Stimulant methamphetamine and dextromethorphan use among Thai adolescents: implications for health of women and children.

For over a decade, amphetamine-type stimulants have made their way into the adolescent culture of Thailand. Coupled with the more recent emergence of the legal, over-the-counter cough medicine dextromethorphan (DM), they represent the most commonly abused substances among Thai youths today. Methamphetamine is the second most popular drug of abuse in Thailand, the first being cannabis. It is available in the crystalline version, ICE, and the less pure methamphetamine tablets. The tablets are frequently crushed and smoked. Its use has gained enormous popularity among teenagers and young adults, including women of child-bearing age. As such, it has become the most common drug being detected in the urine of peripartum women, resulting in peripartum and postpartum complications for both mother and child. DM is a newer drug which has gained popularity among middle school and high school students due to its easy availability as a single product over the counter. It is usually taken with soft drinks at parties and gathering. It is metabolized by CYP4502D6 to dextrorphan, the substance responsible for the feeling of euphoria. Consequently, those who are poor metabolizers often experience the "negative" effects associated with the drug. The recreational use of methamphetamine and dextromethorphan in teenagers and young adults in Thailand is a serious problem. Recognizing not only the toxicological but also the emotional and psychosocial impacts of these drugs on Thai youth is an integral part of approaching the problem.