By Neville Elder 01/15/17

I accidentally "robo-tripped" on cough medicine. Did I relapse?

Cough medicine being poured into a medicine cup
You can’t plan for everything.

Living as a recovered alcoholic isn’t a cakewalk. And I'm always watchful for the traditional pitfalls of my life among "civilians"—the misplaced glass at a holiday party that could lead to an unintentional mouthful of vodka and coke, or the misheard order in a restaurant that may herald the delivery of an extra glass of white wine that will sit unguarded at the table. You’ve got to be vigilant, but you’ve got to be bold. I have no qualms about asking a friend to taste a drink for me if I'm unsure of its contents.

But, as much as you prepare, you can’t plan for everything.

I’d always been wary of Robitussin DM cough syrup. But recently, as I found myself spaced out from a sleepless night of coughing, and sick from a chest cold that wouldn’t budge, I found myself examining the innocuous little red bottle on the shelf at the grocery store. I had to do something. My next door neighbors were giving me the stink-eye in the hall, and my girlfriend refused to sleep over.

In the supermarket, I turned the bottle over in my hand, squinted at the tiny warning on the label. I checked for drug interactions—I was taking an antidepressant called bupropion and a mood stabilizer called oxcarbazepine—and I dropped it in my shopping basket. I knew dextromethorphan (DM) is the ingredient in Robitussin that messes you up if you're not careful. There’s some pretty terrifying threads about its recreational use on Reddit. Deliberately drinking more than the recommended dose induces euphoria, auditory changes, as well as other effects, and users often report out-of-body experiences and hallucinations.

I’d been an old fashioned boozer for a long time, but I've been sober for 11 years. I’d never had much luck with drugs, but after I quit drinking I filled that big ol’ abyss with as much food, sex, therapy, TV and jogging as I could. It took me about five years before I figured out alcohol was just my first choice; I was just another addict on the run from myself.

I wanted some sleep. So I took a swig, and waited a while. It didn’t seem to have any side effects, and with the virtually immediate cessation of my hacking, I went to bed. I slept like a baby. I woke at 6am coughing again, so I took another slurp and went back to sleep.

I got up a couple of hours later, a little foggy, so I made some coffee. Something was wrong. I was dizzy and my teeth were chattering. I was sweating, like I was getting sick again. When I looked in the bathroom mirror, I discovered my pupils as big as dinner plates.

I fired up the internet for help. It turns out that bupropion—the drug I was taking for depression—inhibits the enzyme in the liver that breaks down DM. Although the first dose I’d taken the night before hadn’t affected me, the DM hadn’t disappeared. In other words, when I took the second slug, it just sat on top of the first one. But still, it shouldn’t have affected me this much! I mean, a far as I could tell, a robo-trip needed a full 6-ounce bottle, just to get the engine running.

When I re-read the label, it said always use the cap, which was marked with a line for a 10ml dose. When you measure out 10ml, it isn’t very much, and I’d taken a good swig—probably double the recommended dose—twice.

I was scared now, I was high and it felt like shit. I didn’t want to spend my Saturday out of my box! I discovered that the symptoms I was experiencing were similar to serotonin syndrome. When serotonin is released in the brain, it can produce feelings of well-being and happiness. You’ve probably heard of tryptophan? The substance released in the brain that gives you that post-turkey stupor after the Thanksgiving feast? Well, serotonin comes from that. It makes you feel good. But too much of it can be toxic—in fact, in some of the darker corners of Mother Nature’s creation, it’s used as a poison.

I looked at some of the forums devoted to this particular subject. I found out that some people who robo-tripped on DM while taking bupropion had been hospitalized. They’d had trips lasting for two or three days, and like mine, it wasn’t a fun high. There was no communing with the universe on this ride, just shaking, sweating, seizures and muscle damage.

I looked at the bottle, it was still two-thirds full. A lot of my distress was a good old fashioned panic attack, so I went back to bed and tried to concentrate on a gloomy Icelandic crime drama on Netflix. It took a few hours, but the tremors subsided and my temperature dropped back to normal. My eyes in the bathroom mirror, however, were like two big black moons staring back at me.

I was left with a familiar guilt the next morning. When I’d sobered up from hangovers in the past, whether I’d disgraced myself or not, I always felt a deep shame. That feeling just wasn’t part of my life anymore.

Was this a relapse? I called my sober friend, John, the next day. He told me I’d been really stupid but no, it wasn’t a relapse. I wouldn’t have to go to rehab, he joked, or start "counting days" again.

“Call it a ‘freelapse,’” he said.

You can’t let your guard down. A few weeks later at my friend's wedding, a slightly inebriated cousin of the bride told me it was bad luck to toast with water at a wedding. I wouldn’t be swayed and I refused the sparkling champagne he tried to force on me.

“The bad luck,” I replied, “will be yours, dear cousin, if I'm drunk before the bride and groom’s first dance.”

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