Comments on: The Truth About Tolerance http://blog.ericw.org/2010/02/the-truth-about-tolerance/ live, love, hurt Fri, 30 Jul 2010 16:23:15 +0000 hourly 1 http://wordpress.org/?v=3.2.1 By: Eric Will http://blog.ericw.org/2010/02/the-truth-about-tolerance/#comment-5 Eric Will Sat, 06 Feb 2010 01:39:16 +0000 http://pain.ericw.org/?p=43#comment-5 <p>I would certainly recommend taking a capsule as opposed to the syrup itself. It's not hard to find a DXM-only formulation, but the syrup itself has a lot of sugar in it, which is no good. However, DXM abusers/addicts often drink several bottles a day with no long-term effects.</p> <p>I wouldn't say you'd have to take it every time you took your medicine. You'd have to look at your dose of DXM compared to its half-life and take it on a regular basis. Probably Delsym (dextromethorphan polysterix) would be a good idea, as it has a time-release mechanism making it good for q12h dosing. Also, metabolism of DXM depends on an extremely variable mechanism (person to person).</p> <p>As to the cost, yes, it would add up. There may be prescription preparations of DXM that would allow insurance coverage, but I doubt it.</p> I would certainly recommend taking a capsule as opposed to the syrup itself. It’s not hard to find a DXM-only formulation, but the syrup itself has a lot of sugar in it, which is no good. However, DXM abusers/addicts often drink several bottles a day with no long-term effects.

I wouldn’t say you’d have to take it every time you took your medicine. You’d have to look at your dose of DXM compared to its half-life and take it on a regular basis. Probably Delsym (dextromethorphan polysterix) would be a good idea, as it has a time-release mechanism making it good for q12h dosing. Also, metabolism of DXM depends on an extremely variable mechanism (person to person).

As to the cost, yes, it would add up. There may be prescription preparations of DXM that would allow insurance coverage, but I doubt it.

]]> By: Stephen Belcher http://blog.ericw.org/2010/02/the-truth-about-tolerance/#comment-4 Stephen Belcher Sat, 06 Feb 2010 01:27:09 +0000 http://pain.ericw.org/?p=43#comment-4 <p>OK, should have asked this as well: is this something that needs to be maintained with every dose, or is it like the dissociative drugs resetting nerve pain issues temporarily and only needing to be done periodically? Cough syrup is expensive, and if you're on a daily dose of <i>X</i>mg <i>qid</i> of whatever opioid, and you had to take a swig of Robitussin every time, that could add a pile of money on an already-expensive condition.</p> <p>That's not to mention the dangers if your cough syrup of choice had acetaminophen in addition to the DXM, as a formulation of narcotics with 750mg qid would put you dangerously close to liver damage by itself; you can't take hardly any in that case. Also, narcotics are designed to do no long-term damage as they can be maintenance medications, but cough syrup probably isn't; is it risky to take that indefinitely?</p> OK, should have asked this as well: is this something that needs to be maintained with every dose, or is it like the dissociative drugs resetting nerve pain issues temporarily and only needing to be done periodically? Cough syrup is expensive, and if you’re on a daily dose of Xmg qid of whatever opioid, and you had to take a swig of Robitussin every time, that could add a pile of money on an already-expensive condition.

That’s not to mention the dangers if your cough syrup of choice had acetaminophen in addition to the DXM, as a formulation of narcotics with 750mg qid would put you dangerously close to liver damage by itself; you can’t take hardly any in that case. Also, narcotics are designed to do no long-term damage as they can be maintenance medications, but cough syrup probably isn’t; is it risky to take that indefinitely?

]]> By: Eric Will http://blog.ericw.org/2010/02/the-truth-about-tolerance/#comment-3 Eric Will Sat, 06 Feb 2010 00:33:01 +0000 http://pain.ericw.org/?p=43#comment-3 <p>Certainly not that much, no. I would say no more than 30-60mg of dextromethorphan, with 60 being on the "very high" side. DXM can have psychoactive effects as low as 90mg and sometimes less, depending on body mass.</p> Certainly not that much, no. I would say no more than 30-60mg of dextromethorphan, with 60 being on the “very high” side. DXM can have psychoactive effects as low as 90mg and sometimes less, depending on body mass.

]]> By: Stephen Belcher http://blog.ericw.org/2010/02/the-truth-about-tolerance/#comment-2 Stephen Belcher Sat, 06 Feb 2010 00:29:18 +0000 http://pain.ericw.org/?p=43#comment-2 <p>Dumbed down even further; is this basically saying that, to make your pain-relief drugs work better, you should take them with a shot or three of cough syrup?</p> Dumbed down even further; is this basically saying that, to make your pain-relief drugs work better, you should take them with a shot or three of cough syrup?

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