Introduction to the FAQ v4.0

A lot has happened since I published Version 3 of the DXM FAQ; some of it
has been good, some not so good. I’d like to take a moment to address some
of these changes and some of my concerns. I still do not regret having
published the FAQ, and out of all the feedback I have received (including
letters from physicians, scientists, parents, and just plain druggies),
less than one percent has been negative. The reasons I gave for its
publication still apply, but those of you familiar with v3.0 will notice
that this version shows considerably less praise for DXM.

When I published the FAQ on Usenet (and then the World Wide Web), it was my
expectation that it would be of interest primarily to psychonauts,
experienced psychedelic users, and others who use drugs for
self-exploration and spiritual purposes. I knew, of course, that not
everyone who did DXM would use it with the intention of expanding the mind,
but I reasoned that, given the relative unpleasantness of consuming cough
syrup, and the “heaviness” of the DXM experience, most people would find
casual, recreational use of DXM unlikely. Things didn’t quite turn out how
I expected.

Also at that time there was a severe shortage of information from former
DXM users about adverse effects of long-term use. I had reasoned that
long-term use was probably not a good idea, but probably not terribly
dangerous. Of the people I had interviewed who had used DXM regularly, very
few had any problem with it, and those who did recovered when they stopped
using it.

Since then there has been a great increase in DXM use (or at least more
people are talking about it). My concern that the FAQ had started a “DXM
epidemic” turned out to be mostly baseless; the majority of new DXM users
seem to hear about it the same way that DXM users have always learned about
it: from their friends. Some do learn about it from the FAQ, but for the
most part you have to know about DXM in the first place before finding or
understanding the FAQ.

As I have spoken to more and more users of DXM, I have learned that more
people have negative experiences with the drug than I had expected. Most of
these are simply people who try it once, decide they don’t like it, and
never try it again. A few people, on the other hand, seem to be greatly
susceptible to DXM addiction and some of these have suffered long-term
health consequences. A very few may have suffered permanent brain damage
from extremely heavy use of DXM (e.g., an 8oz bottle of Maximum Strength
syrup every day). On the other hand, some people consume the same amount
for years seemingly without consequence. And while some people can consume
DXM regularly without psychological consequences, others suffer from severe
depression and psychotic breaks, even leading to a few cases of suicide

This brings me to the most relevant new information about DXM: Olney’s
findings of NMDA Antagonist Neurotoxicity (NAN). There is great debate
right now whether NAN is relevant at recreational doses or not. In animals,
the dosage required to induce NAN is far in excess of the anaesthetic dose,
and humans typically take sub-anaesthetic doses of dissociatives. On the
other hand, there may be danger with long-term use at considerably lower
dosages that the animal models do not show.

The data from human experiences are hard to interpret. Many heavy PCP users
suffer obvious cognitive and motor impairment; however, PCP has neurotoxic
effects (in particular in the cerebellum) not shared by other dissociatives
including DXM or ketamine. Ketamine is probably a better approximation of
DXM, but very few people have done large amounts of ketamine for long
periods of time. A notable exception is John Lilly, who is a bit of a nut,
but was probably a bit of a nut before doing ketamine, and (at least the
last time I checked) he doesn’t seem to suffer from cognitive impairment.

There are a few DXM users who have suffered long-term consequences. Out of
approximately five hundred current and former DXM users I have heard from,
three have suffered lasting cognitive impairment. Additionally, there is
one published paper on cognitive impairment from chronic DXM use, although
the author suggests an underlying temporal lobe seizure disorder. DXM has
been shown to increase the frequency of complex partial seizures, and it’s
possible that it is the seizures, and not the DXM itself, which is causing
problems. Unfortunately, it has also been suggested temporal lobe
epileptics may also be more susceptible to dissociative addiction.
Hopefully much of this will be resolved in the next few years.

Until then, my official recommendation is not to use DXM at all. Since I
know this isn’t likely to happen, my own personal belief is that DXM is
probably pretty safe when used occasionally (e.g., once or twice a month)
at the lower plateaus, and rarely (e.g., once or twice a year) at the
higher plateaus. I have yet to hear from anyone who used DXM with this or
less frequency who has suffered any impairment, temporary or permanent.
Actually, to be technically correct, nobody using it once a week for less
than six months has ever seemed to have problems, but it’s always best to
keep a wide safety margin.

Another thing to keep in mind is that DXM in the upper plateaus is a
considerably different experience than the lower plateaus, and may be
better suited to spiritual or ritual use. Even at the lower plateaus, DXM
is not really well suited as a frequent recreational drug.

So what do you do then if you find yourself in that particularly human
condition of ennui (for which psychedelics are a most effective medicine)?
Well, ideally I’d suggest you hop on a plane to Amsterdam (or somewhere
else where 2CB and marijuana are legal). Unfortunately this isn’t an ideal
world, and flying across the Atlantic is outside the means of most of us
(including me). A more reasonable suggestion would be to do your part to
change the laws in this country so that psychedelics can regain their
rightful place as tools for mental, emotional, and spiritual exploration
and growth. Remember, the laws aren’t going to change unless we work to
change them.

In summary, I’m not nearly as convinced that DXM is a benevolent
psychedelic as I used to be. It is in many ways considerably more powerful
(and certainly more dangerous) than LSD or mushrooms. Like all psychedelics
it can profoundly change you; unlike others, these changes are not
necessarily under your control, especially if you are not very familiar
with yourself. DXM can be a great tool for spiritual rebirth, but it can
also turn you into a paranoid, antisocial asshole. I still believe that DXM
has a place among psychedelics, but do understand that it is not a
replacement for LSD, mushrooms, 2CB, or even ketamine. It is a unique and
uniquely powerful mind-altering drug, and one which I think most people
would do best to avoid.

William White

March 15, 1997

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