Locked down and anxious, 17-year-old Fang Suyi found her ideal escape from reality in the form of a cough medicine.

The high school senior from Shanghai had learned about dextromethorphan, a cough suppressant, while browsing the microblogging platform Weibo. There, now-deleted accounts that tended to make reference to psychosis in their usernames promoted the medicine, peddling its potential as a way of easing anxiety and depression.

Convinced by what she read, the teenager first used the oral medication during the citywide coronavirus lockdown in the spring. Fang said she once took 18 pills, each 15 milligrams, even though the recommended dosage is less than 30 milligrams per day.

“I was having arguments with my family and experiencing a severe mental breakdown,” Fang said. “I took the pills and felt like I was floating on water and nothing really mattered anymore. I didn’t feel any joy but I felt an escape from reality. The only thing that existed in the world was me.”

Dextromethorphan, often referred to using the abbreviation DX on Chinese social media platforms, is being touted by online users as a solution for stress and anxiety, and youngsters are flocking to such posts in droves. Social media trends aimed at young users that flout the unsupervised usage of medicines, including dextromethorphan and diabetes drugs to lose weight, is a global problem, not to mention other viral online challenges that have even resulted in deaths.

The dearth of data and scant reporting — including a lack of statistics from hospitals and police — on the use of dextromethorphan among young Chinese make it difficult to determine its extent, but anecdotal evidence and a large number of videos surfacing on social media platforms indicate the problem exists.

On short video platform Kuaishou, hundreds of posts tagged with meisha, referring to dextromethorphan, have received thousands of “likes,” suggesting their popularity and reach. Many users posting such videos often brag about overdosing on the medicine, while suggesting to others to do the same.

“DX or not? You can’t go home after taking DX. High as hell,” some video captions blurt, using similar or the same language and are usually accompanied by psychedelic or blurred shots, implying a hallucinatory experience.

It’s unclear if those users making such claims received medical assistance after taking high dosages of the cough suppressant, though there has been an uptick in hospitals handling overdose cases. At Beijing Gaoxin Hospital, one of the country’s leading drug rehabilitation centers, the number of those coming with a dextromethorphan addiction rose from 50 in 2017 to more than 400 in 2021, with over two-thirds taking it as a recreational drug, financial media outlet Caixin reported in September.

Amid the growing misuse of the drug, authorities last year listed most dextromethorphan medicines as prescription drugs. But some that can be bought over the counter are easily accessible online via food delivery platforms and e-commerce apps — including Ele.me, Meituan, and Taobao, which all require real-name registration — and cost between 10 yuan to 20 yuan ($1.5-$3), making it affordable to many youngsters.

Fang said she bought the drug via a food delivery platform that was still delivering medicines during the Shanghai lockdown, without her parent’s knowledge. And when her father found out and took her to hospital, the doctor, unaware of the teen’s high dosage, said dextromethorphan was safe to treat coughs and colds.

Miao Jia, an assistant professor of sociology at New York University Shanghai, has been researching substance abuse and said she has been noticing a growing trend of usage among youngsters over the years. She told Sixth Tone that many minors tend to become dependent on drugs to escape from their problems.

“‘Life is bitter, therefore I need to do something to get me out of it’ — that’s what minors are thinking about when they are taking drugs. We live in an era of excessive entertainment and high consumerism, and their role in life is infinitely magnified. The oversaturation of entertainment is accepted by many young people, and it’s difficult to resist this extreme stimulation.”

This Sixth Tone reporter was added to one chat group on messaging app QQ with over 100 users, where they discussed all things dextromethorphan. One individual said groups on QQ and discussion platform Tieba can also help secure false prescriptions for those having trouble accessing the medicine, and minors often interacted with adult members to vent frustrations about their life.

“This is my second home,” said one member of the QQ chat group.

Some experts say that the rise in mental health issues among the country’s young demographic may also be contributing to the dependence on certain drugs. The pandemic has exacerbated the problem in China and elsewhere, with one mental health counselor saying in April that “Shanghai was in the ‘psychological emergency’ stage” during the monthslong lockdown.

Zhang Yingcheng, a resident physician at Shanghai Huangpu Mental Health Center, told Sixth Tone that addiction is more of an “accompanying problem” that arises either from issues at home or school. He said that many people tend to use drugs due to stress and those with depression and anxiety are more likely to fall into the habit, adding that criticizing such behavior could further worsen their dependence.

“They feel good after taking the drugs, but they may be scolded after taking it,” he said. “Now that they’ve already been told off, what’s the reason left for them to stop taking drugs?”

Experts say that social media platforms occasionally accelerate problems by amplifying potentially harmful content. Miao believes that tech companies should bear the responsibility of monitoring videos that contain unsolicited medical advice.

“It’s like the videos that teach people to kill themselves. When they are shared around, they may lead to negative consequences,” said Miao. “Censorship technology is well developed nowadays, the key is to make the platforms aware of the danger involved in the content.”

Responding to Sixth Tone’s questions on the dextromethorphan trend, a Kuaishou hotline employee said that the platform reviews all content in adherence to relevant laws. A company media representative later added that they noticed videos promoting certain medicines after Sixth Tone’s calls and said the platform will investigate the trend “as soon as possible.”

Tieba wasn’t available for comment by publication time.

Apart from social media platforms shouldering responsibility, experts also call on the need for better education, both at home and school, to make youngsters more aware of the harms of addiction. But many who pop pills like dextromethorphan, a gateway drug, including Fang, said they aren’t ready to give up yet despite knowing of the potential harm — she said she will use it in moderation so she wouldn’t become addicted to it.

“I know overdosing on the medicine causes health problems,” Fang said. “But I’m too depressed to think about all that.”

Editor: Bibek Bhandari.

(Header image: Robtoz and nPine/VCG)