Dextromethorphan (DXM or DM) is an antitussive (cough suppressant) drug. It is one of the active ingredients in many over-the-counter cold and cough medicines, including generic labels and store brands, Benylin DM, Mucinex DM, Robitussin, NyQuil, Dimetapp, Vicks, Coricidin, Delsym, TheraFlu, and others. Dextromethorphan has also found other uses in medicine, ranging from pain relief topsychological applications. It is sold in syrup, tablet, spray, and lozenge forms. In its pure form, dextromethorphan occurs as a white powder.

Street Names – Dex, DXM, Robo, Skittles, Syrup, Triple-C, Vitamin D, Tussin

Effects – At doses much higher than medically recommended, dextromethorphan is classified as a dissociative hallucinogen, possessing certain effects that are somewhat similar to the dissociative agents ketamine and phencyclidine. It may produce distortions of the visual field – feelings of dissociation, distorted bodily perception, and excitement, as well as a loss of sense of time. Some users report stimulant-like euphoria, particularly in response to music.

Withdrawal Symptoms – Symptoms of dextromethorphan withdrawal include restlessness, insomnia, vomiting, diarrhea, muscle aches, cold flashes, bone aches, depression, problems with memory and thinking, obsession and craving for the drug.

Long-term use – The long-term side-effects of dextromethorphan abuse are not yet fully known, but it is believed that dextromethorphan abuse may cause things such as depression, liver problems, psychosis and learning and memory problems. As well, abusing dextromethorphan can lead to coma or death.

Statistics – According to a 2006 survey conducted by the National Survey on Drug Use and Health (NSDUH), an estimated 3.1 million individuals aged 12 to 25 have used a nonprescription cough and cold medication to get high.  In addition, young women between the ages of 12 and 17 were more likely than young men of the same age group to misuse a nonprescription cough and cold product; men aged 18 to 25 were more likely to misuse these products when compared with women in this age group, however. The Partnership for a Drug-Free America report that an estimated 10% of teenagers intentionally take excessive doses of DXM to get high.


MDMA (3,4-methylenedioxy-N-methylamphetamine) is an empathogenic drug of the phenethylamine and amphetamine classes of drugs. MDMA has become widely known as “ecstasy” (shortened to “E”, “X”, or “XTC”), usually referring to its street pill form, although this term may also include the presence of possible adulterants.

Street Names – X, E, or XTC, Adam, Molly, Beans, Candy, Disco Biscuits, Vitamin E or Vitamin X, pills, rolls

Effects – The effects of MDMA on the human brain and body are complex. It induces serotonin, dopamine, and norepinephrine release, and can act directly on a number of different receptors. It’s not fully understood why MDMA induces such unusual psychoactive effects. Most explanations focus on serotonin release. MDMA causes serotonin vesicles in the neurons to release quantities of serotonin into the synapses. Short-term experiential effects, which tend to last less than 4 hours, include:

  • Mental and physical euphoria
  • A sense of general well-being and contentedness
  • Decreased negative emotion and behavior such as stress, anxiety, fear, and paranoia
  • Increased sociability and feelings of communication being easy or simple
  • Increased urge to communicate with others
  • Increased empathy and feelings of closeness or connection with others[11]
  • Reduced insecurity, defensiveness, and fear of emotional injury[12]
  • Decreased irritability, aggression, anger, and jealousy
  • A sense of increased insightfulness and introspection[11][13]
  • Mild psychedelia (colors and sounds are enhanced, mild closed-eye visuals, improved pattern recognition, etc.)
  • Enhanced tactile sensations (touching, hugging, and sex)

Long-term use – MDMA causes a reduction in the concentration of serotonin transporters in the brain. The rate at which the brain recovers from serotonergic changes is unclear. Effects reported by some users once the acute effects of MDMA have worn off include:

  • Psychological
  • Anxiety and paranoia
  • Depression
  • Irritability
  • Fatigue
  • Impaired attention, focus, and concentration, as well as drive and motivation (due to depleted serotonin levels)
  • Residual feelings of empathy, emotional sensitivity, and a sense of closeness to others
  • Physiological
  • Dizziness, lightheadedness, or vertigo
  • Loss of appetite
  • Gastrointestinal disturbances, such as diarrhea or constipation
  • Insomnia
  • Exhaustion
  • Jaw soreness, from bruxism

Withdrawal Symptoms – The artificially enhanced sense of well-being created by the boost in these neurotransmitters cannot be replicated naturally, and the individual would have to take more Ecstasy to continue feeling this way. In fact, serotonin levels fall well below even natural levels when someone is coming off of Ecstasy. This can remain the case for days, weeks or even years after short or long-term use. These depleted serotonin level is what causes the depression and anxiety that man Ecstasy users experience after having taken the drug. This can be best described as one of the primary Ecstasy withdrawal symptoms that users experience and complain of, and one that can come with a wide spectrum of other related problems and disorders.

Statistics – Ecstasy has been a common drug of abuse since the 1980’s, when it first become a drug of choice among party-goers are raves and on the night club scene. According to statistics regarding use of the drug over the past several years, rates of use of Ecstasy are still extremely high over twenty years later. In 2007, there were over 12 million individuals in the U.S. alone who had used Ecstasy at least once in their lifetime. By 2009, past-month use of Ecstasy in the U.S. had increased by 37% within one year. There are currently over 14 million lifetime users of the drug, and there are no signs that rates of use will be declining at any point in the near future.