much you're on as you keep dosing. The effects will start to come in waves and may not be pleasant. If you feel the need, it's recommended to take a high initial dose and a lower dose 1-2 hours in.

=== Predosing ===

One should make sure there is only DXM in the product they are taking. Grapefruit juice can potentiate dxm due to intactions with cytochrome P450.<ref>http://medicine.iupui.edu/clinpharm/ddis/2d6references/#dextromethorphanSub</ref>

== Effects ==
The high is not for everyone; it is said to loosely follow the rule of thirds: one third hates it, one third doesn't care, and one third like it.

DXM manifests its effects in a series of plateaus, with dose determining which plateau (and subsequently which effects) one will experience. Lower dose plateaus can be well suited to relaxation, light social interaction and listening to music, however higher doses result in a more encompassing dissociative experience which does not lend itself to attentive presence. At high doses your mind becomes as big as the universe. Strong experiences of detachment, depersonalization, and out-of-body experiences are commonly experienced with DXM at higher doses. These all-encompassing states are startling and uncomfortable for some.

=== Positive ===

* Euphoria, mood lift
* Increased giggling and laughing
* Dissociation of mind from body (positive when sought)
* Creative dream-like experiences
* Increased tactile sensation
* Some users report empathy and forgiveness towards other people

=== Neutral ===

* Pupil dilation
* Visual stop motion effect (flanging or strobing)
* Visual and aural (auditory) hallucinations
* Decreased sexual functioning (difficulty achieving orgasm)
* Confusion, disorientation
* Skin sensitivity, alters tactile (touch) and skin sensations
* Robotic, zombie-like walking, "robo-walk"
* Discoordination, reduced agility
* Loss of appetite
* Involuntary flexing of muscles
* Feelings of merging with adjacent objects like a couch or bed (with higher doses)

=== Negative ===

* Vomiting
* Dizzyness
* Body itching
* Rash, red blotchy skin
* Diarrhea
* Fever
* Tachycardia (racing, pounding heart)
* Some users report feeling disconnected, isolated from others

=== After-Effects ===

* Some users report hangover or depression that might last up to a few days.

=== Robo-Walk ===

The robo-walk feels like all of the muscles in your body are activated at once. You can still walk but forget about running or balance. Imagine the large muscles in your body all tensing up at once, so to walk you don't try to move your leg, you try and relax it in the way you want to go. Detailed coordination such as running, jumping, or maneuvering around furniture becomes much harder if not impossible. However, when you hit the third you really wouldn't want to be moving around anyway. The best thing to do is get a good pair of headphones, turn off the lights, close your eyes and let your mind wander.

== Plateaus ==
There are four 'stages' to DXM trips called '''plateaus'''. The first two are very similar, and the last two are similar.

There are two kind of trips: Sub third and beyond second plateau. If you take a first or second plateau dose, it's totally possible to socialize. Lower plateau doses are relatively easy to hide compared to higher plateau doses. Since you're dissociating yourself, you can remove yourself from awkward social situations or chaotic events. It would also be fun to chill in your room and play a video game and listen to music. The music will get better and you'll get more spacey. If you take a third or fourth plateau dose, it's recommend to trip alone, as it's not a social drug at this dose. The best way to enjoy it is to lay back and listen to music with your eyes closed. If you've ever meditated, you know how your mind can wander without your control. On DXM, you have a tendency to 'unlock' hidden memories. So the best thing is to let your mind take you where it wants to go. It usually knows whats best.

Choosing your destination plateau will depend a lot on what other drugs you've done and how comfortable you are with your mind.

=== First Plateau ===

Feels a bit 'off'. Perhaps like you're a bit buzzed from alcohol or a big hit off a bong.

'''First Plateau dose: 1-2mg/lb.'''

=== Second Plateau ===

You feel like your stoned. Your consciousness feels like it's distancing itself from reality, like it's taking a 'step back' into yourself. The second is supposed to be fun, it's introducing you to the idea that reality is a dream. Music is awesome to listen to and you can walk outside and perhaps hallucinate a small-mild amount. You can socialize with friends and they might take you for sober, or you could say you're slightly drunk.

'''Second Plateau dose: 2-5mg/lb.'''

'''Transitional'''

Most people stop their DXM journey here, as the final two are not really 'fun' but 'enlightening'. We don't recommend crossing this threshold until you're ready to move on from games of the mind to exercises of the consciousness. Enjoy the 2nd plat as long as you can because right now it's more of a fun experience and there is no going back once you've been here. It's like once you see what's behind the curtain, you can't enjoy the show.
Not to say that its not enjoyable, but it looses it's fun charm.

=== Third Plateau ===
This is where you start tripping. You cannot ignore the feeling inside of you. At this point its no longer a social drug and should be done by yourself or with a sitter. This is most akin to an acid trip: it feels very distorted and lasts a couple hours. The third plateau isn't 'party-mode' or even 'socialize-mode'. Its more like 'alone-and-tripping-mode'.
Inside your mind is an entirely new universe to explore. You think of water and an ocean appears. You create universes and live lifetimes inside your mind.
That's what the higher plateaus do.
'''Third Plateau dose: 5-7.5mg/lb.'''

=== Fourth Plateau ===
This is the deep meditative state. Few people enjoy going this far, as all you can really do (or want to do) is sit, listen to music, close your eyes, and become god. You can create universes in your mind just by thinking of them.

'''Fourth Plateau dose: 7.5-10mg/lb.'''

== Harm Reduction ==

See [[Dissociatives#Harm_Reduction|Dissociative Harm Reduction]] for general information.

=== Dangerous Ingredients Commonly Used in DXM Products ===

Many products which contain DXM also contain other medication or otherwise non-medically-active ingredients that can cause serious harm in the doses found in DXM containing products. If a user intends to use an OTC cough medication in order to get high on DXM they almost always will have to consume a dangerous quantity of other dangerous ingredients if they are present in the medication. For this reason it is strongly recommended to find a source which contains /only/ DXM.

The following is a summary of other ingredients commonly found in DXM products.

* : Acetaminophen/Paracetamol/APAP is a painkiller commonly found in over the counter flu medication, and is used in many Tylenol and Panadol brand products.
: Acetaminophen/paracetamol/APAP is hepatoxic in high doses. This means it will damage your liver if taken in high doses.
:: Your body can only process a certain amount of APAP at once before it the normal pathways become saturated.
:: Once the regular pathways used for metabolizing APAP have been saturated the remaining APAP gets broken down in the liver by an enzyme called
:: cytochrome P450. ::: '''When forced to break down APAP this enzyme produces toxic metabolites!'''

The effects of an acetaminophen overdose may not be apparent for up to sixteen hours after the user has ingested the APAP! This makes APAP overdose even more dangerous because of the chance that a user might take more or not take notice after thinking they are 'in the clear'.

'''Under no circumstances should anyone attempt to use any DXM product containing 'Paracetamol', also known as 'APAP' & 'Acetaminophen'!'''

* '''Guaifenesin''' is an expectorant. It works by causing the lungs to produce more fluid, making it easier to cough up phlegm.
: Guaifenesin is added to many OTC cough, cold and flu medications to help treat the 'stuffed up' feeling which often found in viruses and colds.

: Guaifenesin overdoses cause severe nausea and vomiting in most users. Some users report being able to use products which contain some guaifensin and
: other users report no negative effects from guaifenesin containing products.
: '''It is strongly recommended to avoid products which contain Guaifenesin when using DXM!'''

* '''Antihistamines''' such as '''[[DPH|Diphenhydramine]]''' are often found in sleep-aids, night-time formulations of cold medications and allergy medications.
: Antihistamines are sometimes found with DXM in night or 'PM' versions of products, and should generally be avoided when using DXM. When taken in
: high doses antihistamines can cause dizzyness, nausea, a strong dysphoria, paranoia, delirium and hallucinations. Many antihistamines, OTC or prescription
: can also have a dangerous synergy with some of the effects produced by DXM.

* '''Food Coloring & other "Inactive" Ingredients'''
: Many DXM products contain dyes which can cause allergic reactions in some users. Usually these dyes are not harmful in low doses however in doses which may be
: required for DXM's effects they can become problematic. '''Tartrazine (FD&C Yellow #5)''' is one of the most notable coloring ingredients to cause reactions.

: Cough syrups usually contain one or more chemical used to make them taste sweet.
: '''Glucose, sucrose, invert sugar, and fructose''' are commonly used sweetening agents. These sweeteners pose an obvious risk to people with blood sugar conditions
: such as diabetes or hypoglycemia.

: Thickening agents such as '''propylene glycol''' or '''polyethylene glycol''' are found in most cough syrups. These are not toxic but may cause an upset stomach
: when consumed in large doses.

=== Interactions ===
DXM has several potentially dangerous interactions with pharmaceutical and recreational drugs including some analgesics (painkillers), antihistamines, antidepressants and stimulants.

DXM has the potential to cause [[Serotonin Syndrome]] if mixed with other serotonergic drugs such as [[Antidepressants|antidepressants]], MAOIs, empathogens which affect serotonin release such as [[MDMA]], [[MDA]], [[Mephedrone]], etc. Serotonin Syndrome causes discomfort, excitability, irritability, and can be deadly <ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464814/</ref> if not treated.
* See [[Drug_Combinations|Drug combinations]] and [[Dissociatives#Interactions|Dissociative Interactions]] for more information.

== Chemistry and Pharmacology ==

IUPAC:(4bS,8aR,9S)-3-Methoxy-11-methyl-6,7,8,8a,9,10-hexahydro-5H-9,4b-(epiminoethano)phenanthrene.

Dextromethorphan is the dextrorotartory enantiomer of levomethophan, which is the methyl ether of levophanol, both opioid analgesics.

=== Pharmacodynamics ===

{| class="wikitable"
|+ Binding receptors
|-
| NMDA - 7253
|-
| SERT - 2015
|-
| NET - 110606
|-
| Sigma-1 - 23
|-
| Sigma-2 - 240
|}

=== Pharmacokinectics ===

Following oral dosing, DXM is rapidly absorbed from the GI tract. Where it enters the bloodstream, and crosses the blood-brain barrier.

At therapeutic doses, DXM acts centrally (brain) as opposed to locally (Respiratory tract). It's rapidly absorbed from the GI tract into the active metabolite Dextrophan (DXO) in the liver by the cytochrome P450 enzyme CYP2D6.

Around one in 10 of the Caucasian population has little or no CYP2D6 enzyme activity, leading to long-lived high drug levels.

== Images ==
<gallery mode="packed-hover">
Image:Dxm1.jpg|''Robitussin brand DXM Gel Caps''
Image:Dxm_gelcap.jpg
</gallery>

== Links ==

[http://www.erowid.org/chemicals/dxm/faq/dxm_faq.shtml DXM FAQ]

[http://en.wikipedia.org/wiki/Dextromethorphan Wikipedia]

== References ==

<references />

[[Category:Dissociative]]
[[Category:Drugs]]

DXM

2015-03-28T17:57:19Z

GrimReaper: /* Images */

[[File:Dxm_gelcap.jpg|350px|right]]

'''Dextromethorphan''' (also known as 'DXM', 'DM' or 'robo') is an over-the-counter antitussive (cough treatment) which when taken at doses exceeding the recommended therapeutic range becomes a powerful [[Dissociatives|dissociative]] drug which also has some psychedelic properties.

While DXM can be used safely it is not an inherently safe drug. Repeated use within a short period of time, combination with certain types of drugs, certain genetic factors and the prevalence of other active ingredients which become harmful at needed doses found in many brands of cough medication make for a chemical which must be used with caution.

It's mechanism of action is via multiple effects, including actions as a nonselective serotonin reuptake inhibitor and a sigma-1 receptor agonist. DXM and it's major metabolite, dextrorphan, also act as an NMDA receptor antagonist at high doses, which produces effects similar to, yet distinct from, the dissociative states created by other dissociative anaesthetics such as [[Ketamine]] and [[PCP]].

DXM does not typically show up in normal drug tests however it can produce false positive results for PCP and/or Opioids in extended or specialized drug tests. Proper occasional use should not produce these false-positive results after a couple days have passed.

== History ==
The racemic parent compound racemorphan was first described in a Swiss and US patent application from Hoffmann-La Roche in 1946 and 1947, respectively; a patent was granted in 1950. A resolution of the two isomers of racemorphan with tartaric acid was published in 1952, and DXM was successfully tested in 1954 as part of US Navy and CIA-funded research on nonaddictive substitutes for codeine. The FDA approved DXM in 1958 after research supported its legitimacy and effectiveness as a cough suppressant. After its approval, it was introduced as an OTC medication under the name Romilar, which was introduced as a replacement for codeine containing cough remedies in an effort to cut down on abuse. In early 1960s Beat poets Allen Ginsberg and Peter Orlovsky, musicians such as Daevid Allen Soft Machine, and alternative authors such as Jack Kerouac known to have used DXM in the form of Romilar. In 1973, Romilar was taken off the shelves after a burst in sales because of frequent misuse, and was replaced by cough syrup in an attempt to cut down on abuse. In 1975, the popularity and extensive abuse of DXM was recognized, and Romilar was removed from the OTC market. However, DXM was specifically excluded from the Controlled Substances Act (CSA) of 1970, therefore, it was still legal to produce and use. A few years after its removal from OTC, companies began introducing refined DXM products (e.g., Robitussin, Vicks-44, Dextrotussion) that were designed to limit recreational use by creating an unpleasant taste if consumed in large quantities. Within a short time those same manufactures began to produce forms of DXM with "some appealing flavoring," which led at least one researcher to suggest that the cycle of recreational abuse may be repeated. In 1996, DXM HBr powder could be purchased in bulk from online retailers, allowing users to avoid consuming DXM in syrup preparations.

== Different Forms ==

DXM is widely available in over-the-counter cough treatments which appear in different forms including gelcaps, lozenges and syrups. DXM is also less commonly found in a more pure form, either extracted or bought directly from a chemical manufacturer.

While there are some products available which contain only DXM as active medical ingredients it is common to find products which contain DXM but also contain enough of another active ingredient to pose a serious risk to the user's health.

=== Extracted ===

The ideal source of DXM would be an extraction, but that requires time and a chemical procedure which most people are not equipped to do. It's not a complicated process however it does carry some risks in itself. There is a technique known as the 'Agent Lemon extraction'.

=== Syrup ===

Cough syrup is the most common source for DXM users. While there are many brand name and no-name syrups which only contain DXM as an active ingredient there are many active and "inactive" ingredients commonly found in cough syrups which can cause negative effects ranging in severity. See [[DXM#HarmReduction|Harm Reduction]] for more information.

Some say the high produced from syrup is mostly sedating. You may feel sluggish when using it to get high on DXM, possibly as a result of other ingredients found in syrup however because of the even dispersion of DXM throughout the syrup it is said to produce a more 'solid' trip.

===Gel Caps===

DXM Gelcaps such as RobitussinDM Gelcaps or other no-name brand products containing only DXM encased in a gelcap are often the preferred source for DXM users. For most users gelcaps which contain only DXM produce a more clear headed high in lower doses. Most users experience fewer side effects from gelcaps than from syrup however some users report an upset stomach from the gelcaps, indicating that some users may have a sensitivity to the edible plastics used to make the gelcaps.

===Lozenges===

There are also sore-throat and cough medications containing DXM which exist in the form of a hard-candy like lozenge. These sometimes contain only DXM, however most brands of DXM lozenges also contain analgesics such as acetaminophen or benzocaine. Some brands such as '''Cordicin Cough and Cold''' (also known as '''CCC''') have a variety of products, most of which contain other active ingredients such as antihistamines or CPM (Chlorpheniramine Maleate) and may have one or two products which contain only DXM.

WARNING: Cordicin Cough & Cold is one of the most commonly used sources of DXM, and also one of the most dangerous. Nearly every single CCC product contains other active ingredients such as CPM, which can cause severe and life-threatening symptoms including seizures, shortness of breath or troubled breathing, weakness, loss of consciousness, severe dryness of the mouth, nose or throat, bleeding from the skin, mouth, eyes, rectum and vagina, and possibly death.

https://www.erowid.org/chemicals/dxm/dxm_info2.shtml

As always when using lozenges always choose a product which only has DXM in it.

===Delsym===

Delsym is brand with many formulations which contain Dextromethorphan Polistrex.

This is an extended release form of DXM which produced a longer lasting trip with weaker effects. It is said to be impossible to reach the third plateau using DXM which may be preferable for this reason to beginners or users who would prefer a longer and weaker trip.

== Dosage ==

'''DXM doses are affected by weight'''. See [http://taimapedia.org/images/4/46/DXMDosingChart.png this chart] for easy dosing.
Dosage refers to DXM HBR. HBR and Polistirex doses vary significantly due to polistirex slow absorbsion rate. (1mg of DXM polistirex is equivalent to about 6mg DXM HBR)

{| class="wikitable"
|+ Oral
|-
| Light || 100-200mg
|-
| Common || 200-400mg
|-
| Strong || 300-600mg
|-
| Heavy || 600-1500mg
|-
| Risk of death || 2.2g+
|}

== Duration ==

{| class="wikitable"
|+ Oral
|-
| Total || 6-8 hours
|}

=== Redosing ===

Redosing is not advised.

It's better to know how much you've taken at the start of the trip, rather than guestimate how much you're on as you keep dosing. The effects will start to come in waves and may not be pleasant. If you feel the need, it's recommended to take a high initial dose and a lower dose 1-2 hours in.

=== Predosing ===

One should make sure there is only DXM in the product they are taking. Grapefruit juice can potentiate dxm due to intactions with cytochrome P450.<ref>http://medicine.iupui.edu/clinpharm/ddis/2d6references/#dextromethorphanSub</ref>

== Effects ==
The high is not for everyone; it is said to loosely follow the rule of thirds: one third hates it, one third doesn't care, and one third like it.

DXM manifests its effects in a series of plateaus, with dose determining which plateau (and subsequently which effects) one will experience. Lower dose plateaus can be well suited to relaxation, light social interaction and listening to music, however higher doses result in a more encompassing dissociative experience which does not lend itself to attentive presence. At high doses your mind becomes as big as the universe. Strong experiences of detachment, depersonalization, and out-of-body experiences are commonly experienced with DXM at higher doses. These all-encompassing states are startling and uncomfortable for some.

=== Positive ===

* Euphoria, mood lift
* Increased giggling and laughing
* Dissociation of mind from body (positive when sought)
* Creative dream-like experiences
* Increased tactile sensation
* Some users report empathy and forgiveness towards other people

=== Neutral ===

* Pupil dilation
* Visual stop motion effect (flanging or strobing)
* Visual and aural (auditory) hallucinations
* Decreased sexual functioning (difficulty achieving orgasm)
* Confusion, disorientation
* Skin sensitivity, alters tactile (touch) and skin sensations
* Robotic, zombie-like walking, "robo-walk"
* Discoordination, reduced agility
* Loss of appetite
* Involuntary flexing of muscles
* Feelings of merging with adjacent objects like a couch or bed (with higher doses)

=== Negative ===

* Vomiting
* Dizzyness
* Body itching
* Rash, red blotchy skin
* Diarrhea
* Fever
* Tachycardia (racing, pounding heart)
* Some users report feeling disconnected, isolated from others

=== After-Effects ===

* Some users report hangover or depression that might last up to a few days.

=== Robo-Walk ===

The robo-walk feels like all of the muscles in your body are activated at once. You can still walk but forget about running or balance. Imagine the large muscles in your body all tensing up at once, so to walk you don't try to move your leg, you try and relax it in the way you want to go. Detailed coordination such as running, jumping, or maneuvering around furniture becomes much harder if not impossible. However, when you hit the third you really wouldn't want to be moving around anyway. The best thing to do is get a good pair of headphones, turn off the lights, close your eyes and let your mind wander.

== Plateaus ==
There are four 'stages' to DXM trips called '''plateaus'''. The first two are very similar, and the last two are similar.

There are two kind of trips: Sub third and beyond second plateau. If you take a first or second plateau dose, it's totally possible to socialize. Lower plateau doses are relatively easy to hide compared to higher plateau doses. Since you're dissociating yourself, you can remove yourself from awkward social situations or chaotic events. It would also be fun to chill in your room and play a video game and listen to music. The music will get better and you'll get more spacey. If you take a third or fourth plateau dose, it's recommend to trip alone, as it's not a social drug at this dose. The best way to enjoy it is to lay back and listen to music with your eyes closed. If you've ever meditated, you know how your mind can wander without your control. On DXM, you have a tendency to 'unlock' hidden memories. So the best thing is to let your mind take you where it wants to go. It usually knows whats best.

Choosing your destination plateau will depend a lot on what other drugs you've done and how comfortable you are with your mind.

=== First Plateau ===

Feels a bit 'off'. Perhaps like you're a bit buzzed from alcohol or a big hit off a bong.

'''First Plateau dose: 1-2mg/lb.'''

=== Second Plateau ===

You feel like your stoned. Your consciousness feels like it's distancing itself from reality, like it's taking a 'step back' into yourself. The second is supposed to be fun, it's introducing you to the idea that reality is a dream. Music is awesome to listen to and you can walk outside and perhaps hallucinate a small-mild amount. You can socialize with friends and they might take you for sober, or you could say you're slightly drunk.

'''Second Plateau dose: 2-5mg/lb.'''

'''Transitional'''

Most people stop their DXM journey here, as the final two are not really 'fun' but 'enlightening'. We don't recommend crossing this threshold until you're ready to move on from games of the mind to exercises of the consciousness. Enjoy the 2nd plat as long as you can because right now it's more of a fun experience and there is no going back once you've been here. It's like once you see what's behind the curtain, you can't enjoy the show.
Not to say that its not enjoyable, but it looses it's fun charm.

=== Third Plateau ===
This is where you start tripping. You cannot ignore the feeling inside of you. At this point its no longer a social drug and should be done by yourself or with a sitter. This is most akin to an acid trip: it feels very distorted and lasts a couple hours. The third plateau isn't 'party-mode' or even 'socialize-mode'. Its more like 'alone-and-tripping-mode'.
Inside your mind is an entirely new universe to explore. You think of water and an ocean appears. You create universes and live lifetimes inside your mind.
That's what the higher plateaus do.
'''Third Plateau dose: 5-7.5mg/lb.'''

=== Fourth Plateau ===
This is the deep meditative state. Few people enjoy going this far, as all you can really do (or want to do) is sit, listen to music, close your eyes, and become god. You can create universes in your mind just by thinking of them.

'''Fourth Plateau dose: 7.5-10mg/lb.'''

== Harm Reduction ==

See [[Dissociatives#Harm_Reduction|Dissociative Harm Reduction]] for general information.

=== Dangerous Ingredients Commonly Used in DXM Products ===

Many products which contain DXM also contain other medication or otherwise non-medically-active ingredients that can cause serious harm in the doses found in DXM containing products. If a user intends to use an OTC cough medication in order to get high on DXM they almost always will have to consume a dangerous quantity of other dangerous ingredients if they are present in the medication. For this reason it is strongly recommended to find a source which contains /only/ DXM.

The following is a summary of other ingredients commonly found in DXM products.

* : Acetaminophen/Paracetamol/APAP is a painkiller commonly found in over the counter flu medication, and is used in many Tylenol and Panadol brand products.
: Acetaminophen/paracetamol/APAP is hepatoxic in high doses. This means it will damage your liver if taken in high doses.
:: Your body can only process a certain amount of APAP at once before it the normal pathways become saturated.
:: Once the regular pathways used for metabolizing APAP have been saturated the remaining APAP gets broken down in the liver by an enzyme called
:: cytochrome P450. ::: '''When forced to break down APAP this enzyme produces toxic metabolites!'''

The effects of an acetaminophen overdose may not be apparent for up to sixteen hours after the user has ingested the APAP! This makes APAP overdose even more dangerous because of the chance that a user might take more or not take notice after thinking they are 'in the clear'.

'''Under no circumstances should anyone attempt to use any DXM product containing 'Paracetamol', also known as 'APAP' & 'Acetaminophen'!'''

* '''Guaifenesin''' is an expectorant. It works by causing the lungs to produce more fluid, making it easier to cough up phlegm.
: Guaifenesin is added to many OTC cough, cold and flu medications to help treat the 'stuffed up' feeling which often found in viruses and colds.

: Guaifenesin overdoses cause severe nausea and vomiting in most users. Some users report being able to use products which contain some guaifensin and
: other users report no negative effects from guaifenesin containing products.
: '''It is strongly recommended to avoid products which contain Guaifenesin when using DXM!'''

* '''Antihistamines''' such as '''[[DPH|Diphenhydramine]]''' are often found in sleep-aids, night-time formulations of cold medications and allergy medications.
: Antihistamines are sometimes found with DXM in night or 'PM' versions of products, and should generally be avoided when using DXM. When taken in
: high doses antihistamines can cause dizzyness, nausea, a strong dysphoria, paranoia, delirium and hallucinations. Many antihistamines, OTC or prescription
: can also have a dangerous synergy with some of the effects produced by DXM.

* '''Food Coloring & other "Inactive" Ingredients'''
: Many DXM products contain dyes which can cause allergic reactions in some users. Usually these dyes are not harmful in low doses however in doses which may be
: required for DXM's effects they can become problematic. '''Tartrazine (FD&C Yellow #5)''' is one of the most notable coloring ingredients to cause reactions.

: Cough syrups usually contain one or more chemical used to make them taste sweet.
: '''Glucose, sucrose, invert sugar, and fructose''' are commonly used sweetening agents. These sweeteners pose an obvious risk to people with blood sugar conditions
: such as diabetes or hypoglycemia.

: Thickening agents such as '''propylene glycol''' or '''polyethylene glycol''' are found in most cough syrups. These are not toxic but may cause an upset stomach
: when consumed in large doses.

=== Interactions ===
DXM has several potentially dangerous interactions with pharmaceutical and recreational drugs including some analgesics (painkillers), antihistamines, antidepressants and stimulants.

DXM has the potential to cause [[Serotonin Syndrome]] if mixed with other serotonergic drugs such as [[Antidepressants|antidepressants]], MAOIs, empathogens which affect serotonin release such as [[MDMA]], [[MDA]], [[Mephedrone]], etc. Serotonin Syndrome causes discomfort, excitability, irritability, and can be deadly <ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464814/</ref> if not treated.
* See [[Drug_Combinations|Drug combinations]] and [[Dissociatives#Interactions|Dissociative Interactions]] for more information.

== Chemistry and Pharmacology ==

IUPAC:(4bS,8aR,9S)-3-Methoxy-11-methyl-6,7,8,8a,9,10-hexahydro-5H-9,4b-(epiminoethano)phenanthrene.

Dextromethorphan is the dextrorotartory enantiomer of levomethophan, which is the methyl ether of levophanol, both opioid analgesics.

=== Pharmacodynamics ===

{| class="wikitable"
|+ Binding receptors
|-
| NMDA - 7253
|-
| SERT - 2015
|-
| NET - 110606
|-
| Sigma-1 - 23
|-
| Sigma-2 - 240
|}

=== Pharmacokinectics ===

Following oral dosing, DXM is rapidly absorbed from the GI tract. Where it enters the bloodstream, and crosses the blood-brain barrier.

At therapeutic doses, DXM acts centrally (brain) as opposed to locally (Respiratory tract). It's rapidly absorbed from the GI tract into the active metabolite Dextrophan (DXO) in the liver by the cytochrome P450 enzyme CYP2D6.

Around one in 10 of the Caucasian population has little or no CYP2D6 enzyme activity, leading to long-lived high drug levels.

== Images ==
<gallery mode="packed-hover">
Image:Dxm1.jpg|''Robitussin brand DXM Gel Caps''
</gallery>

== Links ==

[http://www.erowid.org/chemicals/dxm/faq/dxm_faq.shtml DXM FAQ]

[http://en.wikipedia.org/wiki/Dextromethorphan Wikipedia]

== References ==

<references />

[[Category:Dissociative]]
[[Category:Drugs]]

DXM

2015-03-28T17:54:48Z

GrimReaper:

[[File:Dxm_gelcap.jpg|350px|right]]

'''Dextromethorphan''' (also known as 'DXM', 'DM' or 'robo') is an over-the-counter antitussive (cough treatment) which when taken at doses exceeding the recommended therapeutic range becomes a powerful [[Dissociatives|dissociative]] drug which also has some psychedelic properties.

While DXM can be used safely it is not an inherently safe drug. Repeated use within a short period of time, combination with certain types of drugs, certain genetic factors and the prevalence of other active ingredients which become harmful at needed doses found in many brands of cough medication make for a chemical which must be used with caution.

It's mechanism of action is via multiple effects, including actions as a nonselective serotonin reuptake inhibitor and a sigma-1 receptor agonist. DXM and it's major metabolite, dextrorphan, also act as an NMDA receptor antagonist at high doses, which produces effects similar to, yet distinct from, the dissociative states created by other dissociative anaesthetics such as [[Ketamine]] and [[PCP]].

DXM does not typically show up in normal drug tests however it can produce false positive results for PCP and/or Opioids in extended or specialized drug tests. Proper occasional use should not produce these false-positive results after a couple days have passed.

== History ==
The racemic parent compound racemorphan was first described in a Swiss and US patent application from Hoffmann-La Roche in 1946 and 1947, respectively; a patent was granted in 1950. A resolution of the two isomers of racemorphan with tartaric acid was published in 1952, and DXM was successfully tested in 1954 as part of US Navy and CIA-funded research on nonaddictive substitutes for codeine. The FDA approved DXM in 1958 after research supported its legitimacy and effectiveness as a cough suppressant. After its approval, it was introduced as an OTC medication under the name Romilar, which was introduced as a replacement for codeine containing cough remedies in an effort to cut down on abuse. In early 1960s Beat poets Allen Ginsberg and Peter Orlovsky, musicians such as Daevid Allen Soft Machine, and alternative authors such as Jack Kerouac known to have used DXM in the form of Romilar. In 1973, Romilar was taken off the shelves after a burst in sales because of frequent misuse, and was replaced by cough syrup in an attempt to cut down on abuse. In 1975, the popularity and extensive abuse of DXM was recognized, and Romilar was removed from the OTC market. However, DXM was specifically excluded from the Controlled Substances Act (CSA) of 1970, therefore, it was still legal to produce and use. A few years after its removal from OTC, companies began introducing refined DXM products (e.g., Robitussin, Vicks-44, Dextrotussion) that were designed to limit recreational use by creating an unpleasant taste if consumed in large quantities. Within a short time those same manufactures began to produce forms of DXM with "some appealing flavoring," which led at least one researcher to suggest that the cycle of recreational abuse may be repeated. In 1996, DXM HBr powder could be purchased in bulk from online retailers, allowing users to avoid consuming DXM in syrup preparations.

== Different Forms ==

DXM is widely available in over-the-counter cough treatments which appear in different forms including gelcaps, lozenges and syrups. DXM is also less commonly found in a more pure form, either extracted or bought directly from a chemical manufacturer.

While there are some products available which contain only DXM as active medical ingredients it is common to find products which contain DXM but also contain enough of another active ingredient to pose a serious risk to the user's health.

=== Extracted ===

The ideal source of DXM would be an extraction, but that requires time and a chemical procedure which most people are not equipped to do. It's not a complicated process however it does carry some risks in itself. There is a technique known as the 'Agent Lemon extraction'.

=== Syrup ===

Cough syrup is the most common source for DXM users. While there are many brand name and no-name syrups which only contain DXM as an active ingredient there are many active and "inactive" ingredients commonly found in cough syrups which can cause negative effects ranging in severity. See [[DXM#HarmReduction|Harm Reduction]] for more information.

Some say the high produced from syrup is mostly sedating. You may feel sluggish when using it to get high on DXM, possibly as a result of other ingredients found in syrup however because of the even dispersion of DXM throughout the syrup it is said to produce a more 'solid' trip.

===Gel Caps===

DXM Gelcaps such as RobitussinDM Gelcaps or other no-name brand products containing only DXM encased in a gelcap are often the preferred source for DXM users. For most users gelcaps which contain only DXM produce a more clear headed high in lower doses. Most users experience fewer side effects from gelcaps than from syrup however some users report an upset stomach from the gelcaps, indicating that some users may have a sensitivity to the edible plastics used to make the gelcaps.

===Lozenges===

There are also sore-throat and cough medications containing DXM which exist in the form of a hard-candy like lozenge. These sometimes contain only DXM, however most brands of DXM lozenges also contain analgesics such as acetaminophen or benzocaine. Some brands such as '''Cordicin Cough and Cold''' (also known as '''CCC''') have a variety of products, most of which contain other active ingredients such as antihistamines or CPM (Chlorpheniramine Maleate) and may have one or two products which contain only DXM.

WARNING: Cordicin Cough & Cold is one of the most commonly used sources of DXM, and also one of the most dangerous. Nearly every single CCC product contains other active ingredients such as CPM, which can cause severe and life-threatening symptoms including seizures, shortness of breath or troubled breathing, weakness, loss of consciousness, severe dryness of the mouth, nose or throat, bleeding from the skin, mouth, eyes, rectum and vagina, and possibly death.

https://www.erowid.org/chemicals/dxm/dxm_info2.shtml

As always when using lozenges always choose a product which only has DXM in it.

===Delsym===

Delsym is brand with many formulations which contain Dextromethorphan Polistrex.

This is an extended release form of DXM which produced a longer lasting trip with weaker effects. It is said to be impossible to reach the third plateau using DXM which may be preferable for this reason to beginners or users who would prefer a longer and weaker trip.

== Dosage ==

'''DXM doses are affected by weight'''. See [http://taimapedia.org/images/4/46/DXMDosingChart.png this chart] for easy dosing.
Dosage refers to DXM HBR. HBR and Polistirex doses vary significantly due to polistirex slow absorbsion rate. (1mg of DXM polistirex is equivalent to about 6mg DXM HBR)

{| class="wikitable"
|+ Oral
|-
| Light || 100-200mg
|-
| Common || 200-400mg
|-
| Strong || 300-600mg
|-
| Heavy || 600-1500mg
|-
| Risk of death || 2.2g+
|}

== Duration ==

{| class="wikitable"
|+ Oral
|-
| Total || 6-8 hours
|}

=== Redosing ===

Redosing is not advised.

It's better to know how much you've taken at the start of the trip, rather than guestimate how much you're on as you keep dosing. The effects will start to come in waves and may not be pleasant. If you feel the need, it's recommended to take a high initial dose and a lower dose 1-2 hours in.

=== Predosing ===

One should make sure there is only DXM in the product they are taking. Grapefruit juice can potentiate dxm due to intactions with cytochrome P450.<ref>http://medicine.iupui.edu/clinpharm/ddis/2d6references/#dextromethorphanSub</ref>

== Effects ==
The high is not for everyone; it is said to loosely follow the rule of thirds: one third hates it, one third doesn't care, and one third like it.

DXM manifests its effects in a series of plateaus, with dose determining which plateau (and subsequently which effects) one will experience. Lower dose plateaus can be well suited to relaxation, light social interaction and listening to music, however higher doses result in a more encompassing dissociative experience which does not lend itself to attentive presence. At high doses your mind becomes as big as the universe. Strong experiences of detachment, depersonalization, and out-of-body experiences are commonly experienced with DXM at higher doses. These all-encompassing states are startling and uncomfortable for some.

=== Positive ===

* Euphoria, mood lift
* Increased giggling and laughing
* Dissociation of mind from body (positive when sought)
* Creative dream-like experiences
* Increased tactile sensation
* Some users report empathy and forgiveness towards other people

=== Neutral ===

* Pupil dilation
* Visual stop motion effect (flanging or strobing)
* Visual and aural (auditory) hallucinations
* Decreased sexual functioning (difficulty achieving orgasm)
* Confusion, disorientation
* Skin sensitivity, alters tactile (touch) and skin sensations
* Robotic, zombie-like walking, "robo-walk"
* Discoordination, reduced agility
* Loss of appetite
* Involuntary flexing of muscles
* Feelings of merging with adjacent objects like a couch or bed (with higher doses)

=== Negative ===

* Vomiting
* Dizzyness
* Body itching
* Rash, red blotchy skin
* Diarrhea
* Fever
* Tachycardia (racing, pounding heart)
* Some users report feeling disconnected, isolated from others

=== After-Effects ===

* Some users report hangover or depression that might last up to a few days.

=== Robo-Walk ===

The robo-walk feels like all of the muscles in your body are activated at once. You can still walk but forget about running or balance. Imagine the large muscles in your body all tensing up at once, so to walk you don't try to move your leg, you try and relax it in the way you want to go. Detailed coordination such as running, jumping, or maneuvering around furniture becomes much harder if not impossible. However, when you hit the third you really wouldn't want to be moving around anyway. The best thing to do is get a good pair of headphones, turn off the lights, close your eyes and let your mind wander.

== Plateaus ==
There are four 'stages' to DXM trips called '''plateaus'''. The first two are very similar, and the last two are similar.

There are two kind of trips: Sub third and beyond second plateau. If you take a first or second plateau dose, it's totally possible to socialize. Lower plateau doses are relatively easy to hide compared to higher plateau doses. Since you're dissociating yourself, you can remove yourself from awkward social situations or chaotic events. It would also be fun to chill in your room and play a video game and listen to music. The music will get better and you'll get more spacey. If you take a third or fourth plateau dose, it's recommend to trip alone, as it's not a social drug at this dose. The best way to enjoy it is to lay back and listen to music with your eyes closed. If you've ever meditated, you know how your mind can wander without your control. On DXM, you have a tendency to 'unlock' hidden memories. So the best thing is to let your mind take you where it wants to go. It usually knows whats best.

Choosing your destination plateau will depend a lot on what other drugs you've done and how comfortable you are with your mind.

=== First Plateau ===

Feels a bit 'off'. Perhaps like you're a bit buzzed from alcohol or a big hit off a bong.

'''First Plateau dose: 1-2mg/lb.'''

=== Second Plateau ===

You feel like your stoned. Your consciousness feels like it's distancing itself from reality, like it's taking a 'step back' into yourself. The second is supposed to be fun, it's introducing you to the idea that reality is a dream. Music is awesome to listen to and you can walk outside and perhaps hallucinate a small-mild amount. You can socialize with friends and they might take you for sober, or you could say you're slightly drunk.

'''Second Plateau dose: 2-5mg/lb.'''

'''Transitional'''

Most people stop their DXM journey here, as the final two are not really 'fun' but 'enlightening'. We don't recommend crossing this threshold until you're ready to move on from games of the mind to exercises of the consciousness. Enjoy the 2nd plat as long as you can because right now it's more of a fun experience and there is no going back once you've been here. It's like once you see what's behind the curtain, you can't enjoy the show.
Not to say that its not enjoyable, but it looses it's fun charm.

=== Third Plateau ===
This is where you start tripping. You cannot ignore the feeling inside of you. At this point its no longer a social drug and should be done by yourself or with a sitter. This is most akin to an acid trip: it feels very distorted and lasts a couple hours. The third plateau isn't 'party-mode' or even 'socialize-mode'. Its more like 'alone-and-tripping-mode'.
Inside your mind is an entirely new universe to explore. You think of water and an ocean appears. You create universes and live lifetimes inside your mind.
That's what the higher plateaus do.
'''Third Plateau dose: 5-7.5mg/lb.'''

=== Fourth Plateau ===
This is the deep meditative state. Few people enjoy going this far, as all you can really do (or want to do) is sit, listen to music, close your eyes, and become god. You can create universes in your mind just by thinking of them.

'''Fourth Plateau dose: 7.5-10mg/lb.'''

== Harm Reduction ==

See [[Dissociatives#Harm_Reduction|Dissociative Harm Reduction]] for general information.

=== Dangerous Ingredients Commonly Used in DXM Products ===

Many products which contain DXM also contain other medication or otherwise non-medically-active ingredients that can cause serious harm in the doses found in DXM containing products. If a user intends to use an OTC cough medication in order to get high on DXM they almost always will have to consume a dangerous quantity of other dangerous ingredients if they are present in the medication. For this reason it is strongly recommended to find a source which contains /only/ DXM.

The following is a summary of other ingredients commonly found in DXM products.

* : Acetaminophen/Paracetamol/APAP is a painkiller commonly found in over the counter flu medication, and is used in many Tylenol and Panadol brand products.
: Acetaminophen/paracetamol/APAP is hepatoxic in high doses. This means it will damage your liver if taken in high doses.
:: Your body can only process a certain amount of APAP at once before it the normal pathways become saturated.
:: Once the regular pathways used for metabolizing APAP have been saturated the remaining APAP gets broken down in the liver by an enzyme called
:: cytochrome P450. ::: '''When forced to break down APAP this enzyme produces toxic metabolites!'''

The effects of an acetaminophen overdose may not be apparent for up to sixteen hours after the user has ingested the APAP! This makes APAP overdose even more dangerous because of the chance that a user might take more or not take notice after thinking they are 'in the clear'.

'''Under no circumstances should anyone attempt to use any DXM product containing 'Paracetamol', also known as 'APAP' & 'Acetaminophen'!'''

* '''Guaifenesin''' is an expectorant. It works by causing the lungs to produce more fluid, making it easier to cough up phlegm.
: Guaifenesin is added to many OTC cough, cold and flu medications to help treat the 'stuffed up' feeling which often found in viruses and colds.

: Guaifenesin overdoses cause severe nausea and vomiting in most users. Some users report being able to use products which contain some guaifensin and
: other users report no negative effects from guaifenesin containing products.
: '''It is strongly recommended to avoid products which contain Guaifenesin when using DXM!'''

* '''Antihistamines''' such as '''[[DPH|Diphenhydramine]]''' are often found in sleep-aids, night-time formulations of cold medications and allergy medications.
: Antihistamines are sometimes found with DXM in night or 'PM' versions of products, and should generally be avoided when using DXM. When taken in
: high doses antihistamines can cause dizzyness, nausea, a strong dysphoria, paranoia, delirium and hallucinations. Many antihistamines, OTC or prescription
: can also have a dangerous synergy with some of the effects produced by DXM.

* '''Food Coloring & other "Inactive" Ingredients'''
: Many DXM products contain dyes which can cause allergic reactions in some users. Usually these dyes are not harmful in low doses however in doses which may be
: required for DXM's effects they can become problematic. '''Tartrazine (FD&C Yellow #5)''' is one of the most notable coloring ingredients to cause reactions.

: Cough syrups usually contain one or more chemical used to make them taste sweet.
: '''Glucose, sucrose, invert sugar, and fructose''' are commonly used sweetening agents. These sweeteners pose an obvious risk to people with blood sugar conditions
: such as diabetes or hypoglycemia.

: Thickening agents such as '''propylene glycol''' or '''polyethylene glycol''' are found in most cough syrups. These are not toxic but may cause an upset stomach
: when consumed in large doses.

=== Interactions ===
DXM has several potentially dangerous interactions with pharmaceutical and recreational drugs including some analgesics (painkillers), antihistamines, antidepressants and stimulants.

DXM has the potential to cause [[Serotonin Syndrome]] if mixed with other serotonergic drugs such as [[Antidepressants|antidepressants]], MAOIs, empathogens which affect serotonin release such as [[MDMA]], [[MDA]], [[Mephedrone]], etc. Serotonin Syndrome causes discomfort, excitability, irritability, and can be deadly <ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464814/</ref> if not treated.
* See [[Drug_Combinations|Drug combinations]] and [[Dissociatives#Interactions|Dissociative Interactions]] for more information.

== Chemistry and Pharmacology ==

IUPAC:(4bS,8aR,9S)-3-Methoxy-11-methyl-6,7,8,8a,9,10-hexahydro-5H-9,4b-(epiminoethano)phenanthrene.

Dextromethorphan is the dextrorotartory enantiomer of levomethophan, which is the methyl ether of levophanol, both opioid analgesics.

=== Pharmacodynamics ===

{| class="wikitable"
|+ Binding receptors
|-
| NMDA - 7253
|-
| SERT - 2015
|-
| NET - 110606
|-
| Sigma-1 - 23
|-
| Sigma-2 - 240
|}

=== Pharmacokinectics ===

Following oral dosing, DXM is rapidly absorbed from the GI tract. Where it enters the bloodstream, and crosses the blood-brain barrier.

At therapeutic doses, DXM acts centrally (brain) as opposed to locally (Respiratory tract). It's rapidly absorbed from the GI tract into the active metabolite Dextrophan (DXO) in the liver by the cytochrome P450 enzyme CYP2D6.

Around one in 10 of the Caucasian population has little or no CYP2D6 enzyme activity, leading to long-lived high drug levels.

== Images ==
<gallery mode="packed-hover">
Image:Dxm1.jpg|''Robitussin brand DXM Gel Caps''
Image:Romilarad.jpg|''1968 Ad, Romilar Chewable Cough Tablets''
</gallery>
== Links ==

[http://www.erowid.org/chemicals/dxm/faq/dxm_faq.shtml DXM FAQ]

[http://en.wikipedia.org/wiki/Dextromethorphan Wikipedia]

== References ==

<references />

[[Category:Dissociative]]
[[Category:Drugs]]

File:Romilarad.jpg

2015-03-28T17:51:57Z

GrimReaper:

DXM

2015-03-28T17:41:54Z

GrimReaper: /* History */

[[File:Dxm_gelcap.jpg|350px|right]]

'''Dextromethorphan''' (also known as 'DXM', 'DM' or 'robo') is an over-the-counter antitussive (cough treatment) which when taken at doses exceeding the recommended therapeutic range becomes a powerful [[Dissociatives|dissociative]] drug which also has some psychedelic properties.

While DXM can be used safely it is not an inherently safe drug. Repeated use within a short period of time, combination with certain types of drugs, certain genetic factors and the prevalence of other active ingredients which become harmful at needed doses found in many brands of cough medication make for a chemical which must be used with caution.

It's mechanism of action is via multiple effects, including actions as a nonselective serotonin reuptake inhibitor and a sigma-1 receptor agonist. DXM and it's major metabolite, dextrorphan, also act as an NMDA receptor antagonist at high doses, which produces effects similar to, yet distinct from, the dissociative states created by other dissociative anaesthetics such as [[Ketamine]] and [[PCP]].

DXM does not typically show up in normal drug tests however it can produce false positive results for PCP and/or Opioids in extended or specialized drug tests. Proper occasional use should not produce these false-positive results after a couple days have passed.

== History ==
The racemic parent compound racemorphan was first described in a Swiss and US patent application from Hoffmann-La Roche in 1946 and 1947, respectively; a patent was granted in 1950. A resolution of the two isomers of racemorphan with tartaric acid was published in 1952, and DXM was successfully tested in 1954 as part of US Navy and CIA-funded research on nonaddictive substitutes for codeine. The FDA approved DXM in 1958 after research supported its legitimacy and effectiveness as a cough suppressant. After its approval, it was introduced as an OTC medication under the name Romilar, which was introduced as a replacement for codeine containing cough remedies in an effort to cut down on abuse. In early 1960s Beat poets Allen Ginsberg and Peter Orlovsky, musicians such as Daevid Allen Soft Machine, and alternative authors such as Jack Kerouac known to have used DXM in the form of Romilar. In 1973, Romilar was taken off the shelves after a burst in sales because of frequent misuse, and was replaced by cough syrup in an attempt to cut down on abuse. In 1975, the popularity and extensive abuse of DXM was recognized, and Romilar was removed from the OTC market. However, DXM was specifically excluded from the Controlled Substances Act (CSA) of 1970, therefore, it was still legal to produce and use. A few years after its removal from OTC, companies began introducing refined DXM products (e.g., Robitussin, Vicks-44, Dextrotussion) that were designed to limit recreational use by creating an unpleasant taste if consumed in large quantities. Within a short time those same manufactures began to produce forms of DXM with "some appealing flavoring," which led at least one researcher to suggest that the cycle of recreational abuse may be repeated. In 1996, DXM HBr powder could be purchased in bulk from online retailers, allowing users to avoid consuming DXM in syrup preparations.

== Different Forms ==

DXM is widely available in over-the-counter cough treatments which appear in different forms including gelcaps, lozenges and syrups. DXM is also less commonly found in a more pure form, either extracted or bought directly from a chemical manufacturer.

While there are some products available which contain only DXM as active medical ingredients it is common to find products which contain DXM but also contain enough of another active ingredient to pose a serious risk to the user's health.

=== Extracted ===

The ideal source of DXM would be an extraction, but that requires time and a chemical procedure which most people are not equipped to do. It's not a complicated process however it does carry some risks in itself. There is a technique known as the 'Agent Lemon extraction'.

=== Syrup ===

Cough syrup is the most common source for DXM users. While there are many brand name and no-name syrups which only contain DXM as an active ingredient there are many active and "inactive" ingredients commonly found in cough syrups which can cause negative effects ranging in severity. See [[DXM#HarmReduction|Harm Reduction]] for more information.

Some say the high produced from syrup is mostly sedating. You may feel sluggish when using it to get high on DXM, possibly as a result of other ingredients found in syrup however because of the even dispersion of DXM throughout the syrup it is said to produce a more 'solid' trip.

===Gel Caps===

DXM Gelcaps such as RobitussinDM Gelcaps or other no-name brand products containing only DXM encased in a gelcap are often the preferred source for DXM users. For most users gelcaps which contain only DXM produce a more clear headed high in lower doses. Most users experience fewer side effects from gelcaps than from syrup however some users report an upset stomach from the gelcaps, indicating that some users may have a sensitivity to the edible plastics used to make the gelcaps.

===Lozenges===

There are also sore-throat and cough medications containing DXM which exist in the form of a hard-candy like lozenge. These sometimes contain only DXM, however most brands of DXM lozenges also contain analgesics such as acetaminophen or benzocaine. Some brands such as '''Cordicin Cough and Cold''' (also known as '''CCC''') have a variety of products, most of which contain other active ingredients such as antihistamines or CPM (Chlorpheniramine Maleate) and may have one or two products which contain only DXM.

WARNING: Cordicin Cough & Cold is one of the most commonly used sources of DXM, and also one of the most dangerous. Nearly every single CCC product contains other active ingredients such as CPM, which can cause severe and life-threatening symptoms including seizures, shortness of breath or troubled breathing, weakness, loss of consciousness, severe dryness of the mouth, nose or throat, bleeding from the skin, mouth, eyes, rectum and vagina, and possibly death.

https://www.erowid.org/chemicals/dxm/dxm_info2.shtml

As always when using lozenges always choose a product which only has DXM in it.

===Delsym===

Delsym is brand with many formulations which contain Dextromethorphan Polistrex.

This is an extended release form of DXM which produced a longer lasting trip with weaker effects. It is said to be impossible to reach the third plateau using DXM which may be preferable for this reason to beginners or users who would prefer a longer and weaker trip.

== Dosage ==

'''DXM doses are affected by weight'''. See [http://taimapedia.org/images/4/46/DXMDosingChart.png this chart] for easy dosing.
Dosage refers to DXM HBR. HBR and Polistirex doses vary significantly due to polistirex slow absorbsion rate. (1mg of DXM polistirex is equivalent to about 6mg DXM HBR)

{| class="wikitable"
|+ Oral
|-
| Light || 100-200mg
|-
| Common || 200-400mg
|-
| Strong || 300-600mg
|-
| Heavy || 600-1500mg
|-
| Risk of death || 2.2g+
|}

== Duration ==

{| class="wikitable"
|+ Oral
|-
| Total || 6-8 hours
|}

=== Redosing ===

Redosing is not advised.

It's better to know how much you've taken at the start of the trip, rather than guestimate how much you're on as you keep dosing. The effects will start to come in waves and may not be pleasant. If you feel the need, it's recommended to take a high initial dose and a lower dose 1-2 hours in.

=== Predosing ===

One should make sure there is only DXM in the product they are taking. Grapefruit juice can potentiate dxm due to intactions with cytochrome P450.<ref>http://medicine.iupui.edu/clinpharm/ddis/2d6references/#dextromethorphanSub</ref>

== Effects ==
The high is not for everyone; it is said to loosely follow the rule of thirds: one third hates it, one third doesn't care, and one third like it.

DXM manifests its effects in a series of plateaus, with dose determining which plateau (and subsequently which effects) one will experience. Lower dose plateaus can be well suited to relaxation, light social interaction and listening to music, however higher doses result in a more encompassing dissociative experience which does not lend itself to attentive presence. At high doses your mind becomes as big as the universe. Strong experiences of detachment, depersonalization, and out-of-body experiences are commonly experienced with DXM at higher doses. These all-encompassing states are startling and uncomfortable for some.

=== Positive ===

* Euphoria, mood lift
* Increased giggling and laughing
* Dissociation of mind from body (positive when sought)
* Creative dream-like experiences
* Increased tactile sensation
* Some users report empathy and forgiveness towards other people

=== Neutral ===

* Pupil dilation
* Visual stop motion effect (flanging or strobing)
* Visual and aural (auditory) hallucinations
* Decreased sexual functioning (difficulty achieving orgasm)
* Confusion, disorientation
* Skin sensitivity, alters tactile (touch) and skin sensations
* Robotic, zombie-like walking, "robo-walk"
* Discoordination, reduced agility
* Loss of appetite
* Involuntary flexing of muscles
* Feelings of merging with adjacent objects like a couch or bed (with higher doses)

=== Negative ===

* Vomiting
* Dizzyness
* Body itching
* Rash, red blotchy skin
* Diarrhea
* Fever
* Tachycardia (racing, pounding heart)
* Some users report feeling disconnected, isolated from others

=== After-Effects ===

* Some users report hangover or depression that might last up to a few days.

=== Robo-Walk ===

The robo-walk feels like all of the muscles in your body are activated at once. You can still walk but forget about running or balance. Imagine the large muscles in your body all tensing up at once, so to walk you don't try to move your leg, you try and relax it in the way you want to go. Detailed coordination such as running, jumping, or maneuvering around furniture becomes much harder if not impossible. However, when you hit the third you really wouldn't want to be moving around anyway. The best thing to do is get a good pair of headphones, turn off the lights, close your eyes and let your mind wander.

== Plateaus ==
There are four 'stages' to DXM trips called '''plateaus'''. The first two are very similar, and the last two are similar.

There are two kind of trips: Sub third and beyond second plateau. If you take a first or second plateau dose, it's totally possible to socialize. Lower plateau doses are relatively easy to hide compared to higher plateau doses. Since you're dissociating yourself, you can remove yourself from awkward social situations or chaotic events. It would also be fun to chill in your room and play a video game and listen to music. The music will get better and you'll get more spacey. If you take a third or fourth plateau dose, it's recommend to trip alone, as it's not a social drug at this dose. The best way to enjoy it is to lay back and listen to music with your eyes closed. If you've ever meditated, you know how your mind can wander without your control. On DXM, you have a tendency to 'unlock' hidden memories. So the best thing is to let your mind take you where it wants to go. It usually knows whats best.

Choosing your destination plateau will depend a lot on what other drugs you've done and how comfortable you are with your mind.

=== First Plateau ===

Feels a bit 'off'. Perhaps like you're a bit buzzed from alcohol or a big hit off a bong.

'''First Plateau dose: 1-2mg/lb.'''

=== Second Plateau ===

You feel like your stoned. Your consciousness feels like it's distancing itself from reality, like it's taking a 'step back' into yourself. The second is supposed to be fun, it's introducing you to the idea that reality is a dream. Music is awesome to listen to and you can walk outside and perhaps hallucinate a small-mild amount. You can socialize with friends and they might take you for sober, or you could say you're slightly drunk.

'''Second Plateau dose: 2-5mg/lb.'''

'''Transitional'''

Most people stop their DXM journey here, as the final two are not really 'fun' but 'enlightening'. We don't recommend crossing this threshold until you're ready to move on from games of the mind to exercises of the consciousness. Enjoy the 2nd plat as long as you can because right now it's more of a fun experience and there is no going back once you've been here. It's like once you see what's behind the curtain, you can't enjoy the show.
Not to say that its not enjoyable, but it looses it's fun charm.

=== Third Plateau ===
This is where you start tripping. You cannot ignore the feeling inside of you. At this point its no longer a social drug and should be done by yourself or with a sitter. This is most akin to an acid trip: it feels very distorted and lasts a couple hours. The third plateau isn't 'party-mode' or even 'socialize-mode'. Its more like 'alone-and-tripping-mode'.
Inside your mind is an entirely new universe to explore. You think of water and an ocean appears. You create universes and live lifetimes inside your mind.
That's what the higher plateaus do.
'''Third Plateau dose: 5-7.5mg/lb.'''

=== Fourth Plateau ===
This is the deep meditative state. Few people enjoy going this far, as all you can really do (or want to do) is sit, listen to music, close your eyes, and become god. You can create universes in your mind just by thinking of them.

'''Fourth Plateau dose: 7.5-10mg/lb.'''

== Harm Reduction ==

See [[Dissociatives#Harm_Reduction|Dissociative Harm Reduction]] for general information.

=== Dangerous Ingredients Commonly Used in DXM Products ===

Many products which contain DXM also contain other medication or otherwise non-medically-active ingredients that can cause serious harm in the doses found in DXM containing products. If a user intends to use an OTC cough medication in order to get high on DXM they almost always will have to consume a dangerous quantity of other dangerous ingredients if they are present in the medication. For this reason it is strongly recommended to find a source which contains /only/ DXM.

The following is a summary of other ingredients commonly found in DXM products.

* : Acetaminophen/Paracetamol/APAP is a painkiller commonly found in over the counter flu medication, and is used in many Tylenol and Panadol brand products.
: Acetaminophen/paracetamol/APAP is hepatoxic in high doses. This means it will damage your liver if taken in high doses.
:: Your body can only process a certain amount of APAP at once before it the normal pathways become saturated.
:: Once the regular pathways used for metabolizing APAP have been saturated the remaining APAP gets broken down in the liver by an enzyme called
:: cytochrome P450. ::: '''When forced to break down APAP this enzyme produces toxic metabolites!'''

The effects of an acetaminophen overdose may not be apparent for up to sixteen hours after the user has ingested the APAP! This makes APAP overdose even more dangerous because of the chance that a user might take more or not take notice after thinking they are 'in the clear'.

'''Under no circumstances should anyone attempt to use any DXM product containing 'Paracetamol', also known as 'APAP' & 'Acetaminophen'!'''

* '''Guaifenesin''' is an expectorant. It works by causing the lungs to produce more fluid, making it easier to cough up phlegm.
: Guaifenesin is added to many OTC cough, cold and flu medications to help treat the 'stuffed up' feeling which often found in viruses and colds.

: Guaifenesin overdoses cause severe nausea and vomiting in most users. Some users report being able to use products which contain some guaifensin and
: other users report no negative effects from guaifenesin containing products.
: '''It is strongly recommended to avoid products which contain Guaifenesin when using DXM!'''

* '''Antihistamines''' such as '''[[DPH|Diphenhydramine]]''' are often found in sleep-aids, night-time formulations of cold medications and allergy medications.
: Antihistamines are sometimes found with DXM in night or 'PM' versions of products, and should generally be avoided when using DXM. When taken in
: high doses antihistamines can cause dizzyness, nausea, a strong dysphoria, paranoia, delirium and hallucinations. Many antihistamines, OTC or prescription
: can also have a dangerous synergy with some of the effects produced by DXM.

* '''Food Coloring & other "Inactive" Ingredients'''
: Many DXM products contain dyes which can cause allergic reactions in some users. Usually these dyes are not harmful in low doses however in doses which may be
: required for DXM's effects they can become problematic. '''Tartrazine (FD&C Yellow #5)''' is one of the most notable coloring ingredients to cause reactions.

: Cough syrups usually contain one or more chemical used to make them taste sweet.
: '''Glucose, sucrose, invert sugar, and fructose''' are commonly used sweetening agents. These sweeteners pose an obvious risk to people with blood sugar conditions
: such as diabetes or hypoglycemia.

: Thickening agents such as '''propylene glycol''' or '''polyethylene glycol''' are found in most cough syrups. These are not toxic but may cause an upset stomach
: when consumed in large doses.

=== Interactions ===
DXM has several potentially dangerous interactions with pharmaceutical and recreational drugs including some analgesics (painkillers), antihistamines, antidepressants and stimulants.

DXM has the potential to cause [[Serotonin Syndrome]] if mixed with other serotonergic drugs such as [[Antidepressants|antidepressants]], MAOIs, empathogens which affect serotonin release such as [[MDMA]], [[MDA]], [[Mephedrone]], etc. Serotonin Syndrome causes discomfort, excitability, irritability, and can be deadly <ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464814/</ref> if not treated.
* See [[Drug_Combinations|Drug combinations]] and [[Dissociatives#Interactions|Dissociative Interactions]] for more information.

== Chemistry and Pharmacology ==

IUPAC:(4bS,8aR,9S)-3-Methoxy-11-methyl-6,7,8,8a,9,10-hexahydro-5H-9,4b-(epiminoethano)phenanthrene.

Dextromethorphan is the dextrorotartory enantiomer of levomethophan, which is the methyl ether of levophanol, both opioid analgesics.

=== Pharmacodynamics ===

{| class="wikitable"
|+ Binding receptors
|-
| NMDA - 7253
|-
| SERT - 2015
|-
| NET - 110606
|-
| Sigma-1 - 23
|-
| Sigma-2 - 240
|}

=== Pharmacokinectics ===

Following oral dosing, DXM is rapidly absorbed from the GI tract. Where it enters the bloodstream, and crosses the blood-brain barrier.

At therapeutic doses, DXM acts centrally (brain) as opposed to locally (Respiratory tract). It's rapidly absorbed from the GI tract into the active metabolite Dextrophan (DXO) in the liver by the cytochrome P450 enzyme CYP2D6.

Around one in 10 of the Caucasian population has little or no CYP2D6 enzyme activity, leading to long-lived high drug levels.

== Images ==

<gallery mode="packed-hover">
Image:Dxm1.jpg|''Robitussin brand DXM Gel Caps''
</gallery>
== Links ==

[http://www.erowid.org/chemicals/dxm/faq/dxm_faq.shtml DXM FAQ]

[http://en.wikipedia.org/wiki/Dextromethorphan Wikipedia]

== References ==

<references />

[[Category:Dissociative]]
[[Category:Drugs]]

DXM

2015-03-28T17:23:52Z

GrimReaper:

[[File:Dxm_gelcap.jpg|350px|right]]

'''Dextromethorphan''' (also known as 'DXM', 'DM' or 'robo') is an over-the-counter antitussive (cough treatment) which when taken at doses exceeding the recommended therapeutic range becomes a powerful [[Dissociatives|dissociative]] drug which also has some psychedelic properties.

While DXM can be used safely it is not an inherently safe drug. Repeated use within a short period of time, combination with certain types of drugs, certain genetic factors and the prevalence of other active ingredients which become harmful at needed doses found in many brands of cough medication make for a chemical which must be used with caution.

It's mechanism of action is via multiple effects, including actions as a nonselective serotonin reuptake inhibitor and a sigma-1 receptor agonist. DXM and it's major metabolite, dextrorphan, also act as an NMDA receptor antagonist at high doses, which produces effects similar to, yet distinct from, the dissociative states created by other dissociative anaesthetics such as [[Ketamine]] and [[PCP]].

DXM does not typically show up in normal drug tests however it can produce false positive results for PCP and/or Opioids in extended or specialized drug tests. Proper occasional use should not produce these false-positive results after a couple days have passed.

== History ==
The FDA approved DXM in 1958 after research supported its legitimacy and effectiveness as a cough suppressant. After its approval, it was introduced as an OTC medication under the name Romilar, which was introduced as a replacement for codeine containing cough remedies in an effort to cut down on abuse. In early 1960s Beat poets Allen Ginsberg and Peter Orlovsky, musicians such as Daevid Allen Soft Machine, and alternative authors such as Jack Kerouac known to have used DXM in the form of Romilar. In 1975, the popularity and extensive abuse of DXM was recognized, and Romilar was removed from the OTC market. However, DXM was specifically excluded from the Controlled Substances Act (CSA) of 1970, therefore, it was still legal to produce and use. A few years after its removal from OTC, companies began introducing refined DXM products (e.g., Robitussin, Vicks-44, Dextrotussion) that were designed to limit recreational use by creating an unpleasant taste if consumed in large quantities. Within a short time those same manufactures began to produce forms of DXM with "some appealing flavoring," which led at least one researcher to suggest that the cycle of recreational abuse may be repeated.

== Different Forms ==

DXM is widely available in over-the-counter cough treatments which appear in different forms including gelcaps, lozenges and syrups. DXM is also less commonly found in a more pure form, either extracted or bought directly from a chemical manufacturer.

While there are some products available which contain only DXM as active medical ingredients it is common to find products which contain DXM but also contain enough of another active ingredient to pose a serious risk to the user's health.

=== Extracted ===

The ideal source of DXM would be an extraction, but that requires time and a chemical procedure which most people are not equipped to do. It's not a complicated process however it does carry some risks in itself. There is a technique known as the 'Agent Lemon extraction'.

=== Syrup ===

Cough syrup is the most common source for DXM users. While there are many brand name and no-name syrups which only contain DXM as an active ingredient there are many active and "inactive" ingredients commonly found in cough syrups which can cause negative effects ranging in severity. See [[DXM#HarmReduction|Harm Reduction]] for more information.

Some say the high produced from syrup is mostly sedating. You may feel sluggish when using it to get high on DXM, possibly as a result of other ingredients found in syrup however because of the even dispersion of DXM throughout the syrup it is said to produce a more 'solid' trip.

===Gel Caps===

DXM Gelcaps such as RobitussinDM Gelcaps or other no-name brand products containing only DXM encased in a gelcap are often the preferred source for DXM users. For most users gelcaps which contain only DXM produce a more clear headed high in lower doses. Most users experience fewer side effects from gelcaps than from syrup however some users report an upset stomach from the gelcaps, indicating that some users may have a sensitivity to the edible plastics used to make the gelcaps.

===Lozenges===

There are also sore-throat and cough medications containing DXM which exist in the form of a hard-candy like lozenge. These sometimes contain only DXM, however most brands of DXM lozenges also contain analgesics such as acetaminophen or benzocaine. Some brands such as '''Cordicin Cough and Cold''' (also known as '''CCC''') have a variety of products, most of which contain other active ingredients such as antihistamines or CPM (Chlorpheniramine Maleate) and may have one or two products which contain only DXM.

WARNING: Cordicin Cough & Cold is one of the most commonly used sources of DXM, and also one of the most dangerous. Nearly every single CCC product contains other active ingredients such as CPM, which can cause severe and life-threatening symptoms including seizures, shortness of breath or troubled breathing, weakness, loss of consciousness, severe dryness of the mouth, nose or throat, bleeding from the skin, mouth, eyes, rectum and vagina, and possibly death.

https://www.erowid.org/chemicals/dxm/dxm_info2.shtml

As always when using lozenges always choose a product which only has DXM in it.

===Delsym===

Delsym is brand with many formulations which contain Dextromethorphan Polistrex.

This is an extended release form of DXM which produced a longer lasting trip with weaker effects. It is said to be impossible to reach the third plateau using DXM which may be preferable for this reason to beginners or users who would prefer a longer and weaker trip.

== Dosage ==

'''DXM doses are affected by weight'''. See [http://taimapedia.org/images/4/46/DXMDosingChart.png this chart] for easy dosing.
Dosage refers to DXM HBR. HBR and Polistirex doses vary significantly due to polistirex slow absorbsion rate. (1mg of DXM polistirex is equivalent to about 6mg DXM HBR)

{| class="wikitable"
|+ Oral
|-
| Light || 100-200mg
|-
| Common || 200-400mg
|-
| Strong || 300-600mg
|-
| Heavy || 600-1500mg
|-
| Risk of death || 2.2g+
|}

== Duration ==

{| class="wikitable"
|+ Oral
|-
| Total || 6-8 hours
|}

=== Redosing ===

Redosing is not advised.

It's better to know how much you've taken at the start of the trip, rather than guestimate how much you're on as you keep dosing. The effects will start to come in waves and may not be pleasant. If you feel the need, it's recommended to take a high initial dose and a lower dose 1-2 hours in.

=== Predosing ===

One should make sure there is only DXM in the product they are taking. Grapefruit juice can potentiate dxm due to intactions with cytochrome P450.<ref>http://medicine.iupui.edu/clinpharm/ddis/2d6references/#dextromethorphanSub</ref>

== Effects ==
The high is not for everyone; it is said to loosely follow the rule of thirds: one third hates it, one third doesn't care, and one third like it.

DXM manifests its effects in a series of plateaus, with dose determining which plateau (and subsequently which effects) one will experience. Lower dose plateaus can be well suited to relaxation, light social interaction and listening to music, however higher doses result in a more encompassing dissociative experience which does not lend itself to attentive presence. At high doses your mind becomes as big as the universe. Strong experiences of detachment, depersonalization, and out-of-body experiences are commonly experienced with DXM at higher doses. These all-encompassing states are startling and uncomfortable for some.

=== Positive ===

* Euphoria, mood lift
* Increased giggling and laughing
* Dissociation of mind from body (positive when sought)
* Creative dream-like experiences
* Increased tactile sensation
* Some users report empathy and forgiveness towards other people

=== Neutral ===

* Pupil dilation
* Visual stop motion effect (flanging or strobing)
* Visual and aural (auditory) hallucinations
* Decreased sexual functioning (difficulty achieving orgasm)
* Confusion, disorientation
* Skin sensitivity, alters tactile (touch) and skin sensations
* Robotic, zombie-like walking, "robo-walk"
* Discoordination, reduced agility
* Loss of appetite
* Involuntary flexing of muscles
* Feelings of merging with adjacent objects like a couch or bed (with higher doses)

=== Negative ===

* Vomiting
* Dizzyness
* Body itching
* Rash, red blotchy skin
* Diarrhea
* Fever
* Tachycardia (racing, pounding heart)
* Some users report feeling disconnected, isolated from others

=== After-Effects ===

* Some users report hangover or depression that might last up to a few days.

=== Robo-Walk ===

The robo-walk feels like all of the muscles in your body are activated at once. You can still walk but forget about running or balance. Imagine the large muscles in your body all tensing up at once, so to walk you don't try to move your leg, you try and relax it in the way you want to go. Detailed coordination such as running, jumping, or maneuvering around furniture becomes much harder if not impossible. However, when you hit the third you really wouldn't want to be moving around anyway. The best thing to do is get a good pair of headphones, turn off the lights, close your eyes and let your mind wander.

== Plateaus ==
There are four 'stages' to DXM trips called '''plateaus'''. The first two are very similar, and the last two are similar.

There are two kind of trips: Sub third and beyond second plateau. If you take a first or second plateau dose, it's totally possible to socialize. Lower plateau doses are relatively easy to hide compared to higher plateau doses. Since you're dissociating yourself, you can remove yourself from awkward social situations or chaotic events. It would also be fun to chill in your room and play a video game and listen to music. The music will get better and you'll get more spacey. If you take a third or fourth plateau dose, it's recommend to trip alone, as it's not a social drug at this dose. The best way to enjoy it is to lay back and listen to music with your eyes closed. If you've ever meditated, you know how your mind can wander without your control. On DXM, you have a tendency to 'unlock' hidden memories. So the best thing is to let your mind take you where it wants to go. It usually knows whats best.

Choosing your destination plateau will depend a lot on what other drugs you've done and how comfortable you are with your mind.

=== First Plateau ===

Feels a bit 'off'. Perhaps like you're a bit buzzed from alcohol or a big hit off a bong.

'''First Plateau dose: 1-2mg/lb.'''

=== Second Plateau ===

You feel like your stoned. Your consciousness feels like it's distancing itself from reality, like it's taking a 'step back' into yourself. The second is supposed to be fun, it's introducing you to the idea that reality is a dream. Music is awesome to listen to and you can walk outside and perhaps hallucinate a small-mild amount. You can socialize with friends and they might take you for sober, or you could say you're slightly drunk.

'''Second Plateau dose: 2-5mg/lb.'''

'''Transitional'''

Most people stop their DXM journey here, as the final two are not really 'fun' but 'enlightening'. We don't recommend crossing this threshold until you're ready to move on from games of the mind to exercises of the consciousness. Enjoy the 2nd plat as long as you can because right now it's more of a fun experience and there is no going back once you've been here. It's like once you see what's behind the curtain, you can't enjoy the show.
Not to say that its not enjoyable, but it looses it's fun charm.

=== Third Plateau ===
This is where you start tripping. You cannot ignore the feeling inside of you. At this point its no longer a social drug and should be done by yourself or with a sitter. This is most akin to an acid trip: it feels very distorted and lasts a couple hours. The third plateau isn't 'party-mode' or even 'socialize-mode'. Its more like 'alone-and-tripping-mode'.
Inside your mind is an entirely new universe to explore. You think of water and an ocean appears. You create universes and live lifetimes inside your mind.
That's what the higher plateaus do.
'''Third Plateau dose: 5-7.5mg/lb.'''

=== Fourth Plateau ===
This is the deep meditative state. Few people enjoy going this far, as all you can really do (or want to do) is sit, listen to music, close your eyes, and become god. You can create universes in your mind just by thinking of them.

'''Fourth Plateau dose: 7.5-10mg/lb.'''

== Harm Reduction ==

See [[Dissociatives#Harm_Reduction|Dissociative Harm Reduction]] for general information.

=== Dangerous Ingredients Commonly Used in DXM Products ===

Many products which contain DXM also contain other medication or otherwise non-medically-active ingredients that can cause serious harm in the doses found in DXM containing products. If a user intends to use an OTC cough medication in order to get high on DXM they almost always will have to consume a dangerous quantity of other dangerous ingredients if they are present in the medication. For this reason it is strongly recommended to find a source which contains /only/ DXM.

The following is a summary of other ingredients commonly found in DXM products.

* : Acetaminophen/Paracetamol/APAP is a painkiller commonly found in over the counter flu medication, and is used in many Tylenol and Panadol brand products.
: Acetaminophen/paracetamol/APAP is hepatoxic in high doses. This means it will damage your liver if taken in high doses.
:: Your body can only process a certain amount of APAP at once before it the normal pathways become saturated.
:: Once the regular pathways used for metabolizing APAP have been saturated the remaining APAP gets broken down in the liver by an enzyme called
:: cytochrome P450. ::: '''When forced to break down APAP this enzyme produces toxic metabolites!'''

The effects of an acetaminophen overdose may not be apparent for up to sixteen hours after the user has ingested the APAP! This makes APAP overdose even more dangerous because of the chance that a user might take more or not take notice after thinking they are 'in the clear'.

'''Under no circumstances should anyone attempt to use any DXM product containing 'Paracetamol', also known as 'APAP' & 'Acetaminophen'!'''

* '''Guaifenesin''' is an expectorant. It works by causing the lungs to produce more fluid, making it easier to cough up phlegm.
: Guaifenesin is added to many OTC cough, cold and flu medications to help treat the 'stuffed up' feeling which often found in viruses and colds.

: Guaifenesin overdoses cause severe nausea and vomiting in most users. Some users report being able to use products which contain some guaifensin and
: other users report no negative effects from guaifenesin containing products.
: '''It is strongly recommended to avoid products which contain Guaifenesin when using DXM!'''

* '''Antihistamines''' such as '''[[DPH|Diphenhydramine]]''' are often found in sleep-aids, night-time formulations of cold medications and allergy medications.
: Antihistamines are sometimes found with DXM in night or 'PM' versions of products, and should generally be avoided when using DXM. When taken in
: high doses antihistamines can cause dizzyness, nausea, a strong dysphoria, paranoia, delirium and hallucinations. Many antihistamines, OTC or prescription
: can also have a dangerous synergy with some of the effects produced by DXM.

* '''Food Coloring & other "Inactive" Ingredients'''
: Many DXM products contain dyes which can cause allergic reactions in some users. Usually these dyes are not harmful in low doses however in doses which may be
: required for DXM's effects they can become problematic. '''Tartrazine (FD&C Yellow #5)''' is one of the most notable coloring ingredients to cause reactions.

: Cough syrups usually contain one or more chemical used to make them taste sweet.
: '''Glucose, sucrose, invert sugar, and fructose''' are commonly used sweetening agents. These sweeteners pose an obvious risk to people with blood sugar conditions
: such as diabetes or hypoglycemia.

: Thickening agents such as '''propylene glycol''' or '''polyethylene glycol''' are found in most cough syrups. These are not toxic but may cause an upset stomach
: when consumed in large doses.

=== Interactions ===
DXM has several potentially dangerous interactions with pharmaceutical and recreational drugs including some analgesics (painkillers), antihistamines, antidepressants and stimulants.

DXM has the potential to cause [[Serotonin Syndrome]] if mixed with other serotonergic drugs such as [[Antidepressants|antidepressants]], MAOIs, empathogens which affect serotonin release such as [[MDMA]], [[MDA]], [[Mephedrone]], etc. Serotonin Syndrome causes discomfort, excitability, irritability, and can be deadly <ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464814/</ref> if not treated.
* See [[Drug_Combinations|Drug combinations]] and [[Dissociatives#Interactions|Dissociative Interactions]] for more information.

== Chemistry and Pharmacology ==

IUPAC:(4bS,8aR,9S)-3-Methoxy-11-methyl-6,7,8,8a,9,10-hexahydro-5H-9,4b-(epiminoethano)phenanthrene.

Dextromethorphan is the dextrorotartory enantiomer of levomethophan, which is the methyl ether of levophanol, both opioid analgesics.

=== Pharmacodynamics ===

{| class="wikitable"
|+ Binding receptors
|-
| NMDA - 7253
|-
| SERT - 2015
|-
| NET - 110606
|-
| Sigma-1 - 23
|-
| Sigma-2 - 240
|}

=== Pharmacokinectics ===

Following oral dosing, DXM is rapidly absorbed from the GI tract. Where it enters the bloodstream, and crosses the blood-brain barrier.

At therapeutic doses, DXM acts centrally (brain) as opposed to locally (Respiratory tract). It's rapidly absorbed from the GI tract into the active metabolite Dextrophan (DXO) in the liver by the cytochrome P450 enzyme CYP2D6.

Around one in 10 of the Caucasian population has little or no CYP2D6 enzyme activity, leading to long-lived high drug levels.

== Images ==

<gallery mode="packed-hover">
Image:Dxm1.jpg|''Robitussin brand DXM Gel Caps''
</gallery>
== Links ==

[http://www.erowid.org/chemicals/dxm/faq/dxm_faq.shtml DXM FAQ]

[http://en.wikipedia.org/wiki/Dextromethorphan Wikipedia]

== References ==

<references />

[[Category:Dissociative]]
[[Category:Drugs]]

DXM

2015-03-28T17:23:34Z

GrimReaper:

[[File:Dxm_gelcap.jpg|350px|right]]

'''Dextromethorphan''' (also known as 'DXM', 'DM' or 'robo') is an over-the-counter antitussive (cough treatment) which when taken at doses exceeding the recommended therapeutic range becomes a powerful [[Dissociatives|dissociative]] drug which also has some psychedelic properties.

While DXM can be used safely it is not an inherently safe drug. Repeated use within a short period of time, combination with certain types of drugs, certain genetic factors and the prevalence of other active ingredients which become harmful at needed doses found in many brands of cough medication make for a chemical which must be used with caution.

It's mechanism of action is via multiple effects, including actions as a nonselective serotonin reuptake inhibitor and a sigma-1 receptor agonist. DXM and it's major metabolite, dextrorphan, also act as an NMDA receptor antagonist at high doses, which produces effects similar to, yet distinct from, the dissociative states created by other dissociative anaesthetics such as [[Ketamine]] and [[PCP]].

DXM does not typically show up in normal drug tests however it can produce false positive results for PCP and/or Opioids in extended or specialized drug tests. Proper occasional use should not produce these false-positive results after a couple days have passed.

== History ==
The FDA approved DXM in 1958 after research supported its legitimacy and effectiveness as a cough suppressant. After its approval, it was introduced as an OTC medication under the name Romilar, which was introduced as a replacement for codeine containing cough remedies in an effort to cut down on abuse. In early 1960s Beat poets Allen Ginsberg and Peter Orlovsky, musicians such as Daevid Allen Soft Machine, and alternative authors such as Jack Kerouac known to have used DXM in the form of Romilar. In 1975, the popularity and extensive abuse of DXM was recognized, and Romilar was removed from the OTC market. However, DXM was specifically excluded from the Controlled Substances Act (CSA) of 1970, therefore, it was still legal to produce and use. A few years after its removal from OTC, companies began introducing refined DXM products (e.g., Robitussin, Vicks-44, Dextrotussion) that were designed to limit recreational use by creating an unpleasant taste if consumed in large quantities. Within a short time those same manufactures began to produce forms of DXM with "some appealing flavoring," which led at least one researcher to suggest that the cycle of recreational abuse may be repeated.

== Different Forms ==

DXM is widely available in over-the-counter cough treatments which appear in different forms including gelcaps, lozenges and syrups. DXM is also less commonly found in a more pure form, either extracted or bought directly from a chemical manufacturer.

While there are some products available which contain only DXM as active medical ingredients it is common to find products which contain DXM but also contain enough of another active ingredient to pose a serious risk to the user's health.

=== Extracted ===

The ideal source of DXM would be an extraction, but that requires time and a chemical procedure which most people are not equipped to do. It's not a complicated process however it does carry some risks in itself. There is a technique known as the 'Agent Lemon extraction'.

=== Syrup ===

Cough syrup is the most common source for DXM users. While there are many brand name and no-name syrups which only contain DXM as an active ingredient there are many active and "inactive" ingredients commonly found in cough syrups which can cause negative effects ranging in severity. See [[DXM#HarmReduction|Harm Reduction]] for more information.

Some say the high produced from syrup is mostly sedating. You may feel sluggish when using it to get high on DXM, possibly as a result of other ingredients found in syrup however because of the even dispersion of DXM throughout the syrup it is said to produce a more 'solid' trip.

===Gel Caps===

DXM Gelcaps such as RobitussinDM Gelcaps or other no-name brand products containing only DXM encased in a gelcap are often the preferred source for DXM users. For most users gelcaps which contain only DXM produce a more clear headed high in lower doses. Most users experience fewer side effects from gelcaps than from syrup however some users report an upset stomach from the gelcaps, indicating that some users may have a sensitivity to the edible plastics used to make the gelcaps.

===Lozenges===

There are also sore-throat and cough medications containing DXM which exist in the form of a hard-candy like lozenge. These sometimes contain only DXM, however most brands of DXM lozenges also contain analgesics such as acetaminophen or benzocaine. Some brands such as '''Cordicin Cough and Cold''' (also known as '''CCC''') have a variety of products, most of which contain other active ingredients such as antihistamines or CPM (Chlorpheniramine Maleate) and may have one or two products which contain only DXM.

WARNING: Cordicin Cough & Cold is one of the most commonly used sources of DXM, and also one of the most dangerous. Nearly every single CCC product contains other active ingredients such as CPM, which can cause severe and life-threatening symptoms including seizures, shortness of breath or troubled breathing, weakness, loss of consciousness, severe dryness of the mouth, nose or throat, bleeding from the skin, mouth, eyes, rectum and vagina, and possibly death.

https://www.erowid.org/chemicals/dxm/dxm_info2.shtml

As always when using lozenges always choose a product which only has DXM in it.

===Delsym===

Delsym is brand with many formulations which contain Dextromethorphan Polistrex.

This is an extended release form of DXM which produced a longer lasting trip with weaker effects. It is said to be impossible to reach the third plateau using DXM which may be preferable for this reason to beginners or users who would prefer a longer and weaker trip.

== Dosage ==

'''DXM doses are affected by weight'''. See [http://taimapedia.org/images/4/46/DXMDosingChart.png this chart] for easy dosing.
Dosage refers to DXM HBR. HBR and Polistirex doses vary significantly due to polistirex slow absorbsion rate. (1mg of DXM polistirex is equivalent to about 6mg DXM HBR)

{| class="wikitable"
|+ Oral
|-
| Light || 100-200mg
|-
| Common || 200-400mg
|-
| Strong || 300-600mg
|-
| Heavy || 600-1500mg
|-
| Risk of death || 2.2g+
|}

== Duration ==

{| class="wikitable"
|+ Oral
|-
| Total || 6-8 hours
|}

=== Redosing ===

Redosing is not advised.

It's better to know how much you've taken at the start of the trip, rather than guestimate how much you're on as you keep dosing. The effects will start to come in waves and may not be pleasant. If you feel the need, it's recommended to take a high initial dose and a lower dose 1-2 hours in.

=== Predosing ===

One should make sure there is only DXM in the product they are taking. Grapefruit juice can potentiate dxm due to intactions with cytochrome P450.<ref>http://medicine.iupui.edu/clinpharm/ddis/2d6references/#dextromethorphanSub</ref>

== Effects ==
The high is not for everyone; it is said to loosely follow the rule of thirds: one third hates it, one third doesn't care, and one third like it.

DXM manifests its effects in a series of plateaus, with dose determining which plateau (and subsequently which effects) one will experience. Lower dose plateaus can be well suited to relaxation, light social interaction and listening to music, however higher doses result in a more encompassing dissociative experience which does not lend itself to attentive presence. At high doses your mind becomes as big as the universe. Strong experiences of detachment, depersonalization, and out-of-body experiences are commonly experienced with DXM at higher doses. These all-encompassing states are startling and uncomfortable for some.

=== Positive ===

* Euphoria, mood lift
* Increased giggling and laughing
* Dissociation of mind from body (positive when sought)
* Creative dream-like experiences
* Increased tactile sensation
* Some users report empathy and forgiveness towards other people

=== Neutral ===

* Pupil dilation
* Visual stop motion effect (flanging or strobing)
* Visual and aural (auditory) hallucinations
* Decreased sexual functioning (difficulty achieving orgasm)
* Confusion, disorientation
* Skin sensitivity, alters tactile (touch) and skin sensations
* Robotic, zombie-like walking, "robo-walk"
* Discoordination, reduced agility
* Loss of appetite
* Involuntary flexing of muscles
* Feelings of merging with adjacent objects like a couch or bed (with higher doses)

=== Negative ===

* Vomiting
* Dizzyness
* Body itching
* Rash, red blotchy skin
* Diarrhea
* Fever
* Tachycardia (racing, pounding heart)
* Some users report feeling disconnected, isolated from others

=== After-Effects ===

* Some users report hangover or depression that might last up to a few days.

=== Robo-Walk ===

The robo-walk feels like all of the muscles in your body are activated at once. You can still walk but forget about running or balance. Imagine the large muscles in your body all tensing up at once, so to walk you don't try to move your leg, you try and relax it in the way you want to go. Detailed coordination such as running, jumping, or maneuvering around furniture becomes much harder if not impossible. However, when you hit the third you really wouldn't want to be moving around anyway. The best thing to do is get a good pair of headphones, turn off the lights, close your eyes and let your mind wander.

== Plateaus ==
There are four 'stages' to DXM trips called '''plateaus'''. The first two are very similar, and the last two are similar.

There are two kind of trips: Sub third and beyond second plateau. If you take a first or second plateau dose, it's totally possible to socialize. Lower plateau doses are relatively easy to hide compared to higher plateau doses. Since you're dissociating yourself, you can remove yourself from awkward social situations or chaotic events. It would also be fun to chill in your room and play a video game and listen to music. The music will get better and you'll get more spacey. If you take a third or fourth plateau dose, it's recommend to trip alone, as it's not a social drug at this dose. The best way to enjoy it is to lay back and listen to music with your eyes closed. If you've ever meditated, you know how your mind can wander without your control. On DXM, you have a tendency to 'unlock' hidden memories. So the best thing is to let your mind take you where it wants to go. It usually knows whats best.

Choosing your destination plateau will depend a lot on what other drugs you've done and how comfortable you are with your mind.

=== First Plateau ===

Feels a bit 'off'. Perhaps like you're a bit buzzed from alcohol or a big hit off a bong.

'''First Plateau dose: 1-2mg/lb.'''

=== Second Plateau ===

You feel like your stoned. Your consciousness feels like it's distancing itself from reality, like it's taking a 'step back' into yourself. The second is supposed to be fun, it's introducing you to the idea that reality is a dream. Music is awesome to listen to and you can walk outside and perhaps hallucinate a small-mild amount. You can socialize with friends and they might take you for sober, or you could say you're slightly drunk.

'''Second Plateau dose: 2-5mg/lb.'''

'''Transitional'''

Most people stop their DXM journey here, as the final two are not really 'fun' but 'enlightening'. We don't recommend crossing this threshold until you're ready to move on from games of the mind to exercises of the consciousness. Enjoy the 2nd plat as long as you can because right now it's more of a fun experience and there is no going back once you've been here. It's like once you see what's behind the curtain, you can't enjoy the show.
Not to say that its not enjoyable, but it looses it's fun charm.

=== Third Plateau ===
This is where you start tripping. You cannot ignore the feeling inside of you. At this point its no longer a social drug and should be done by yourself or with a sitter. This is most akin to an acid trip: it feels very distorted and lasts a couple hours. The third plateau isn't 'party-mode' or even 'socialize-mode'. Its more like 'alone-and-tripping-mode'.
Inside your mind is an entirely new universe to explore. You think of water and an ocean appears. You create universes and live lifetimes inside your mind.
That's what the higher plateaus do.
'''Third Plateau dose: 5-7.5mg/lb.'''

=== Fourth Plateau ===
This is the deep meditative state. Few people enjoy going this far, as all you can really do (or want to do) is sit, listen to music, close your eyes, and become god. You can create universes in your mind just by thinking of them.

'''Fourth Plateau dose: 7.5-10mg/lb.'''

== Harm Reduction ==

See [[Dissociatives#Harm_Reduction|Dissociative Harm Reduction]] for general information.

=== Dangerous Ingredients Commonly Used in DXM Products ===

Many products which contain DXM also contain other medication or otherwise non-medically-active ingredients that can cause serious harm in the doses found in DXM containing products. If a user intends to use an OTC cough medication in order to get high on DXM they almost always will have to consume a dangerous quantity of other dangerous ingredients if they are present in the medication. For this reason it is strongly recommended to find a source which contains /only/ DXM.

The following is a summary of other ingredients commonly found in DXM products.

* : Acetaminophen/Paracetamol/APAP is a painkiller commonly found in over the counter flu medication, and is used in many Tylenol and Panadol brand products.
: Acetaminophen/paracetamol/APAP is hepatoxic in high doses. This means it will damage your liver if taken in high doses.
:: Your body can only process a certain amount of APAP at once before it the normal pathways become saturated.
:: Once the regular pathways used for metabolizing APAP have been saturated the remaining APAP gets broken down in the liver by an enzyme called
:: cytochrome P450. ::: '''When forced to break down APAP this enzyme produces toxic metabolites!'''

The effects of an acetaminophen overdose may not be apparent for up to sixteen hours after the user has ingested the APAP! This makes APAP overdose even more dangerous because of the chance that a user might take more or not take notice after thinking they are 'in the clear'.

'''Under no circumstances should anyone attempt to use any DXM product containing 'Paracetamol', also known as 'APAP' & 'Acetaminophen'!'''

* '''Guaifenesin''' is an expectorant. It works by causing the lungs to produce more fluid, making it easier to cough up phlegm.
: Guaifenesin is added to many OTC cough, cold and flu medications to help treat the 'stuffed up' feeling which often found in viruses and colds.

: Guaifenesin overdoses cause severe nausea and vomiting in most users. Some users report being able to use products which contain some guaifensin and
: other users report no negative effects from guaifenesin containing products.
: '''It is strongly recommended to avoid products which contain Guaifenesin when using DXM!'''

* '''Antihistamines''' such as '''[[DPH|Diphenhydramine]]''' are often found in sleep-aids, night-time formulations of cold medications and allergy medications.
: Antihistamines are sometimes found with DXM in night or 'PM' versions of products, and should generally be avoided when using DXM. When taken in
: high doses antihistamines can cause dizzyness, nausea, a strong dysphoria, paranoia, delirium and hallucinations. Many antihistamines, OTC or prescription
: can also have a dangerous synergy with some of the effects produced by DXM.

* '''Food Coloring & other "Inactive" Ingredients'''
: Many DXM products contain dyes which can cause allergic reactions in some users. Usually these dyes are not harmful in low doses however in doses which may be
: required for DXM's effects they can become problematic. '''Tartrazine (FD&C Yellow #5)''' is one of the most notable coloring ingredients to cause reactions.

: Cough syrups usually contain one or more chemical used to make them taste sweet.
: '''Glucose, sucrose, invert sugar, and fructose''' are commonly used sweetening agents. These sweeteners pose an obvious risk to people with blood sugar conditions
: such as diabetes or hypoglycemia.

: Thickening agents such as '''propylene glycol''' or '''polyethylene glycol''' are found in most cough syrups. These are not toxic but may cause an upset stomach
: when consumed in large doses.

=== Interactions ===
DXM has several potentially dangerous interactions with pharmaceutical and recreational drugs including some analgesics (painkillers), antihistamines, antidepressants and stimulants.

DXM has the potential to cause [[Serotonin Syndrome]] if mixed with other serotonergic drugs such as [[Antidepressants|antidepressants]], MAOIs, empathogens which affect serotonin release such as [[MDMA]], [[MDA]], [[Mephedrone]], etc. Serotonin Syndrome causes discomfort, excitability, irritability, and can be deadly <ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464814/</ref> if not treated.
* See [[Drug_Combinations|Drug combinations]] and [[Dissociatives#Interactions|Dissociative Interactions]] for more information.

== Chemistry and Pharmacology ==

IUPAC:(4bS,8aR,9S)-3-Methoxy-11-methyl-6,7,8,8a,9,10-hexahydro-5H-9,4b-(epiminoethano)phenanthrene.

Dextromethorphan is the dextrorotartory enantiomer of levomethophan, which is the methyl ether of levophanol, both opioid analgesics.

=== Pharmacodynamics ===

{| class="wikitable"
|+ Binding receptors
|-
| NMDA - 7253
|-
| SERT - 2015
|-
| NET - 110606
|-
| Sigma-1 - 23
|-
| Sigma-2 - 240
|}

=== Pharmacokinectics ===

Following oral dosing, DXM is rapidly absorbed from the GI tract. Where it enters the bloodstream, and crosses the blood-brain barrier.

At therapeutic doses, DXM acts centrally (brain) as opposed to locally (Respiratory tract). It's rapidly absorbed from the GI tract into the active metabolite Dextrophan (DXO) in the liver by the cytochrome P450 enzyme CYP2D6.

Around one in 10 of the Caucasian population has little or no CYP2D6 enzyme activity, leading to long-lived high drug levels.

== Images ==

<gallery mode="packed-hover">
Image:Dxm1.jpg|''Robitussin brand DXM Gel Caps''
</gallery>
== Links ==

[http://www.erowid.org/chemicals/dxm/faq/dxm_faq.shtml DXM FAQ]

[http://en.wikipedia.org/wiki/Dextromethorphan Wikipedia]

== References ==

<references />

[[Category:Dissociative]]
[[Category:Drugs]]

DXM

2015-03-28T07:42:45Z

GrimReaper:

[[File:Dxm_gelcap.jpg|350px|right]]

'''Dextromethorphan''' (also known as 'DXM', 'DM' or 'robo') is an over-the-counter antitussive (cough treatment) which when taken at doses exceeding the recommended therapeutic range becomes a powerful [[Dissociatives|dissociative]] drug which also has some psychedelic properties.

While DXM can be used safely it is not an inherently safe drug. Repeated use within a short period of time, combination with certain types of drugs, certain genetic factors and the prevalence of other active ingredients which become harmful at needed doses found in many brands of cough medication make for a chemical which must be used with caution.

It's mechanism of action is via multiple effects, including actions as a nonselective serotonin reuptake inhibitor and a sigma-1 receptor agonist. DXM and it's major metabolite, dextrorphan, also act as an NMDA receptor antagonist at high doses, which produces effects similar to, yet distinct from, the dissociative states created by other dissociative anaesthetics such as [[Ketamine]] and [[PCP]].

DXM does not typically show up in normal drug tests however it can produce false positive results for PCP and/or Opioids in extended or specialized drug tests. Proper occasional use should not produce these false-positive results after a couple days have passed.

== Different Forms ==

DXM is widely available in over-the-counter cough treatments which appear in different forms including gelcaps, lozenges and syrups. DXM is also less commonly found in a more pure form, either extracted or bought directly from a chemical manufacturer.

While there are some products available which contain only DXM as active medical ingredients it is common to find products which contain DXM but also contain enough of another active ingredient to pose a serious risk to the user's health.

=== Extracted ===

The ideal source of DXM would be an extraction, but that requires time and a chemical procedure which most people are not equipped to do. It's not a complicated process however it does carry some risks in itself. There is a technique known as the 'Agent Lemon extraction'.

=== Syrup ===

Cough syrup is the most common source for DXM users. While there are many brand name and no-name syrups which only contain DXM as an active ingredient there are many active and "inactive" ingredients commonly found in cough syrups which can cause negative effects ranging in severity. See [[DXM#HarmReduction|Harm Reduction]] for more information.

Some say the high produced from syrup is mostly sedating. You may feel sluggish when using it to get high on DXM, possibly as a result of other ingredients found in syrup however because of the even dispersion of DXM throughout the syrup it is said to produce a more 'solid' trip.

===Gel Caps===

DXM Gelcaps such as RobitussinDM Gelcaps or other no-name brand products containing only DXM encased in a gelcap are often the preferred source for DXM users. For most users gelcaps which contain only DXM produce a more clear headed high in lower doses. Most users experience fewer side effects from gelcaps than from syrup however some users report an upset stomach from the gelcaps, indicating that some users may have a sensitivity to the edible plastics used to make the gelcaps.

===Lozenges===

There are also sore-throat and cough medications containing DXM which exist in the form of a hard-candy like lozenge. These sometimes contain only DXM, however most brands of DXM lozenges also contain analgesics such as acetaminophen or benzocaine. Some brands such as '''Cordicin Cough and Cold''' (also known as '''CCC''') have a variety of products, most of which contain other active ingredients such as antihistamines or CPM (Chlorpheniramine Maleate) and may have one or two products which contain only DXM.

WARNING: Cordicin Cough & Cold is one of the most commonly used sources of DXM, and also one of the most dangerous. Nearly every single CCC product contains other active ingredients such as CPM, which can cause severe and life-threatening symptoms including seizures, shortness of breath or troubled breathing, weakness, loss of consciousness, severe dryness of the mouth, nose or throat, bleeding from the skin, mouth, eyes, rectum and vagina, and possibly death.

https://www.erowid.org/chemicals/dxm/dxm_info2.shtml

As always when using lozenges always choose a product which only has DXM in it.

===Delsym===

Delsym is brand with many formulations which contain Dextromethorphan Polistrex.

This is an extended release form of DXM which produced a longer lasting trip with weaker effects. It is said to be impossible to reach the third plateau using DXM which may be preferable for this reason to beginners or users who would prefer a longer and weaker trip.

== Dosage ==

'''DXM doses are affected by weight'''. See [http://taimapedia.org/images/4/46/DXMDosingChart.png this chart] for easy dosing.
Dosage refers to DXM HBR. HBR and Polistirex doses vary significantly due to polistirex slow absorbsion rate. (1mg of DXM polistirex is equivalent to about 6mg DXM HBR)

{| class="wikitable"
|+ Oral
|-
| Light || 100-200mg
|-
| Common || 200-400mg
|-
| Strong || 300-600mg
|-
| Heavy || 600-1500mg
|-
| Risk of death || 2.2g+
|}

== Duration ==

{| class="wikitable"
|+ Oral
|-
| Total || 6-8 hours
|}

=== Redosing ===

Redosing is not advised.

It's better to know how much you've taken at the start of the trip, rather than guestimate how much you're on as you keep dosing. The effects will start to come in waves and may not be pleasant. If you feel the need, it's recommended to take a high initial dose and a lower dose 1-2 hours in.

=== Predosing ===

One should make sure there is only DXM in the product they are taking. Grapefruit juice can potentiate dxm due to intactions with cytochrome P450.<ref>http://medicine.iupui.edu/clinpharm/ddis/2d6references/#dextromethorphanSub</ref>

== Effects ==
The high is not for everyone; it is said to loosely follow the rule of thirds: one third hates it, one third doesn't care, and one third like it.

DXM manifests its effects in a series of plateaus, with dose determining which plateau (and subsequently which effects) one will experience. Lower dose plateaus can be well suited to relaxation, light social interaction and listening to music, however higher doses result in a more encompassing dissociative experience which does not lend itself to attentive presence. At high doses your mind becomes as big as the universe. Strong experiences of detachment, depersonalization, and out-of-body experiences are commonly experienced with DXM at higher doses. These all-encompassing states are startling and uncomfortable for some.

=== Positive ===

* Euphoria, mood lift
* Increased giggling and laughing
* Dissociation of mind from body (positive when sought)
* Creative dream-like experiences
* Increased tactile sensation
* Some users report empathy and forgiveness towards other people

=== Neutral ===

* Pupil dilation
* Visual stop motion effect (flanging or strobing)
* Visual and aural (auditory) hallucinations
* Decreased sexual functioning (difficulty achieving orgasm)
* Confusion, disorientation
* Skin sensitivity, alters tactile (touch) and skin sensations
* Robotic, zombie-like walking, "robo-walk"
* Discoordination, reduced agility
* Loss of appetite
* Involuntary flexing of muscles
* Feelings of merging with adjacent objects like a couch or bed (with higher doses)

=== Negative ===

* Vomiting
* Dizzyness
* Body itching
* Rash, red blotchy skin
* Diarrhea
* Fever
* Tachycardia (racing, pounding heart)
* Some users report feeling disconnected, isolated from others

=== After-Effects ===

* Some users report hangover or depression that might last up to a few days.

=== Robo-Walk ===

The robo-walk feels like all of the muscles in your body are activated at once. You can still walk but forget about running or balance. Imagine the large muscles in your body all tensing up at once, so to walk you don't try to move your leg, you try and relax it in the way you want to go. Detailed coordination such as running, jumping, or maneuvering around furniture becomes much harder if not impossible. However, when you hit the third you really wouldn't want to be moving around anyway. The best thing to do is get a good pair of headphones, turn off the lights, close your eyes and let your mind wander.

== Plateaus ==
There are four 'stages' to DXM trips called '''plateaus'''. The first two are very similar, and the last two are similar.

There are two kind of trips: Sub third and beyond second plateau. If you take a first or second plateau dose, it's totally possible to socialize. Lower plateau doses are relatively easy to hide compared to higher plateau doses. Since you're dissociating yourself, you can remove yourself from awkward social situations or chaotic events. It would also be fun to chill in your room and play a video game and listen to music. The music will get better and you'll get more spacey. If you take a third or fourth plateau dose, it's recommend to trip alone, as it's not a social drug at this dose. The best way to enjoy it is to lay back and listen to music with your eyes closed. If you've ever meditated, you know how your mind can wander without your control. On DXM, you have a tendency to 'unlock' hidden memories. So the best thing is to let your mind take you where it wants to go. It usually knows whats best.

Choosing your destination plateau will depend a lot on what other drugs you've done and how comfortable you are with your mind.

=== First Plateau ===

Feels a bit 'off'. Perhaps like you're a bit buzzed from alcohol or a big hit off a bong.

'''First Plateau dose: 1-2mg/lb.'''

=== Second Plateau ===

You feel like your stoned. Your consciousness feels like it's distancing itself from reality, like it's taking a 'step back' into yourself. The second is supposed to be fun, it's introducing you to the idea that reality is a dream. Music is awesome to listen to and you can walk outside and perhaps hallucinate a small-mild amount. You can socialize with friends and they might take you for sober, or you could say you're slightly drunk.

'''Second Plateau dose: 2-5mg/lb.'''

'''Transitional'''

Most people stop their DXM journey here, as the final two are not really 'fun' but 'enlightening'. We don't recommend crossing this threshold until you're ready to move on from games of the mind to exercises of the consciousness. Enjoy the 2nd plat as long as you can because right now it's more of a fun experience and there is no going back once you've been here. It's like once you see what's behind the curtain, you can't enjoy the show.
Not to say that its not enjoyable, but it looses it's fun charm.

=== Third Plateau ===
This is where you start tripping. You cannot ignore the feeling inside of you. At this point its no longer a social drug and should be done by yourself or with a sitter. This is most akin to an acid trip: it feels very distorted and lasts a couple hours. The third plateau isn't 'party-mode' or even 'socialize-mode'. Its more like 'alone-and-tripping-mode'.
Inside your mind is an entirely new universe to explore. You think of water and an ocean appears. You create universes and live lifetimes inside your mind.
That's what the higher plateaus do.
'''Third Plateau dose: 5-7.5mg/lb.'''

=== Fourth Plateau ===
This is the deep meditative state. Few people enjoy going this far, as all you can really do (or want to do) is sit, listen to music, close your eyes, and become god. You can create universes in your mind just by thinking of them.

'''Fourth Plateau dose: 7.5-10mg/lb.'''

== Harm Reduction ==

See [[Dissociatives#Harm_Reduction|Dissociative Harm Reduction]] for general information.

=== Dangerous Ingredients Commonly Used in DXM Products ===

Many products which contain DXM also contain other medication or otherwise non-medically-active ingredients that can cause serious harm in the doses found in DXM containing products. If a user intends to use an OTC cough medication in order to get high on DXM they almost always will have to consume a dangerous quantity of other dangerous ingredients if they are present in the medication. For this reason it is strongly recommended to find a source which contains /only/ DXM.

The following is a summary of other ingredients commonly found in DXM products.

* : Acetaminophen/Paracetamol/APAP is a painkiller commonly found in over the counter flu medication, and is used in many Tylenol and Panadol brand products.
: Acetaminophen/paracetamol/APAP is hepatoxic in high doses. This means it will damage your liver if taken in high doses.
:: Your body can only process a certain amount of APAP at once before it the normal pathways become saturated.
:: Once the regular pathways used for metabolizing APAP have been saturated the remaining APAP gets broken down in the liver by an enzyme called
:: cytochrome P450. ::: '''When forced to break down APAP this enzyme produces toxic metabolites!'''

The effects of an acetaminophen overdose may not be apparent for up to sixteen hours after the user has ingested the APAP! This makes APAP overdose even more dangerous because of the chance that a user might take more or not take notice after thinking they are 'in the clear'.

'''Under no circumstances should anyone attempt to use any DXM product containing 'Paracetamol', also known as 'APAP' & 'Acetaminophen'!'''

* '''Guaifenesin''' is an expectorant. It works by causing the lungs to produce more fluid, making it easier to cough up phlegm.
: Guaifenesin is added to many OTC cough, cold and flu medications to help treat the 'stuffed up' feeling which often found in viruses and colds.

: Guaifenesin overdoses cause severe nausea and vomiting in most users. Some users report being able to use products which contain some guaifensin and
: other users report no negative effects from guaifenesin containing products.
: '''It is strongly recommended to avoid products which contain Guaifenesin when using DXM!'''

* '''Antihistamines''' such as '''[[DPH|Diphenhydramine]]''' are often found in sleep-aids, night-time formulations of cold medications and allergy medications.
: Antihistamines are sometimes found with DXM in night or 'PM' versions of products, and should generally be avoided when using DXM. When taken in
: high doses antihistamines can cause dizzyness, nausea, a strong dysphoria, paranoia, delirium and hallucinations. Many antihistamines, OTC or prescription
: can also have a dangerous synergy with some of the effects produced by DXM.

* '''Food Coloring & other "Inactive" Ingredients'''
: Many DXM products contain dyes which can cause allergic reactions in some users. Usually these dyes are not harmful in low doses however in doses which may be
: required for DXM's effects they can become problematic. '''Tartrazine (FD&C Yellow #5)''' is one of the most notable coloring ingredients to cause reactions.

: Cough syrups usually contain one or more chemical used to make them taste sweet.
: '''Glucose, sucrose, invert sugar, and fructose''' are commonly used sweetening agents. These sweeteners pose an obvious risk to people with blood sugar conditions
: such as diabetes or hypoglycemia.

: Thickening agents such as '''propylene glycol''' or '''polyethylene glycol''' are found in most cough syrups. These are not toxic but may cause an upset stomach
: when consumed in large doses.

=== Interactions ===
DXM has several potentially dangerous interactions with pharmaceutical and recreational drugs including some analgesics (painkillers), antihistamines, antidepressants and stimulants.

DXM has the potential to cause [[Serotonin Syndrome]] if mixed with other serotonergic drugs such as [[Antidepressants|antidepressants]], MAOIs, empathogens which affect serotonin release such as [[MDMA]], [[MDA]], [[Mephedrone]], etc. Serotonin Syndrome causes discomfort, excitability, irritability, and can be deadly <ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464814/</ref> if not treated.
* See [[Drug_Combinations|Drug combinations]] and [[Dissociatives#Interactions|Dissociative Interactions]] for more information.

== Chemistry and Pharmacology ==

IUPAC:(4bS,8aR,9S)-3-Methoxy-11-methyl-6,7,8,8a,9,10-hexahydro-5H-9,4b-(epiminoethano)phenanthrene.

Dextromethorphan is the dextrorotartory enantiomer of levomethophan, which is the methyl ether of levophanol, both opioid analgesics.

=== Pharmacodynamics ===

{| class="wikitable"
|+ Binding receptors
|-
| NMDA - 7253
|-
| SERT - 2015
|-
| NET - 110606
|-
| Sigma-1 - 23
|-
| Sigma-2 - 240
|}

=== Pharmacokinectics ===

Following oral dosing, DXM is rapidly absorbed from the GI tract. Where it enters the bloodstream, and crosses the blood-brain barrier.

At therapeutic doses, DXM acts centrally (brain) as opposed to locally (Respiratory tract). It's rapidly absorbed from the GI tract into the active metabolite Dextrophan (DXO) in the liver by the cytochrome P450 enzyme CYP2D6.

Around one in 10 of the Caucasian population has little or no CYP2D6 enzyme activity, leading to long-lived high drug levels.

== Images ==

<gallery mode="packed-hover">
Image:Dxm1.jpg|''Robitussin brand DXM Gel Caps''
</gallery>
== Links ==

[http://www.erowid.org/chemicals/dxm/faq/dxm_faq.shtml DXM FAQ]

[http://en.wikipedia.org/wiki/Dextromethorphan Wikipedia]

== References ==

<references />

[[Category:Dissociative]]
[[Category:Drugs]]

DXM

2015-03-28T07:33:59Z

GrimReaper:

[[File:Dxm_gelcap.jpg|350px|right]]

'''Dextromethorphan''' (also known as 'DXM' or 'robo') is an over-the-counter antitussive (cough treatment) which when taken at doses exceeding the recommended therapeutic range becomes a powerful [[Dissociatives|dissociative]] drug which also has some psychedelic properties.

While DXM can be used safely it is not an inherently safe drug. Repeated use within a short period of time, combination with certain types of drugs, certain genetic factors and the prevalence of other active ingredients which become harmful at needed doses found in many brands of cough medication make for a chemical which must be used with caution.

It's mechanism of action is via multiple effects, including actions as a nonselective serotonin reuptake inhibitor and a sigma-1 receptor agonist. DXM and it's major metabolite, dextrorphan, also act as an NMDA receptor antagonist at high doses, which produces effects similar to, yet distinct from, the dissociative states created by other dissociative anaesthetics such as [[Ketamine]] and [[PCP]].

DXM does not typically show up in normal drug tests however it can produce false positive results for PCP and/or Opioids in extended or specialized drug tests. Proper occasional use should not produce these false-positive results after a couple days have passed.

== Different Forms ==

DXM is widely available in over-the-counter cough treatments which appear in different forms including gelcaps, lozenges and syrups. DXM is also less commonly found in a more pure form, either extracted or bought directly from a chemical manufacturer.

While there are some products available which contain only DXM as active medical ingredients it is common to find products which contain DXM but also contain enough of another active ingredient to pose a serious risk to the user's health.

=== Extracted ===

The ideal source of DXM would be an extraction, but that requires time and a chemical procedure which most people are not equipped to do. It's not a complicated process however it does carry some risks in itself. There is a technique known as the 'Agent Lemon extraction'.

=== Syrup ===

Cough syrup is the most common source for DXM users. While there are many brand name and no-name syrups which only contain DXM as an active ingredient there are many active and "inactive" ingredients commonly found in cough syrups which can cause negative effects ranging in severity. See [[DXM#HarmReduction|Harm Reduction]] for more information.

Some say the high produced from syrup is mostly sedating. You may feel sluggish when using it to get high on DXM, possibly as a result of other ingredients found in syrup however because of the even dispersion of DXM throughout the syrup it is said to produce a more 'solid' trip.

===Gel Caps===

DXM Gelcaps such as RobitussinDM Gelcaps or other no-name brand products containing only DXM encased in a gelcap are often the preferred source for DXM users. For most users gelcaps which contain only DXM produce a more clear headed high in lower doses. Most users experience fewer side effects from gelcaps than from syrup however some users report an upset stomach from the gelcaps, indicating that some users may have a sensitivity to the edible plastics used to make the gelcaps.

===Lozenges===

There are also sore-throat and cough medications containing DXM which exist in the form of a hard-candy like lozenge. These sometimes contain only DXM, however most brands of DXM lozenges also contain analgesics such as acetaminophen or benzocaine. Some brands such as '''Cordicin Cough and Cold''' (also known as '''CCC''') have a variety of products, most of which contain other active ingredients such as antihistamines or CPM (Chlorpheniramine Maleate) and may have one or two products which contain only DXM.

WARNING: Cordicin Cough & Cold is one of the most commonly used sources of DXM, and also one of the most dangerous. Nearly every single CCC product contains other active ingredients such as CPM, which can cause severe and life-threatening symptoms including seizures, shortness of breath or troubled breathing, weakness, loss of consciousness, severe dryness of the mouth, nose or throat, bleeding from the skin, mouth, eyes, rectum and vagina, and possibly death.

https://www.erowid.org/chemicals/dxm/dxm_info2.shtml

As always when using lozenges always choose a product which only has DXM in it.

===Delsym===

Delsym is brand with many formulations which contain Dextromethorphan Polistrex.

This is an extended release form of DXM which produced a longer lasting trip with weaker effects. It is said to be impossible to reach the third plateau using DXM which may be preferable for this reason to beginners or users who would prefer a longer and weaker trip.

== Dosage ==

'''DXM doses are affected by weight'''. See [http://taimapedia.org/images/4/46/DXMDosingChart.png this chart] for easy dosing.
Dosage refers to DXM HBR. HBR and Polistirex doses vary significantly due to polistirex slow absorbsion rate. (1mg of DXM polistirex is equivalent to about 6mg DXM HBR)

{| class="wikitable"
|+ Oral
|-
| Light || 100-200mg
|-
| Common || 200-400mg
|-
| Strong || 300-600mg
|-
| Heavy || 600-1500mg
|-
| Risk of death || 2.2g+
|}

== Duration ==

{| class="wikitable"
|+ Oral
|-
| Total || 6-8 hours
|}

=== Redosing ===

Redosing is not advised.

It's better to know how much you've taken at the start of the trip, rather than guestimate how much you're on as you keep dosing. The effects will start to come in waves and may not be pleasant. If you feel the need, it's recommended to take a high initial dose and a lower dose 1-2 hours in.

=== Predosing ===

One should make sure there is only DXM in the product they are taking. Grapefruit juice can potentiate dxm due to intactions with cytochrome P450.<ref>http://medicine.iupui.edu/clinpharm/ddis/2d6references/#dextromethorphanSub</ref>

== Effects ==
The high is not for everyone; it is said to loosely follow the rule of thirds: one third hates it, one third doesn't care, and one third like it.

DXM manifests its effects in a series of plateaus, with dose determining which plateau (and subsequently which effects) one will experience. Lower dose plateaus can be well suited to relaxation, light social interaction and listening to music, however higher doses result in a more encompassing dissociative experience which does not lend itself to attentive presence. At high doses your mind becomes as big as the universe. Strong experiences of detachment, depersonalization, and out-of-body experiences are commonly experienced with DXM at higher doses. These all-encompassing states are startling and uncomfortable for some.

=== Positive ===

* Euphoria, mood lift
* Increased giggling and laughing
* Dissociation of mind from body (positive when sought)
* Creative dream-like experiences
* Increased tactile sensation
* Some users report empathy and forgiveness towards other people

=== Neutral ===

* Pupil dilation
* Visual stop motion effect (flanging or strobing)
* Visual and aural (auditory) hallucinations
* Decreased sexual functioning (difficulty achieving orgasm)
* Confusion, disorientation
* Skin sensitivity, alters tactile (touch) and skin sensations
* Robotic, zombie-like walking, "robo-walk"
* Discoordination, reduced agility
* Loss of appetite
* Involuntary flexing of muscles
* Feelings of merging with adjacent objects like a couch or bed (with higher doses)

=== Negative ===

* Vomiting
* Dizzyness
* Body itching
* Rash, red blotchy skin
* Diarrhea
* Fever
* Tachycardia (racing, pounding heart)
* Some users report feeling disconnected, isolated from others

=== After-Effects ===

* Some users report hangover or depression that might last up to a few days.

=== Robo-Walk ===

The robo-walk feels like all of the muscles in your body are activated at once. You can still walk but forget about running or balance. Imagine the large muscles in your body all tensing up at once, so to walk you don't try to move your leg, you try and relax it in the way you want to go. Detailed coordination such as running, jumping, or maneuvering around furniture becomes much harder if not impossible. However, when you hit the third you really wouldn't want to be moving around anyway. The best thing to do is get a good pair of headphones, turn off the lights, close your eyes and let your mind wander.

== Plateaus ==
There are four 'stages' to DXM trips called '''plateaus'''. The first two are very similar, and the last two are similar.

There are two kind of trips: Sub third and beyond second plateau. If you take a first or second plateau dose, it's totally possible to socialize. Lower plateau doses are relatively easy to hide compared to higher plateau doses. Since you're dissociating yourself, you can remove yourself from awkward social situations or chaotic events. It would also be fun to chill in your room and play a video game and listen to music. The music will get better and you'll get more spacey. If you take a third or fourth plateau dose, it's recommend to trip alone, as it's not a social drug at this dose. The best way to enjoy it is to lay back and listen to music with your eyes closed. If you've ever meditated, you know how your mind can wander without your control. On DXM, you have a tendency to 'unlock' hidden memories. So the best thing is to let your mind take you where it wants to go. It usually knows whats best.

Choosing your destination plateau will depend a lot on what other drugs you've done and how comfortable you are with your mind.

=== First Plateau ===

Feels a bit 'off'. Perhaps like you're a bit buzzed from alcohol or a big hit off a bong.

'''First Plateau dose: 1-2mg/lb.'''

=== Second Plateau ===

You feel like your stoned. Your consciousness feels like it's distancing itself from reality, like it's taking a 'step back' into yourself. The second is supposed to be fun, it's introducing you to the idea that reality is a dream. Music is awesome to listen to and you can walk outside and perhaps hallucinate a small-mild amount. You can socialize with friends and they might take you for sober, or you could say you're slightly drunk.

'''Second Plateau dose: 2-5mg/lb.'''

'''Transitional'''

Most people stop their DXM journey here, as the final two are not really 'fun' but 'enlightening'. We don't recommend crossing this threshold until you're ready to move on from games of the mind to exercises of the consciousness. Enjoy the 2nd plat as long as you can because right now it's more of a fun experience and there is no going back once you've been here. It's like once you see what's behind the curtain, you can't enjoy the show.
Not to say that its not enjoyable, but it looses it's fun charm.

=== Third Plateau ===
This is where you start tripping. You cannot ignore the feeling inside of you. At this point its no longer a social drug and should be done by yourself or with a sitter. This is most akin to an acid trip: it feels very distorted and lasts a couple hours. The third plateau isn't 'party-mode' or even 'socialize-mode'. Its more like 'alone-and-tripping-mode'.
Inside your mind is an entirely new universe to explore. You think of water and an ocean appears. You create universes and live lifetimes inside your mind.
That's what the higher plateaus do.
'''Third Plateau dose: 5-7.5mg/lb.'''

=== Fourth Plateau ===
This is the deep meditative state. Few people enjoy going this far, as all you can really do (or want to do) is sit, listen to music, close your eyes, and become god. You can create universes in your mind just by thinking of them.

'''Fourth Plateau dose: 7.5-10mg/lb.'''

== Harm Reduction ==

See [[Dissociatives#Harm_Reduction|Dissociative Harm Reduction]] for general information.

=== Dangerous Ingredients Commonly Used in DXM Products ===

Many products which contain DXM also contain other medication or otherwise non-medically-active ingredients that can cause serious harm in the doses found in DXM containing products. If a user intends to use an OTC cough medication in order to get high on DXM they almost always will have to consume a dangerous quantity of other dangerous ingredients if they are present in the medication. For this reason it is strongly recommended to find a source which contains /only/ DXM.

The following is a summary of other ingredients commonly found in DXM products.

* : Acetaminophen/Paracetamol/APAP is a painkiller commonly found in over the counter flu medication, and is used in many Tylenol and Panadol brand products.
: Acetaminophen/paracetamol/APAP is hepatoxic in high doses. This means it will damage your liver if taken in high doses.
:: Your body can only process a certain amount of APAP at once before it the normal pathways become saturated.
:: Once the regular pathways used for metabolizing APAP have been saturated the remaining APAP gets broken down in the liver by an enzyme called
:: cytochrome P450. ::: '''When forced to break down APAP this enzyme produces toxic metabolites!'''

The effects of an acetaminophen overdose may not be apparent for up to sixteen hours after the user has ingested the APAP! This makes APAP overdose even more dangerous because of the chance that a user might take more or not take notice after thinking they are 'in the clear'.

'''Under no circumstances should anyone attempt to use any DXM product containing 'Paracetamol', also known as 'APAP' & 'Acetaminophen'!'''

* '''Guaifenesin''' is an expectorant. It works by causing the lungs to produce more fluid, making it easier to cough up phlegm.
: Guaifenesin is added to many OTC cough, cold and flu medications to help treat the 'stuffed up' feeling which often found in viruses and colds.

: Guaifenesin overdoses cause severe nausea and vomiting in most users. Some users report being able to use products which contain some guaifensin and
: other users report no negative effects from guaifenesin containing products.
: '''It is strongly recommended to avoid products which contain Guaifenesin when using DXM!'''

* '''Antihistamines''' such as '''[[DPH|Diphenhydramine]]''' are often found in sleep-aids, night-time formulations of cold medications and allergy medications.
: Antihistamines are sometimes found with DXM in night or 'PM' versions of products, and should generally be avoided when using DXM. When taken in
: high doses antihistamines can cause dizzyness, nausea, a strong dysphoria, paranoia, delirium and hallucinations. Many antihistamines, OTC or prescription
: can also have a dangerous synergy with some of the effects produced by DXM.

* '''Food Coloring & other "Inactive" Ingredients'''
: Many DXM products contain dyes which can cause allergic reactions in some users. Usually these dyes are not harmful in low doses however in doses which may be
: required for DXM's effects they can become problematic. '''Tartrazine (FD&C Yellow #5)''' is one of the most notable coloring ingredients to cause reactions.

: Cough syrups usually contain one or more chemical used to make them taste sweet.
: '''Glucose, sucrose, invert sugar, and fructose''' are commonly used sweetening agents. These sweeteners pose an obvious risk to people with blood sugar conditions
: such as diabetes or hypoglycemia.

: Thickening agents such as '''propylene glycol''' or '''polyethylene glycol''' are found in most cough syrups. These are not toxic but may cause an upset stomach
: when consumed in large doses.

=== Interactions ===
DXM has several potentially dangerous interactions with pharmaceutical and recreational drugs including some analgesics (painkillers), antihistamines, antidepressants and stimulants.

DXM has the potential to cause [[Serotonin Syndrome]] if mixed with other serotonergic drugs such as [[Antidepressants|antidepressants]], MAOIs, empathogens which affect serotonin release such as [[MDMA]], [[MDA]], [[Mephedrone]], etc. Serotonin Syndrome causes discomfort, excitability, irritability, and can be deadly <ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464814/</ref> if not treated.
* See [[Drug_Combinations|Drug combinations]] and [[Dissociatives#Interactions|Dissociative Interactions]] for more information.

== Chemistry and Pharmacology ==

IUPAC:(4bS,8aR,9S)-3-Methoxy-11-methyl-6,7,8,8a,9,10-hexahydro-5H-9,4b-(epiminoethano)phenanthrene.

Dextromethorphan is the dextrorotartory enantiomer of levomethophan, which is the methyl ether of levophanol, both opioid analgesics.

=== Pharmacodynamics ===

{| class="wikitable"
|+ Binding receptors
|-
| NMDA - 7253
|-
| SERT - 2015
|-
| NET - 110606
|-
| Sigma-1 - 23
|-
| Sigma-2 - 240
|}

=== Pharmacokinectics ===

Following oral dosing, DXM is rapidly absorbed from the GI tract. Where it enters the bloodstream, and crosses the blood-brain barrier.

At therapeutic doses, DXM acts centrally (brain) as opposed to locally (Respiratory tract). It's rapidly absorbed from the GI tract into the active metabolite Dextrophan (DXO) in the liver by the cytochrome P450 enzyme CYP2D6.

Around one in 10 of the Caucasian population has little or no CYP2D6 enzyme activity, leading to long-lived high drug levels.

== Images ==

<gallery mode="packed-hover">
Image:Dxm1.jpg|''Robitussin brand DXM Gel Caps''
</gallery>
== Links ==

[http://www.erowid.org/chemicals/dxm/faq/dxm_faq.shtml DXM FAQ]

[http://en.wikipedia.org/wiki/Dextromethorphan Wikipedia]

== References ==

<references />

[[Category:Dissociative]]
[[Category:Drugs]]

DXM

2015-03-28T07:31:19Z

GrimReaper: /* Links */

[[File:Dxm_gelcap.jpg|350px|right]]

'''Dextromethorphan''' (also known as 'DXM' or 'robo') is an over-the-counter antitussive (cough treatment) which when taken at doses exceeding the recommended therapeutic range becomes a powerful [[Dissociatives|dissociative]] drug which also has some psychedelic properties.

While DXM can be used safely it is not an inherently safe drug. Repeated use within a short period of time, combination with certain types of drugs, certain genetic factors and the prevalence of other active ingredients which become harmful at needed doses found in many brands of cough medication make for a chemical which must be used with caution.

It's mechanism of action is via multiple effects, including actions as a nonselective serotonin reuptake inhibitor and a sigma-1 receptor agonist. DXM and it's major metabolite, dextrorphan, also act as an NMDA receptor antagonist at high doses, which produces effects similar to, yet distinct from, the dissociative states created by other dissociative anaesthetics such as [[Ketamine]] and [[PCP]].

DXM does not typically show up in normal drug tests however it can produce false positive results for PCP and/or Opioids in extended or specialized drug tests. Proper occasional use should not produce these false-positive results after a couple days have passed.

== Different Forms ==

DXM is widely available in over-the-counter cough treatments which appear in different forms including gelcaps, lozenges and syrups. DXM is also less commonly found in a more pure form, either extracted or bought directly from a chemical manufacturer.

While there are some products available which contain only DXM as active medical ingredients it is common to find products which contain DXM but also contain enough of another active ingredient to pose a serious risk to the user's health.

=== Extracted ===

The ideal source of DXM would be an extraction, but that requires time and a chemical procedure which most people are not equipped to do. It's not a complicated process however it does carry some risks in itself. There is a technique known as the 'Agent Lemon extraction'.

=== Syrup ===

Cough syrup is the most common source for DXM users. While there are many brand name and no-name syrups which only contain DXM as an active ingredient there are many active and "inactive" ingredients commonly found in cough syrups which can cause negative effects ranging in severity. See [[DXM#HarmReduction|Harm Reduction]] for more information.

Some say the high produced from syrup is mostly sedating. You may feel sluggish when using it to get high on DXM, possibly as a result of other ingredients found in syrup however because of the even dispersion of DXM throughout the syrup it is said to produce a more 'solid' trip.

===Gel Caps===

DXM Gelcaps such as RobitussinDM Gelcaps or other no-name brand products containing only DXM encased in a gelcap are often the preferred source for DXM users. For most users gelcaps which contain only DXM produce a more clear headed high in lower doses. Most users experience fewer side effects from gelcaps than from syrup however some users report an upset stomach from the gelcaps, indicating that some users may have a sensitivity to the edible plastics used to make the gelcaps.

===Lozenges===

There are also sore-throat and cough medications containing DXM which exist in the form of a hard-candy like lozenge. These sometimes contain only DXM, however most brands of DXM lozenges also contain analgesics such as acetaminophen or benzocaine. Some brands such as '''Cordicin Cough and Cold''' (also known as '''CCC''') have a variety of products, most of which contain other active ingredients such as antihistamines or CPM (Chlorpheniramine Maleate) and may have one or two products which contain only DXM.

WARNING: Cordicin Cough & Cold is one of the most commonly used sources of DXM, and also one of the most dangerous. Nearly every single CCC product contains other active ingredients such as CPM, which can cause severe and life-threatening symptoms including seizures, shortness of breath or troubled breathing, weakness, loss of consciousness, severe dryness of the mouth, nose or throat, bleeding from the skin, mouth, eyes, rectum and vagina, and possibly death.

https://www.erowid.org/chemicals/dxm/dxm_info2.shtml

As always when using lozenges always choose a product which only has DXM in it.

===Delsym===

Delsym is brand with many formulations which contain Dextromethorphan Polistrex.

This is an extended release form of DXM which produced a longer lasting trip with weaker effects. It is said to be impossible to reach the third plateau using DXM which may be preferable for this reason to beginners or users who would prefer a longer and weaker trip.

== Dosage ==

'''DXM doses are affected by weight'''. See [http://taimapedia.org/images/4/46/DXMDosingChart.png this chart] for easy dosing.
Dosage refers to DXM HBR. HBR and Polistirex doses vary significantly due to polistirex slow absorbsion rate. (1mg of DXM polistirex is equivalent to about 6mg DXM HBR)

{| class="wikitable"
|+ Oral
|-
| Light || 100-200mg
|-
| Common || 200-400mg
|-
| Strong || 300-600mg
|-
| Heavy || 600-1500mg
|-
| Risk of death || 2.2g+
|}

== Duration ==

{| class="wikitable"
|+ Oral
|-
| Total || 6-8 hours
|}

=== Redosing ===

Redosing is not advised.

It's better to know how much you've taken at the start of the trip, rather than guestimate how much you're on as you keep dosing. The effects will start to come in waves and may not be pleasant. If you feel the need, it's recommended to take a high initial dose and a lower dose 1-2 hours in.

=== Predosing ===

One should make sure there is only DXM in the product they are taking. Grapefruit juice can potentiate dxm due to intactions with cytochrome P450.<ref>http://medicine.iupui.edu/clinpharm/ddis/2d6references/#dextromethorphanSub</ref>

== Effects ==
The high is not for everyone; it is said to loosely follow the rule of thirds: one third hates it, one third doesn't care, and one third like it.

DXM manifests its effects in a series of plateaus, with dose determining which plateau (and subsequently which effects) one will experience. Lower dose plateaus can be well suited to relaxation, light social interaction and listening to music, however higher doses result in a more encompassing dissociative experience which does not lend itself to attentive presence. At high doses your mind becomes as big as the universe. Strong experiences of detachment, depersonalization, and out-of-body experiences are commonly experienced with DXM at higher doses. These all-encompassing states are startling and uncomfortable for some.

=== Positive ===

* Euphoria, mood lift
* Increased giggling and laughing
* Dissociation of mind from body (positive when sought)
* Creative dream-like experiences
* Increased tactile sensation
* Some users report empathy and forgiveness towards other people

=== Neutral ===

* Pupil dilation
* Visual stop motion effect (flanging or strobing)
* Visual and aural (auditory) hallucinations
* Decreased sexual functioning (difficulty achieving orgasm)
* Confusion, disorientation
* Skin sensitivity, alters tactile (touch) and skin sensations
* Robotic, zombie-like walking, "robo-walk"
* Discoordination, reduced agility
* Loss of appetite
* Involuntary flexing of muscles
* Feelings of merging with adjacent objects like a couch or bed (with higher doses)

=== Negative ===

* Vomiting
* Dizzyness
* Body itching
* Rash, red blotchy skin
* Diarrhea
* Fever
* Tachycardia (racing, pounding heart)
* Some users report feeling disconnected, isolated from others

=== After-Effects ===

* Some users report hangover or depression that might last up to a few days.

=== Robo-Walk ===

The robo-walk feels like all of the muscles in your body are activated at once. You can still walk but forget about running or balance. Imagine the large muscles in your body all tensing up at once, so to walk you don't try to move your leg, you try and relax it in the way you want to go. Detailed coordination such as running, jumping, or maneuvering around furniture becomes much harder if not impossible. However, when you hit the third you really wouldn't want to be moving around anyway. The best thing to do is get a good pair of headphones, turn off the lights, close your eyes and let your mind wander.

== Plateaus ==
There are four 'stages' to DXM trips called '''plateaus'''. The first two are very similar, and the last two are similar.

There are two kind of trips: Sub third and beyond second plateau. If you take a first or second plateau dose, it's totally possible to socialize. Lower plateau doses are relatively easy to hide compared to higher plateau doses. Since you're dissociating yourself, you can remove yourself from awkward social situations or chaotic events. It would also be fun to chill in your room and play a video game and listen to music. The music will get better and you'll get more spacey. If you take a third or fourth plateau dose, it's recommend to trip alone, as it's not a social drug at this dose. The best way to enjoy it is to lay back and listen to music with your eyes closed. If you've ever meditated, you know how your mind can wander without your control. On DXM, you have a tendency to 'unlock' hidden memories. So the best thing is to let your mind take you where it wants to go. It usually knows whats best.

Choosing your destination plateau will depend a lot on what other drugs you've done and how comfortable you are with your mind.

=== First Plateau ===

Feels a bit 'off'. Perhaps like you're a bit buzzed from alcohol or a big hit off a bong.

'''First Plateau dose: 1-2mg/lb.'''

=== Second Plateau ===

You feel like your stoned. Your consciousness feels like it's distancing itself from reality, like it's taking a 'step back' into yourself. The second is supposed to be fun, it's introducing you to the idea that reality is a dream. Music is awesome to listen to and you can walk outside and perhaps hallucinate a small-mild amount. You can socialize with friends and they might take you for sober, or you could say you're slightly drunk.

'''Second Plateau dose: 2-5mg/lb.'''

'''Transitional'''

Most people stop their DXM journey here, as the final two are not really 'fun' but 'enlightening'. We don't recommend crossing this threshold until you're ready to move on from games of the mind to exercises of the consciousness. Enjoy the 2nd plat as long as you can because right now it's more of a fun experience and there is no going back once you've been here. It's like once you see what's behind the curtain, you can't enjoy the show.
Not to say that its not enjoyable, but it looses it's fun charm.

=== Third Plateau ===
This is where you start tripping. You cannot ignore the feeling inside of you. At this point its no longer a social drug and should be done by yourself or with a sitter. This is most akin to an acid trip: it feels very distorted and lasts a couple hours. The third plateau isn't 'party-mode' or even 'socialize-mode'. Its more like 'alone-and-tripping-mode'.
Inside your mind is an entirely new universe to explore. You think of water and an ocean appears. You create universes and live lifetimes inside your mind.
That's what the higher plateaus do.
'''Third Plateau dose: 5-7.5mg/lb.'''

=== Fourth Plateau ===
This is the deep meditative state. Few people enjoy going this far, as all you can really do (or want to do) is sit, listen to music, close your eyes, and become god. You can create universes in your mind just by thinking of them.

'''Fourth Plateau dose: 7.5-10mg/lb.'''

== Harm Reduction ==

See [[Dissociatives#Harm_Reduction|Dissociative Harm Reduction]] for general information.

=== Dangerous Ingredients Commonly Used in DXM Products ===

Many products which contain DXM also contain other medication or otherwise non-medically-active ingredients that can cause serious harm in the doses found in DXM containing products. If a user intends to use an OTC cough medication in order to get high on DXM they almost always will have to consume a dangerous quantity of other dangerous ingredients if they are present in the medication. For this reason it is strongly recommended to find a source which contains /only/ DXM.

The following is a summary of other ingredients commonly found in DXM products.

* : Acetaminophen/Paracetamol/APAP is a painkiller commonly found in over the counter flu medication, and is used in many Tylenol and Panadol brand products.
: Acetaminophen/paracetamol/APAP is hepatoxic in high doses. This means it will damage your liver if taken in high doses.
:: Your body can only process a certain amount of APAP at once before it the normal pathways become saturated.
:: Once the regular pathways used for metabolizing APAP have been saturated the remaining APAP gets broken down in the liver by an enzyme called
:: cytochrome P450. ::: '''When forced to break down APAP this enzyme produces toxic metabolites!'''

The effects of an acetaminophen overdose may not be apparent for up to sixteen hours after the user has ingested the APAP! This makes APAP overdose even more dangerous because of the chance that a user might take more or not take notice after thinking they are 'in the clear'.

'''Under no circumstances should anyone attempt to use any DXM product containing 'Paracetamol', also known as 'APAP' & 'Acetaminophen'!'''

* '''Guaifenesin''' is an expectorant. It works by causing the lungs to produce more fluid, making it easier to cough up phlegm.
: Guaifenesin is added to many OTC cough, cold and flu medications to help treat the 'stuffed up' feeling which often found in viruses and colds.

: Guaifenesin overdoses cause severe nausea and vomiting in most users. Some users report being able to use products which contain some guaifensin and
: other users report no negative effects from guaifenesin containing products.
: '''It is strongly recommended to avoid products which contain Guaifenesin when using DXM!'''

* '''Antihistamines''' such as '''[[DPH|Diphenhydramine]]''' are often found in sleep-aids, night-time formulations of cold medications and allergy medications.
: Antihistamines are sometimes found with DXM in night or 'PM' versions of products, and should generally be avoided when using DXM. When taken in
: high doses antihistamines can cause dizzyness, nausea, a strong dysphoria, paranoia, delirium and hallucinations. Many antihistamines, OTC or prescription
: can also have a dangerous synergy with some of the effects produced by DXM.

* '''Food Coloring & other "Inactive" Ingredients'''
: Many DXM products contain dyes which can cause allergic reactions in some users. Usually these dyes are not harmful in low doses however in doses which may be
: required for DXM's effects they can become problematic. '''Tartrazine (FD&C Yellow #5)''' is one of the most notable coloring ingredients to cause reactions.

: Cough syrups usually contain one or more chemical used to make them taste sweet.
: '''Glucose, sucrose, invert sugar, and fructose''' are commonly used sweetening agents. These sweeteners pose an obvious risk to people with blood sugar conditions
: such as diabetes or hypoglycemia.

: Thickening agents such as '''propylene glycol''' or '''polyethylene glycol''' are found in most cough syrups. These are not toxic but may cause an upset stomach
: when consumed in large doses.

=== Interactions ===
DXM has several potentially dangerous interactions with pharmaceutical and recreational drugs including some analgesics (painkillers), antihistamines, antidepressants and stimulants.

DXM has the potential to cause [[Serotonin Syndrome]] if mixed with other serotonergic drugs such as [[Antidepressants|antidepressants]], MAOIs, empathogens which affect serotonin release such as [[MDMA]], [[MDA]], [[Mephedrone]], etc. Serotonin Syndrome causes discomfort, excitability, irritability, and can be deadly <ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464814/</ref> if not treated.
* See [[Drug_Combinations|Drug combinations]] and [[Dissociatives#Interactions|Dissociative Interactions]] for more information.

== Pharmacology ==

IUPAC:(4bS,8aR,9S)-3-Methoxy-11-methyl-6,7,8,8a,9,10-hexahydro-5H-9,4b-(epiminoethano)phenanthrene.

Dextromethorphan is the dextrorotartory enantiomer of levomethophan, which is the methyl ether of levophanol, both opioid analgesics.

== Pharmacodynamics ==

{| class="wikitable"
|+ Binding receptors
|-
| NMDA - 7253
|-
| SERT - 2015
|-
| NET - 110606
|-
| Sigma-1 - 23
|-
| Sigma-2 - 240
|}

== Pharmacokinectics ==

Following oral dosing, DXM is rapidly absorbed from the GI tract. Where it enters the bloodstream, and crosses the blood-brain barrier.

At therapeutic doses, DXM acts centrally (brain) as opposed to locally (Respiratory tract). It's rapidly absorbed from the GI tract into the active metabolite Dextrophan (DXO) in the liver by the cytochrome P450 enzyme CYP2D6.

Around one in 10 of the Caucasian population has little or no CYP2D6 enzyme activity, leading to long-lived high drug levels.

== Images ==

<gallery mode="packed-hover">
Image:Dxm1.jpg|''Robitussin brand DXM Gel Caps''
</gallery>
== Links ==

[http://www.erowid.org/chemicals/dxm/faq/dxm_faq.shtml DXM FAQ]

[http://en.wikipedia.org/wiki/Dextromethorphan Wikipedia]

== References ==

<references />

[[Category:Dissociative]]
[[Category:Drugs]]

DXM

2015-03-28T07:31:08Z

GrimReaper:

[[File:Dxm_gelcap.jpg|350px|right]]

'''Dextromethorphan''' (also known as 'DXM' or 'robo') is an over-the-counter antitussive (cough treatment) which when taken at doses exceeding the recommended therapeutic range becomes a powerful [[Dissociatives|dissociative]] drug which also has some psychedelic properties.

While DXM can be used safely it is not an inherently safe drug. Repeated use within a short period of time, combination with certain types of drugs, certain genetic factors and the prevalence of other active ingredients which become harmful at needed doses found in many brands of cough medication make for a chemical which must be used with caution.

It's mechanism of action is via multiple effects, including actions as a nonselective serotonin reuptake inhibitor and a sigma-1 receptor agonist. DXM and it's major metabolite, dextrorphan, also act as an NMDA receptor antagonist at high doses, which produces effects similar to, yet distinct from, the dissociative states created by other dissociative anaesthetics such as [[Ketamine]] and [[PCP]].

DXM does not typically show up in normal drug tests however it can produce false positive results for PCP and/or Opioids in extended or specialized drug tests. Proper occasional use should not produce these false-positive results after a couple days have passed.

== Different Forms ==

DXM is widely available in over-the-counter cough treatments which appear in different forms including gelcaps, lozenges and syrups. DXM is also less commonly found in a more pure form, either extracted or bought directly from a chemical manufacturer.

While there are some products available which contain only DXM as active medical ingredients it is common to find products which contain DXM but also contain enough of another active ingredient to pose a serious risk to the user's health.

=== Extracted ===

The ideal source of DXM would be an extraction, but that requires time and a chemical procedure which most people are not equipped to do. It's not a complicated process however it does carry some risks in itself. There is a technique known as the 'Agent Lemon extraction'.

=== Syrup ===

Cough syrup is the most common source for DXM users. While there are many brand name and no-name syrups which only contain DXM as an active ingredient there are many active and "inactive" ingredients commonly found in cough syrups which can cause negative effects ranging in severity. See [[DXM#HarmReduction|Harm Reduction]] for more information.

Some say the high produced from syrup is mostly sedating. You may feel sluggish when using it to get high on DXM, possibly as a result of other ingredients found in syrup however because of the even dispersion of DXM throughout the syrup it is said to produce a more 'solid' trip.

===Gel Caps===

DXM Gelcaps such as RobitussinDM Gelcaps or other no-name brand products containing only DXM encased in a gelcap are often the preferred source for DXM users. For most users gelcaps which contain only DXM produce a more clear headed high in lower doses. Most users experience fewer side effects from gelcaps than from syrup however some users report an upset stomach from the gelcaps, indicating that some users may have a sensitivity to the edible plastics used to make the gelcaps.

===Lozenges===

There are also sore-throat and cough medications containing DXM which exist in the form of a hard-candy like lozenge. These sometimes contain only DXM, however most brands of DXM lozenges also contain analgesics such as acetaminophen or benzocaine. Some brands such as '''Cordicin Cough and Cold''' (also known as '''CCC''') have a variety of products, most of which contain other active ingredients such as antihistamines or CPM (Chlorpheniramine Maleate) and may have one or two products which contain only DXM.

WARNING: Cordicin Cough & Cold is one of the most commonly used sources of DXM, and also one of the most dangerous. Nearly every single CCC product contains other active ingredients such as CPM, which can cause severe and life-threatening symptoms including seizures, shortness of breath or troubled breathing, weakness, loss of consciousness, severe dryness of the mouth, nose or throat, bleeding from the skin, mouth, eyes, rectum and vagina, and possibly death.

https://www.erowid.org/chemicals/dxm/dxm_info2.shtml

As always when using lozenges always choose a product which only has DXM in it.

===Delsym===

Delsym is brand with many formulations which contain Dextromethorphan Polistrex.

This is an extended release form of DXM which produced a longer lasting trip with weaker effects. It is said to be impossible to reach the third plateau using DXM which may be preferable for this reason to beginners or users who would prefer a longer and weaker trip.

== Dosage ==

'''DXM doses are affected by weight'''. See [http://taimapedia.org/images/4/46/DXMDosingChart.png this chart] for easy dosing.
Dosage refers to DXM HBR. HBR and Polistirex doses vary significantly due to polistirex slow absorbsion rate. (1mg of DXM polistirex is equivalent to about 6mg DXM HBR)

{| class="wikitable"
|+ Oral
|-
| Light || 100-200mg
|-
| Common || 200-400mg
|-
| Strong || 300-600mg
|-
| Heavy || 600-1500mg
|-
| Risk of death || 2.2g+
|}

== Duration ==

{| class="wikitable"
|+ Oral
|-
| Total || 6-8 hours
|}

=== Redosing ===

Redosing is not advised.

It's better to know how much you've taken at the start of the trip, rather than guestimate how much you're on as you keep dosing. The effects will start to come in waves and may not be pleasant. If you feel the need, it's recommended to take a high initial dose and a lower dose 1-2 hours in.

=== Predosing ===

One should make sure there is only DXM in the product they are taking. Grapefruit juice can potentiate dxm due to intactions with cytochrome P450.<ref>http://medicine.iupui.edu/clinpharm/ddis/2d6references/#dextromethorphanSub</ref>

== Effects ==
The high is not for everyone; it is said to loosely follow the rule of thirds: one third hates it, one third doesn't care, and one third like it.

DXM manifests its effects in a series of plateaus, with dose determining which plateau (and subsequently which effects) one will experience. Lower dose plateaus can be well suited to relaxation, light social interaction and listening to music, however higher doses result in a more encompassing dissociative experience which does not lend itself to attentive presence. At high doses your mind becomes as big as the universe. Strong experiences of detachment, depersonalization, and out-of-body experiences are commonly experienced with DXM at higher doses. These all-encompassing states are startling and uncomfortable for some.

=== Positive ===

* Euphoria, mood lift
* Increased giggling and laughing
* Dissociation of mind from body (positive when sought)
* Creative dream-like experiences
* Increased tactile sensation
* Some users report empathy and forgiveness towards other people

=== Neutral ===

* Pupil dilation
* Visual stop motion effect (flanging or strobing)
* Visual and aural (auditory) hallucinations
* Decreased sexual functioning (difficulty achieving orgasm)
* Confusion, disorientation
* Skin sensitivity, alters tactile (touch) and skin sensations
* Robotic, zombie-like walking, "robo-walk"
* Discoordination, reduced agility
* Loss of appetite
* Involuntary flexing of muscles
* Feelings of merging with adjacent objects like a couch or bed (with higher doses)

=== Negative ===

* Vomiting
* Dizzyness
* Body itching
* Rash, red blotchy skin
* Diarrhea
* Fever
* Tachycardia (racing, pounding heart)
* Some users report feeling disconnected, isolated from others

=== After-Effects ===

* Some users report hangover or depression that might last up to a few days.

=== Robo-Walk ===

The robo-walk feels like all of the muscles in your body are activated at once. You can still walk but forget about running or balance. Imagine the large muscles in your body all tensing up at once, so to walk you don't try to move your leg, you try and relax it in the way you want to go. Detailed coordination such as running, jumping, or maneuvering around furniture becomes much harder if not impossible. However, when you hit the third you really wouldn't want to be moving around anyway. The best thing to do is get a good pair of headphones, turn off the lights, close your eyes and let your mind wander.

== Plateaus ==
There are four 'stages' to DXM trips called '''plateaus'''. The first two are very similar, and the last two are similar.

There are two kind of trips: Sub third and beyond second plateau. If you take a first or second plateau dose, it's totally possible to socialize. Lower plateau doses are relatively easy to hide compared to higher plateau doses. Since you're dissociating yourself, you can remove yourself from awkward social situations or chaotic events. It would also be fun to chill in your room and play a video game and listen to music. The music will get better and you'll get more spacey. If you take a third or fourth plateau dose, it's recommend to trip alone, as it's not a social drug at this dose. The best way to enjoy it is to lay back and listen to music with your eyes closed. If you've ever meditated, you know how your mind can wander without your control. On DXM, you have a tendency to 'unlock' hidden memories. So the best thing is to let your mind take you where it wants to go. It usually knows whats best.

Choosing your destination plateau will depend a lot on what other drugs you've done and how comfortable you are with your mind.

=== First Plateau ===

Feels a bit 'off'. Perhaps like you're a bit buzzed from alcohol or a big hit off a bong.

'''First Plateau dose: 1-2mg/lb.'''

=== Second Plateau ===

You feel like your stoned. Your consciousness feels like it's distancing itself from reality, like it's taking a 'step back' into yourself. The second is supposed to be fun, it's introducing you to the idea that reality is a dream. Music is awesome to listen to and you can walk outside and perhaps hallucinate a small-mild amount. You can socialize with friends and they might take you for sober, or you could say you're slightly drunk.

'''Second Plateau dose: 2-5mg/lb.'''

'''Transitional'''

Most people stop their DXM journey here, as the final two are not really 'fun' but 'enlightening'. We don't recommend crossing this threshold until you're ready to move on from games of the mind to exercises of the consciousness. Enjoy the 2nd plat as long as you can because right now it's more of a fun experience and there is no going back once you've been here. It's like once you see what's behind the curtain, you can't enjoy the show.
Not to say that its not enjoyable, but it looses it's fun charm.

=== Third Plateau ===
This is where you start tripping. You cannot ignore the feeling inside of you. At this point its no longer a social drug and should be done by yourself or with a sitter. This is most akin to an acid trip: it feels very distorted and lasts a couple hours. The third plateau isn't 'party-mode' or even 'socialize-mode'. Its more like 'alone-and-tripping-mode'.
Inside your mind is an entirely new universe to explore. You think of water and an ocean appears. You create universes and live lifetimes inside your mind.
That's what the higher plateaus do.
'''Third Plateau dose: 5-7.5mg/lb.'''

=== Fourth Plateau ===
This is the deep meditative state. Few people enjoy going this far, as all you can really do (or want to do) is sit, listen to music, close your eyes, and become god. You can create universes in your mind just by thinking of them.

'''Fourth Plateau dose: 7.5-10mg/lb.'''

== Harm Reduction ==

See [[Dissociatives#Harm_Reduction|Dissociative Harm Reduction]] for general information.

=== Dangerous Ingredients Commonly Used in DXM Products ===

Many products which contain DXM also contain other medication or otherwise non-medically-active ingredients that can cause serious harm in the doses found in DXM containing products. If a user intends to use an OTC cough medication in order to get high on DXM they almost always will have to consume a dangerous quantity of other dangerous ingredients if they are present in the medication. For this reason it is strongly recommended to find a source which contains /only/ DXM.

The following is a summary of other ingredients commonly found in DXM products.

* : Acetaminophen/Paracetamol/APAP is a painkiller commonly found in over the counter flu medication, and is used in many Tylenol and Panadol brand products.
: Acetaminophen/paracetamol/APAP is hepatoxic in high doses. This means it will damage your liver if taken in high doses.
:: Your body can only process a certain amount of APAP at once before it the normal pathways become saturated.
:: Once the regular pathways used for metabolizing APAP have been saturated the remaining APAP gets broken down in the liver by an enzyme called
:: cytochrome P450. ::: '''When forced to break down APAP this enzyme produces toxic metabolites!'''

The effects of an acetaminophen overdose may not be apparent for up to sixteen hours after the user has ingested the APAP! This makes APAP overdose even more dangerous because of the chance that a user might take more or not take notice after thinking they are 'in the clear'.

'''Under no circumstances should anyone attempt to use any DXM product containing 'Paracetamol', also known as 'APAP' & 'Acetaminophen'!'''

* '''Guaifenesin''' is an expectorant. It works by causing the lungs to produce more fluid, making it easier to cough up phlegm.
: Guaifenesin is added to many OTC cough, cold and flu medications to help treat the 'stuffed up' feeling which often found in viruses and colds.

: Guaifenesin overdoses cause severe nausea and vomiting in most users. Some users report being able to use products which contain some guaifensin and
: other users report no negative effects from guaifenesin containing products.
: '''It is strongly recommended to avoid products which contain Guaifenesin when using DXM!'''

* '''Antihistamines''' such as '''[[DPH|Diphenhydramine]]''' are often found in sleep-aids, night-time formulations of cold medications and allergy medications.
: Antihistamines are sometimes found with DXM in night or 'PM' versions of products, and should generally be avoided when using DXM. When taken in
: high doses antihistamines can cause dizzyness, nausea, a strong dysphoria, paranoia, delirium and hallucinations. Many antihistamines, OTC or prescription
: can also have a dangerous synergy with some of the effects produced by DXM.

* '''Food Coloring & other "Inactive" Ingredients'''
: Many DXM products contain dyes which can cause allergic reactions in some users. Usually these dyes are not harmful in low doses however in doses which may be
: required for DXM's effects they can become problematic. '''Tartrazine (FD&C Yellow #5)''' is one of the most notable coloring ingredients to cause reactions.

: Cough syrups usually contain one or more chemical used to make them taste sweet.
: '''Glucose, sucrose, invert sugar, and fructose''' are commonly used sweetening agents. These sweeteners pose an obvious risk to people with blood sugar conditions
: such as diabetes or hypoglycemia.

: Thickening agents such as '''propylene glycol''' or '''polyethylene glycol''' are found in most cough syrups. These are not toxic but may cause an upset stomach
: when consumed in large doses.

=== Interactions ===
DXM has several potentially dangerous interactions with pharmaceutical and recreational drugs including some analgesics (painkillers), antihistamines, antidepressants and stimulants.

DXM has the potential to cause [[Serotonin Syndrome]] if mixed with other serotonergic drugs such as [[Antidepressants|antidepressants]], MAOIs, empathogens which affect serotonin release such as [[MDMA]], [[MDA]], [[Mephedrone]], etc. Serotonin Syndrome causes discomfort, excitability, irritability, and can be deadly <ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464814/</ref> if not treated.
* See [[Drug_Combinations|Drug combinations]] and [[Dissociatives#Interactions|Dissociative Interactions]] for more information.

== Pharmacology ==

IUPAC:(4bS,8aR,9S)-3-Methoxy-11-methyl-6,7,8,8a,9,10-hexahydro-5H-9,4b-(epiminoethano)phenanthrene.

Dextromethorphan is the dextrorotartory enantiomer of levomethophan, which is the methyl ether of levophanol, both opioid analgesics.

== Pharmacodynamics ==

{| class="wikitable"
|+ Binding receptors
|-
| NMDA - 7253
|-
| SERT - 2015
|-
| NET - 110606
|-
| Sigma-1 - 23
|-
| Sigma-2 - 240
|}

== Pharmacokinectics ==

Following oral dosing, DXM is rapidly absorbed from the GI tract. Where it enters the bloodstream, and crosses the blood-brain barrier.

At therapeutic doses, DXM acts centrally (brain) as opposed to locally (Respiratory tract). It's rapidly absorbed from the GI tract into the active metabolite Dextrophan (DXO) in the liver by the cytochrome P450 enzyme CYP2D6.

Around one in 10 of the Caucasian population has little or no CYP2D6 enzyme activity, leading to long-lived high drug levels.

== Images ==

<gallery mode="packed-hover">
Image:Dxm1.jpg|''Robitussin brand DXM Gel Caps''
</gallery>
== Links ==

[http://www.erowid.org/chemicals/dxm/faq/dxm_faq.shtml DXM FAQ]
[http://en.wikipedia.org/wiki/Dextromethorphan Wikipedia]

== References ==

<references />

[[Category:Dissociative]]
[[Category:Drugs]]

Main Page

2015-03-28T07:25:08Z

GrimReaper:

{{DISPLAYTITLE:Welcome to TripSit Wiki!}}
<table style="max-width: 1000px; display:block;" cellpadding=5>
<tr>
<td valign=top width=30% bgcolor=#f1f1f1>
== Drug Knowledge ==
*'''List of [[:Category:Drugs|Psychoactive Substances]]'''
*Main pages for drug classes:
**[[Psychedelics]]
**[[Dissociatives]]
**[[Stimulants]]
**[[Depressants]]
***[[Opioids]]
***[[Benzodiazepines]]
**[[Antidepressants]]
**[[Deliriants]]
**[[:Category:Ethnobotanical|Ethnobotanicals]]
**[[Research Chemicals]]

* [[Drug combinations]]
* [http://factsheet.tripsit.me/factsheet Factsheets]
* [[Glossary]]

== [[Guides]] ==

* [[Addiction]]
* [[Overdose]]
* [[Panic Attacks]]
* [[How To Deal With A Bad Trip]]
* [[Common Misconceptions About Psychedelics]]
* [[Quick Guide to Stimulant Comedowns]]
* [[Quick Guide to Volumetric Dosing]]
* [[Cold Water Extraction]]

== Tripsitting ==
* [[How_To_Tripsit_Online|How to Tripsit online]]
* [[How_To_Tripsit_In_Real_Life|How to Tripsit in real life]]

== Harm Reduction Supplies & Testing ==
* [[Scales]]
* [[Test Kits]]
* [[Sources for Laboratory Analysis]]

</td>
<td valign=top width=30% bgcolor=#f1f1f1>
== [[:Category:Common Drugs|Common Drugs]] ==

* '''[[:Category:Psychedelic|Psychedelics]]'''
** [[Mushrooms]]
** [[DMT]]
** [[LSD]]
** [[LSA]]
** [[Mescaline]]
** [[2C-X|2C-X series]]
** [[NBOMes|NBOMe series]]
** [[DOx|DOx series]]
** [[AMT|αMT]]
** [[Cannabis]]

* '''[[:Category:Dissociative|Dissociatives]]'''
** [[PCP]]
** [[3-MeO-PCP]]
** [[Ketamine]]
** [[MXE]]
** [[DXM]]
** [[Diphenidine]]
** [[Salvia]]
** [[Nitrous Oxide]]

* '''[[:Category:Stimulant|Stimulants]]'''
** [[Adderall]]
** [[Amphetamine]]
** [[Methamphetamine]]
** [[MDMA]]
** [[MDA]]
** [[Mephedrone]]
** [[Cocaine]]
** [[Methylphenidate]]

* '''[[:Category:Depressant|Depressants]]'''
** [[Alcohol]]
** [[Etizolam]]
** [[GHB]]
** [[Kava]]
** [[Zolpidem]]

* '''[[:Category:Opioid|Opioids]]'''
** [[Kratom]]
** [[Morphine]]
** [[Heroin]]
** [[Codeine]]
** [[Tramadol]]
** [[Hydrocodone]]
** [[Oxycodone]]
** [[Buprenorphine]]
</td>

<td valign=top width=20%>
== Community ==
=== IRC ===
* [[IRC_User_Guide|'''New user guide''']]
* [http://tripsit.me/tripsitapp/ Tripsit's portable IRC distribution]
* [[Channels]]
** [http://chat.tripsit.me/?nick=Social?#tripsit #tripsit]
** [http://chat.tripsit.me/?nick=Social?#home #home]
** [http://chat.tripsit.me/?nick=Social?#drugs #drugs]
* [[How_to_connect_through_Tor|How to Connect through Tor]]
* [[List of IRC bot commands]]
* Moderation [[Commands reference]]

=== TripRadio ===
* [http://radio.tripsit.me Listen Now]

* [[Radio|General info]]
* [[DJ Application|We need DJs!]]
* [[How to DJ|How to setup DJ software]]
</td>

<td valign=top width=25%>
== Important Pages ==
* [[TripSit Rules]]
* [[Network Terms of Service]]
* [[List of staff and their roles]]
* [[TripSit's Plans]]
</td>

</tr>
</table>

[[About|About Tripsit wiki]]

TripSit wiki currently has [[Special:Statistics|{{NUMBEROFPAGES}} pages]].

View a [[Special:AllPages|list of all pages]].

__NOTOC__
__NOEDITSECTION__

Main Page

2015-03-28T07:24:18Z

GrimReaper:

{{DISPLAYTITLE:Welcome to TripSit Wiki!}}
<table style="max-width: 1000px; display:block;" cellpadding=5>
<tr>
<td valign=top width=30% bgcolor=#f1f1f1>
== Drug Knowledge ==
*'''List of [[:Category:Drugs|Psychoactive Substances]]'''
*Main pages for drug classes:
**[[Psychedelics]]
**[[Dissociatives]]
**[[Stimulants]]
**[[Depressants]]
***[[Opioids]]
***[[Benzodiazepines]]
**[[Antidepressants]]
**[[Deliriants]]
**[[:Category:Ethnobotanical|Ethnobotanicals]]
**[[Research Chemicals]]

* [[Drug combinations]]
* [http://factsheet.tripsit.me/factsheet Factsheets]
* [[Glossary]]

== [[Guides]] ==

* [[Addiction]]
* [[Overdose]]
* [[Panic Attacks]]
* [[How To Deal With A Bad Trip]]
* [[Common Misconceptions About Psychedelics]]
* [[Quick Guide to Stimulant Comedowns]]
* [[Quick Guide to Volumetric Dosing]]
* [[Cold Water Extraction]]

== Tripsitting ==
* [[How_To_Tripsit_Online|How to Tripsit online]]
* [[How_To_Tripsit_In_Real_Life|How to Tripsit in real life]]

== Harm Reduction Supplies & Testing ==
* [[Scales]]
* [[Test Kits]]
* [[Sources for Laboratory Analysis]]

</td>
<td valign=top width=30% bgcolor=#f1f1f1>
== [[:Category:Common Drugs|Common Drugs]] ==

* '''[[:Category:Psychedelic|Psychedelics]]'''
** [[Mushrooms]]
** [[DMT]]
** [[LSD]]
** [[LSA]]
** [[Mescaline]]
** [[2C-X|2C-X series]]
** [[NBOMes|NBOMe series]]
** [[DOx|DOx series]]
** [[AMT|αMT]]
** [[Cannabis]]

* '''[[:Category:Dissociative|Dissociatives]]'''
** [[PCP]]
** [[3-MeO-PCP]]
** [[Ketamine]]
** [[MXE]]
** [[DXM]]
** [[Diphenidine]]
** [[Salvia]]
** [[Nitrous Oxide]]

* '''[[:Category:Stimulant|Stimulants]]'''
** [[Adderall]]
** [[Amphetamine]]
** [[Methamphetamine]]
** [[MDMA]]
** [[MDA]]
** [[Mephedrone]]
** [[Cocaine]]
** [[Methylphenidate]]

* '''[[:Category:Depressant|Depressants]]'''
** [[Alcohol]]
** [[Etizolam]]
** [[GHB]]
** [[Kava]]
** [[Zolpidem]]

* '''[[:Category:Opioid|Opioids]]'''
** [[Kratom]]
** [[Morphine]]
** [[Heroin]]
** [[Codeine]]
** [[Tramadol]]
** [[Hydrocodone]]
** [[Oxycodone]]
** [[Buprenorphine]]
</td>

<td valign=top width=20%>
== Community ==

=== IRC ===

* [[IRC_User_Guide|'''New user guide''']]
* [http://tripsit.me/tripsitapp/ Tripsit's portable IRC distribution]
* [[Channels]]
** [http://chat.tripsit.me/?nick=Social?#tripsit #tripsit]
** [http://chat.tripsit.me/?nick=Social?#home #home]
** [http://chat.tripsit.me/?nick=Social?#drugs #drugs]
* [[How_to_connect_through_Tor|How to Connect through Tor]]
* [[List of IRC bot commands]]
* Moderation [[Commands reference]]

=== TripRadio ===
* [http://radio.tripsit.me Listen Now]

* [[Radio|General info]]
* [[DJ Application|We need DJs!]]
* [[How to DJ|How to setup DJ software]]
</td>

<td valign=top width=25%>
== Important Pages ==
* [[TripSit Rules]]
* [[Network Terms of Service]]
* [[List of staff and their roles]]
* [[TripSit's Plans]]
</td>

</tr>
</table>

[[About|About Tripsit wiki]]

TripSit wiki currently has [[Special:Statistics|{{NUMBEROFPAGES}} pages]].

View a [[Special:AllPages|list of all pages]].

__NOTOC__
__NOEDITSECTION__