Tag Archives: polysubstance abuse

DXM and Kratom

Popular culture and media is bringing the issue of cough medicine abuse to light. Unfortunately, rather than presenting the dangers of abusing or mixing cough medication, many forms of media tend to glorify the drug. It is reported that 1 in 20 teens have taken DXM to achieve a recreational high. Some users choose to take the stance that its a ‘better’ addiction than alcohol or opioids- however, abusing any medication carries serious risks and consequences. Increasingly, people are experimenting with a combination of DXM and kratom.

What is DXM?

Dextromethorphan or more commonly known as a DXM is an over-the-counter (OTC) cough and cold medication. DXM is from a derivative of morphine, a very powerful opioid, but is not technically an opioid. Due to the effects it can have, it behaves like an opioid without the painkilling effects. It is effective at suppressing the average cough and creates some sedation which can help sick individuals relax or fall asleep. Unfortunately, when taken in much higher doses, DXM sometimes causes individuals to experience a euphoric high which is then sought after. 

According to the Drug Enforcement Agency (DEA), DXM is an antitussive (a type of medication used to stop a cough) found in over 120 cold medications (such as Vicks 44, NyQuil, Robitussin). The typical dosage is 15-30mg taken 3-4 times a day. When abused however, individuals can end up taking 100-1500mg a day. The DEA provides a ranking of “plateaus” which describes how users can manipulate different doses to achieve different effects.

  1. 100-200mg → Mild stimulation
  2. 200-400mg → Euphoria and hallucinations
  3. 300-600mg → Distorted visual perceptions, loss of motor coordination
  4. 500-1500mg → Dissociative sedation

The DEA will schedule certain drugs it deems to be dangerous and hazardous to the public’s health under its own classification system. For example, Methamphetamine is considered a schedule 1 drug and therefore is very dangerous. DXM is not classified under this system. It is typically found in liquid form but illicit websites and users have begun selling the drug in capsule or powder form.

DXM Side Effects

Some side effects of DXM include:

  • Sweating
  • Rashes or red, blotchy skin (not an allergic reaction)
  • Dizziness
  • Lethargy
  • Nausea and vomiting
  • Loss of coordination
  • Slurred speech
  • Impaired judgment
  • Reduced cognitive ability
  • Nystagmus, or rapid eye movements
  • Visual disturbances
  • Liver damage
  • Disorentiation

In high doses, the effects of DXM mimic those of Ketamine and PCP. A DXM overdose is possible if an individual takes enough of it. Given its suppressive effects, it can cause slowed breathing and critical organ function. 

How Long Does DXM Stay In Your System?

Testing for DXM is rare because of its common use as a cough suppressant. However, the drug can trigger false positives for PCP. DXM has a half-life of around 4 hours. A substance’s half-life is the time it takes for the chemical to reduce to 50% of its original size. Given its half-life elimination time, it can be assumed that most users can get rid of the chemical around 16.5 and 33 hours. While the chemical itself may be gone, this does not mean that traces cannot be tested for. 

DXM can be detected in:

  • Urine 24-48 hours after ingestion
  • Blood 3-24 hours after ingestion
  • Saliva does not apply as most OTC medications are taken orally
  • Hair up to 90 days after ingestion

What is Kratom?

Kratom is a plant found in Southeast Asia which is beginning to find its way into U.S. markets. Its leaves contain a chemical which produces a psychotropic (mind-altering) effect. The use of kratom is still pretty minimal in the U.S. but as of now, there is no nationwide ban or enforcement of the drug. In fact, most users can buy it online, although some states have banned the substance. According to the National Poison Data System, between 2011-2017 there were 11 deaths associated with kratom use.

dmx and kratom

Kratom’s effects are unpredictable. It is possible to use as a stimulant in lower doses, but can also have a heavy sedative effect when taken in higher doses. The lack of research on the effects of kratom makes it difficult to fully understand the negative side-effects. However, users can expect to experience:

  • Disrupted sleep
  • Increased energy and alertness
  • Drowsiness
  • Cough suppression
  • Pain reduction
  • Psychosis
  • Weight loss

While not all of these effects are necessarily negative, some negative short-term effects include:

  • Tremors
  • Dizziness
  • Nausea and vomiting
  • Constipation 

How Long Does Kratom Stay In Your System?

There is currently no drug test for kratom. However, the duration of the chemicals presence in your body lasts due to:

  • Frequency of use
  • Age
  • Genetics
  • Body fat
  • Metabolic rate
dxm and kratom

Mixing DXM and Kratom

It is possible to abuse both DXM and kratom to provide a sedative effect on the mind and body. While DXM may do a better job at this than kratom, mixing the two substances can greatly enhance the suppression effects. If taken at the same time, bodily function and critical organs may slow down to a dangerously low point, putting the user at risk of an overdose. The use of Naloxone has been proven to work against a patient overdosing on DXM and may save their life. 

Treatment

Cough syrup addiction and the tendency to mix it with other drugs as seen in popular culture presents a serious risk to those who do not understand the dangers. If you or a loved one is struggling with cough syrup abuse or addiction, please contact us today so we can begin the journey to a sober life.

Ativan and Alcohol

Mixing alcohol with most drugs is likely to nearly always have a negative effect on the body. Many people are hoping to heighten the “positive” effects each drug. However, they do not realize that this also significantly heightens the negative and dangerous effects. Of course, there are ways to prevent the accidental mixing of drugs. However, it is the intentional mixing of two drugs which becomes a serious cause for concern. With the increase in anxiety disorders in the US, there is a correlating increase in the amount of drugs prescribed to treat such ailments. Ativan and Xanax are both drugs with a large number of prescriptions to patients who deal with issues such as anxiety. Further, some people use alcohol as a means to deal with anxiety. Ativan and alcohol are a common and dangerous combination.

What is Ativan?

Ativan is a benzodiazepine with use as a sedative, muscle relaxant or tranquilizer. It is also the brand name for the drug lorazepam. It is in the class of psychoactive drugs. Further, it is one of the most abused pharmaceutical drugs in the US. Other benzodiazepines (or ‘benzos’) include Xanax and Valium. Ativan may be prescribed to treat patients who suffer from:

  • Anxiety
  • Nervous tension
  • Psychological issues
  • Insomnia
  • Epilepsy

Ativan users develop a tolerance over time. A tolerance is the body’s way of getting used to a drug. Overtime, a user will need to continually up their dosage in order to feel the same effects. Thus, because Ativan is such a potent drug, it is rarely prescribed for periods over 4 months. 

Ativan, like most other benzos, works by blocking the gamma-aminobutyric acid (GABA) neurotransmitter to essentially slow down overactive mental processes. It is commonly sold in a tablet/pill form and takes around 45 minutes to start feeling the effects. Xanax operates much in the same way as Ativan, but Xanax is more popular in mainstream culture and on the streets. Given that Ativan is a depressant, the side effects will include drowsiness and tiredness. Some other side effects include:

  • Dizziness
  • Muscle weakness
  • Headache
  • Blurred vision
  • Insomnia
  • Nausea
  • Vomiting
  • Skin rash
ativan and alcohol

Ativan Abuse and Addiction

Ativan is considered to be a Schedule IV Controlled Substance by the Drug Enforcement Agency (DEA). According to the DEA, a Schedule IV substance is one which has “a low potential for abuse relative to substance in Schedule III.” DEA definitions are based on a relative scale where the drugs are essentially compared in their potential for abuse. While the definition for Schedule IV includes “low potential for abuse”, it is important to realize that it is in comparison to much more potent and dangerous drugs such as Ketamine or Codeine. So make no mistake, Ativan is still very dangerous. So, is Ativan addictive? Absolutely, because not only does Ativan create a physical dependence but it also creates a psychological one. Users who abuse Ativan will likely see the negative consequences in their life but will still continue to abuse the drug. 

According to the National Institute on Drug Abuse, benzo related overdoses have risen from 1,135 in 1999 to 11,537 in 2017- that is a 916% increase. As a central nervous system depressant, Ativan will slow and suppress the activity of crucial organs such as the lungs. In some cases, taking too much Ativan can completely stop your breathing. 

ativan and alcohol

Knowing the signs of an overdose can save your life or the life of someone else:

  • Pale, cool, bluish skin or lips
  • Very shallow, slow breathing
  • Over-sedation
  • Drowsiness
  • Loss of coordination/motor skills
  • Slurred speech
  • Memory loss
  • Confusion
  • Weakness
  • Loss of consciousness
  • Muscle weakness
  • Unresponsiveness

Any overdose is a serious medical emergency and requires immediate attention. 

How Long Does Ativan Stay In Your System?

The half-life of Ativan is around 12 hours. A chemical half-life is the determination of how long it takes for the chemical to reduce to half of its initial ingested amount. 10mg of Ativan will take 12 hours to effectively become 5mg in the body. However, an active metabolite of Ativan, glucuronide has a half life of 18 hours. It takes around 5 days for 95% of the lorazepam to leave your body. While the drug may have left your body, traces of it and its metabolites may remain longer in the body and can be detected with various tests.

Ativan can be detected in your system by:

  • Urine- up to 6-9 days after ingestion
  • Blood- up to 3 days
  • Saliva- around 8 hours
  • Hair follicle- up to 4 weeks
ativan and alcohol

While these figures can provide a good estimation of the effectiveness of drug tests, there are several other factors which must be considered when determining how long Ativan stays in your system.

  • Body composition- your build/composition will play a big factor in how long traces can be detected. Everything from your height and weight, genetics, metabolic rate, age and body fat percentage.
  • Frequency of use- your history with Ativan (essentially any benzodiazepine) will determine how well your body processes it. As previously mentioned, Ativan users will develop a tolerance which will then increase how long it takes for your body to process the drug. 

Mixing Ativan and Alcohol

Ativan and Alcohol are both central nervous system depressants. They both release GABA which decreases and slows bodily and nerve function. The effects of both drugs are quite similar. The biggest risk of mixing the drugs is the possibility of an overdose. Slowing down bodily function will lead to a drop in blood pressure and slowed breathing. In some cases, breathing can completely stop leading to a blackout and overdose. Taking the drugs together may also lead to engaging in dangerous behavior such as driving or taking other serious risks.

ativan and alcohol

How To Get Help

Dealing with alcohol or benzodiazepine addiction can be difficult. It can impact all aspects of your life and usually requires the help of trained professionals to help you along your journey to recovery. It is important to find treatment that addresses addiction issues as well as mental health. If you or a loved one needs help, please contact us today.

Ambien and Alcohol

Americans are now more distracted than ever. Since the end of the 20th century, more and more screens have been introduced into the average household. Smartphones, tablets, laptops, massive TVs- all contribute to the increase in sleeping disorders. Many people turn to options like Ambien to help. A lot of people in America also drink alcohol, sometimes even with the thought that it helps sleep. Subsequently, the increasing risk of mixing Ambien and alcohol is a real danger.

ambien and alcohol

What is Ambien?

Ambien is the brand name for Zolpidem Tartrate, which is a sedative and falls under the hypnotic class of medication. In general, the purpose is to treat insomnia in patients and is seen as a better alternative to benzodiazepines or barbiturates. Ambien’s design is to provide the same sleep relief as other drugs but without the dangerous side-effects commonly associated with drugs such as Valium. It was approved by the FDA in 1992 during a time where the prevailing sleep-aid, Halcion, was being linked with psychosis, suicide and addiction and was welcomed with open arms. 

ambien and alcohol

Ambien works by binding and activating GABA (gamma-aminobutyric acid) receptors in the brain. GABA is a neurotransmitter which is responsible for blocking impulses between nerve cells in the brain. Ambien binds to the same receptors as benzodiazepines. By binding to the receptors, the chemical essentially slows down brain function, making it easier to fall asleep. While Ambien became popular because it was believed to have less of the harmful side effects of other sleep-aids available at the time, it comes with its own risks:

  • Daytime drowsiness
  • Dizziness
  • Weakness
  • Nausea
  • “Drugged” feeling
  • Insomnia
  • Confusion
  • Headache

Some of the serious side effects of Ambien include:

  • Memory loss
  • New or worsening depression
  • Abnormal thoughts
  • Thoughts of suicide
  • Hallucinations
  • Confusion
  • Agitation
  • Aggressive behavior
  • Anxiety

Ambien Addiction and Abuse

A chemical tolerance is when a higher dose is required to get the same desired results while taking a drug. Essentially, the body gets used to the drug and more of it is required to feel the effects. Unfortunately, Ambien tolerance develops quickly in some patients. Ambien was never designed to be a long-term use drug. However, some patients require their physician to increase the dosage to get the same relief. Increasing the dosage may cause users to develop a dependency to the drug. Some may find that they are unable to fall asleep without it.

ambien and alcohol

In high doses, it is possible for Ambien to provide a euphoric high, which is then be sought after by some. At this point, normal use begins to turn to abuse. According to SAMHSA, Ambien abuse is rare with those who are have a prescription. It is more likely to be with those who acquire it illicitly.

Overdose of Ambien is possible. According to SAMHSA, there were 64,175 Ambien related emergency room visits (ER) and of those 20,793 were related to over-medication. While your risk of overdose will depend on various factors such as body composition, tolerance level and history of use, it is generally considered that taking more than 150mg per kilogram of body weight is lethal. An individual weighing 50 kilograms will need to take 7,500mg of Ambien to experience a fatal overdose. While that may seem like a lot of medication, the 150mg can be greatly reduced when taken with other drugs, especially alcohol. 

How Long Does Ambien Stay in Your System?

Once Ambien enters the body, it takes around 30 minutes for the drug to reach peak potential blood concentration meaning that the full effects are felt around this mark. Compared to other drugs, this is quite fast. However, Ambien has a short half-life of around 1.5 hours. A chemicals half-life is a determination of the time it takes for the chemical to reduce to half of its ingested dose. In other words, after 1.5 hours, the 10mg dose of Ambien is essentially reduces to 5mg. However, it’s possible to feel the effects of the drug for 8 hours and the chemicals will be completely out of the body in about 14 hours. 

It is possible to detect Ambien in the body after the 14 hour mark in various tests:

  • Urine – 72 hours after use
  • Hair – 3 to 5 weeks after use
  • Saliva – 8 hours after use

Drug testing for Ambien is quite rare however circumstances such as traffic incidents may call for testing.

Mixing Ambien and Alcohol

Alcohol is a central nervous system (CNS) depressant. A CNS depressant will slow brain and nerve function thus having an effect on motor and cognitive function. Ambien has very similar CNS depressant effects by binding to the GABA receptors in the brain. Two depressants or drugs mixed together (also referred to as polysubstance abuse) will amplify the overall effects and can pose serious overdose risks. According to the National Institute of Alcohol Abuse and Alcoholism (NIAAA), mixing alcohol with other depressants such as Ambien can cause drowsiness, slowed or difficulty breathing, impaired motor skills, and memory problems. With two powerful depressants working, it can cause breathing to slow to a dangerously low level or stop completely. Death can also occur by engaging in dangerous behavior often associated with alcohol use. 

Getting Help

Getting off Ambien may seem difficult. Especially if the user has been using it for an extended period and believes it is necessary for a good night’s sleep. Someone with a problem with ambien and alcohol needs specialized help. However, with the proper attention and guidance, recovery is possible. If you or a loved one is struggling with addiction, please contact us today to see how we can help.

*Resources:
Hypnotic medications and suicide – NIH
Emergency Department Visits – SAMHSA
Harmful Interactions – NIAAA