University of Virginia School of Medicine, Charlottesville, VA, USA.
Clin Toxicol (Phila). 2011 Jun;49(5):409-15. doi: 10.3109/15563650.2011.585429.
Dextromethorphan (DXM) abuse persists among US youth and should be closely monitored because of the risks of severe medical complications, addiction, and psychiatric sequelae. Prior investigations have demonstrated DXM to be an emerging drug of abuse with increasing national prevalence through 2004.
To extend existing substance abuse survey results by describing demographic, geographic, product, and outcome trends in medically significant DXM abuse cases (those reported to US poison centers).
National Poison Data System (NPDS) data are collected and compiled in real time by all 57 US poison centers. Demographic, geographic, product, and outcome data for all intentional DXM abuse cases reported to the NPDS between 2000 and 2010 were analyzed.
A total of 44,206 DXM abuse cases met inclusion criteria, 34,755 of which were single-substance exposures. The mean annual prevalence of DXM cases reported to poison control centers was 13.4 cases per million population for all ages and 113.0 cases per million for 15-19 year olds. The prevalence of DXM cases for all ages increased steadily (p = 0.002, Cochran-Armitage trend test) until 2006 to a peak of 17.6 calls/million and has subsequently plateaued at 15.7 cases per million in 2010. This trend is also seen in the most commonly abused brand of DXM products, Coricidin(®). A preponderance of male adolescents was noted throughout the study period. The odds of a severe outcome are increased for a multi-substance exposure (OR: 2.53; 95% CI: 2.14-2.99, logistic regression); odds were not significantly increased for any of the most commonly abused product brands.
The increasing trend of DXM abuse cases noted in the first half of the decade by previous studies seems to have peaked at 17.6 calls per million population in 2006. It is likely that a combination of legislative, educational, and economic initiatives are responsible for the observed plateau.
右美沙芬（DXM）滥用在美国青少年中仍然存在，由于其严重的医疗并发症、成瘾和精神后遗症的风险，应密切监测。先前的调查表明，DXM 是一种新出现的滥用药物，到 2004 年，其在全国的流行率不断上升。
通过描述在具有医学重要意义的 DXM 滥用病例（向美国毒物中心报告的病例）中出现的人口统计学、地理、产品和结局趋势，扩展现有的物质滥用调查结果。
所有 57 个美国毒物中心实时收集和编纂国家毒物数据系统（NPDS）数据。对 2000 年至 2010 年期间向 NPDS 报告的所有故意 DXM 滥用病例的人口统计学、地理、产品和结局数据进行分析。
共有 44206 例 DXM 滥用病例符合纳入标准，其中 34755 例为单一物质暴露。向毒物控制中心报告的所有年龄组的 DXM 病例的年平均流行率为每百万人 13.4 例，15-19 岁年龄组为每百万人 113.0 例。向毒物控制中心报告的 DXM 病例的流行率在整个研究期间稳步上升（p = 0.002，Cochran-Armitage 趋势检验），直到 2006 年达到每百万人 17.6 例的峰值，随后在 2010 年稳定在每百万人 15.7 例。在 Coricidin(®) 最常被滥用的 DXM 产品品牌中也观察到了这一趋势。研究期间，大多数男性青少年都是滥用者。多物质暴露的严重结局的可能性增加（OR：2.53；95%CI：2.14-2.99，逻辑回归）；最常滥用的任何产品品牌的可能性都没有显著增加。
前几项研究在这十年的前半段注意到 DXM 滥用病例呈上升趋势，到 2006 年似乎达到了每百万人 17.6 例的峰值。立法、教育和经济举措的结合可能是导致观察到的稳定状态的原因。
