Diagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders(abbreviated DSM) is an extremely important reference book used by the medical profession to diagnose and treat mental disorders. The reason it is important is that it is the standard used to set policy regarding mental illness, not only for physicians, but also for governments, drug and insurance companies, and researchers throughout the world.
Each mental disorder is described in the DSM in terms of its symptoms, treatment and prognosis. Usually, there is a group of symptoms or criteria, and a patient needs a certain number of symptoms to be diagnosed with that condition. Then there are paragraphs on appropriate drugs, treatment plans, and expected outcomes for each disorder.
The DSM is the product of years of research coordinated, collected and published through the American Psychiatric Association, founded in 1884 and representing over 38,000 psychiatric doctors. The book has gone through six editions, DSM-I (1952), DSM-II (1968), DSM-III (1980), DSM-III-R (1987), DSM-IV (1994), and DSM-IV-TR (2000). DSM-V is due to come out in 2013.
One simple change in a new DSM edition can make a profound difference in the lives of many people. For example, homosexuality was once listed the DSM as a pathological mental disorder even in the 1970s, and many people believed that such an official designation by the medical community added to the stigma of being gay. It is no longer in the DSM, although having "persistent and marked distress about one's sexual orientation" is included under "Sexual Disorders Not Otherwise Specified."
Robo-tripping refers to the practice of getting "high" or intoxicated from over-the-counter cough medications. The term comes from the brand name "Robitussin," a popular cough syrup.
Robo-trippers are usually nine to 18 years old -- older adolescents tend to "graduate" from cough syrup and inhalants to stronger drugs (both legal and illicit) or alcohol.
The ingredient in cough medicine that produces the state of intoxication is dextromethorphan or DXM, a narcotic related to codeine and morphine that suppresses coughs. The average dose of cough medicine does not contain enough "DXM" to produce the high, so robo-trippers will often drink the whole bottle, take a handful of pills, or mix them with other substances.
DXM is available in more than 120 over-the-counter cough remedies that come as syrups or pills. You do not need a prescription or to sign anything to buy these medications, which makes it easy for teens to obtain them at drug and grocery stores.
The physical effects of DXM can be euphoria, hallucinations, distorted vision, loss of motor control, and dissociative (out of body) experiences, depending on the amounts taken and the person's body weight. These effects can last six hours. Teens in DXM stupors are prone to accidents.
If a teen abuses cough medications at above-recommended levels and for a long period, she risks serious health problems. Most of these medicines have other ingredients that cause damage to specific organs; for example, acetaminophen at high doses causes liver failure, and anti-histamine abuse can cause cardiovascular toxicity and high blood pressure.
Teens who abuse cough medications usually do not experience withdrawal symptoms when they stop, but they often need help getting out of the "sizzurp" lifestyle. A recent government survey of young people found that approximately three million are abusing these drugs.