Dextromethorphan, which is also known as DXM or DM, is an active ingredient found in over-the-counter (OTC) medications that target symptoms of allergies, the flu, or the common cold. DXM serves two purposes: cough suppressant and decongestant.
DXM is mostly found in medications such as Vicks 44, and NyQuil, and generic products like these.
At extremely high doses, DXM can mimic the effects of dissociative drugs like phencyclidine (PCP) and ketamine, states WebMD.
When dextromethorphan is abused, it is capable of producing a multitude of negative effects. Read on to learn more about DXM’s effects and available treatment options.
Dextromethorphan was initially created in the 1950s and was known as Romilar. However, it was quickly removed from the market in the 1970s due to abuse.
The medicine was not included in the Controlled Substance Act of 1970 and was reintroduced to the public in various medications. Drug manufacturers altered their DXM products to have an unpleasant taste and to deter abuse.
The manufacturers soon focused their efforts on creating a version that did not taste as bad. The result? More DXM abuse.
Dextromethorphan is classified as a synthetic drug because it is produced from a morphine derivative. The drug, however, does not have the same effects as opioid drugs. The drug’s main impact on the brain is to inhibit the action of the excitatory neurotransmitter N-methyl-d-aspartate (NDMA).
In higher doses, DXM effects replicate ketamine and PCP. When the medication is taken as instructed, it is safe and virtually poses no harm. When it is taken in higher doses, it causes disassociative hallucinations that can result in euphoria.
A DXM high is described as euphoric and relaxing. The disassociative effects can be used as an anti-anxiety drug alternative for people in uncomfortable social situations.
There have been reports of teens using the substance and mixing it with alcohol, weed, or opioids to intensify the effects. Using these drugs, in conjunction with DXM, will increase the dangers of dextromethorphan abuse.
Habitual users of dextromethorphan can develop symptoms that meet DSM-IV criteria for substance dependence.
The active ingredient is considered to be non-addictive but is far from benign in excessive doses. The addiction factor was only measured in terms of standard treatment, and effects were not spoken about when taken in extremely high doses.
“Robo-tripping,” which is a practice of gulping high doses of DXM at one time, is an unsafe practice that can damage vital organs when used for extended periods of time.
Robo-tripping can be fatal.
As a cough suppressant and expectorant, the suggested dose is between 10 and 50 milligrams. Those that consume DXM for the psychedelic effects take upward of 100 milligrams, but there have been reports of some users taking up to 1,500 milligrams in a single dose.
A University of Rochester Medical Center report substantiates those recreational DXM dose amounts, stating that recreational users will take anywhere between 240 mg to 1,500 mg.
Doses of this magnitude can present serious health risks.
The method of administration is to consume the substance in large quantities as fast as possible to absorb as much as possible before vomiting.
In many cases, the body will reject the liquid before intoxication has been accomplished.
DXM can also be found in tablet form which leads user’s to crush the pill and snort the powder; it is a much stronger method of consumption and allows someone to achieve intoxication without consuming large amounts of liquid.
While nausea and vomiting are common side effects, several other physical symptoms include:
When taken in excessive doses in amounts mentioned above, the more severe effects of hypertension seizures can cause dangerous complications.
When taken in high enough doses, DXM is capable of producing withdrawal symptoms. The symptoms associated with this drug include:
Symptoms can subside within two days without treatment.
Due to its classification as a disassociative psychedelic, DXM trips often involve hallucinations that dull senses and make the person feel like they are cut off from the world around them.
As mentioned earlier, DXM provides effects that are similar to ketamine and PCP. Dysphoria is also possible when using the substance in high doses, and it is perceived as an out-of-body experience.
Some of the other psychological effects of a DXM trip will include:
In higher doses, the hallucinations can become severe and lead to fear and paranoia. This can lead to a feeling of impending doom. The psychological effects of psychedelics can often have lasting results on mental health.
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An overdose from DXM is quite possible. Using high doses of the drug beyond its intended use can cause adverse effects. Consuming high doses of DXM can produce effects that are technically considered overdose symptoms.
According to MedlinePlus.gov, the overdose symptoms that can result from DXM include:
However, in rare cases, seizures, hypotension, and tachycardia require immediate medical attention. In most cases, DXM overdoses can be treated in the emergency room and don’t result in serious medical complications or death.
Unfortunately, deaths can still be traced to the substance in some circumstances.
Fatal overdoses from DXM occur when high doses are mixed with depressants such as alcohol. There are links that when grapefruit interacts with DXM, it can increase liver toxicity. DXM, however, unlike other psychedelics, could cause hyperactivity, which encourages movements that can lead to accidents.
As a disassociative drug, dextromethorphan addiction can initially be treated through medical detoxification. Depending on the circumstances, addiction specialists at the facility could provide medications such as antipsychotics, prescribed by doctors.
The purpose of this is to help the drug be removed from the body in a secure environment while mitigating any potential complications that may occur. Those who have been abusing substantial amounts of DXM for an extended period, or who have a family history of substance abuse or addiction may be more severely dependent on the substance will benefit most from medical detox.
Those who abuse dextromethorphan casually and are not dependent on it may not require medical detox. In this case, they may be able to detox on an outpatient basis. Upon completion and physical stabilization, the psychological aspects of addiction and substance abuse can be discussed and treated.
The treatment for DXM abuse or addiction can be done on either a residential or outpatient basis. No one will experience addiction in the same way, and what works for one person could not work for another. Treatment requires a customized approach that addresses all underlying issues that contribute to addiction.
Both outpatient and residential treatment can include group and individual therapy sessions, counseling, support group meetings, and educational opportunities, life skills training, and alternative or holistic treatments.
Behavioral therapy is a standard method of treatment that helps change a client’s behaviors and helps them deal with triggers once they are released from care.
If you or someone you love is suffering from dependence on dextromethorphan, it is time to seek help. While you may not require residential aftercare, it is necessary to enter into detox. At Maryland House Detox, we will assist you in transitioning to the next level of care if our clinicians feel that’s what you require.
Antoniou, T., & Juurlink, D. N. (2014, November 04). Dextromethorphan abuse. Retrieved from http://www.cmaj.ca/content/186/16/E631
Dextromethorphan (DXM). (n.d.). Retrieved from http://www.cesar.umd.edu/cesar/drugs/dxm.asp#4
MedlinePlus.gov. (n.d.). Dextromethorphan: MedlinePlus Drug Information. Retrieved from https://medlineplus.gov/druginfo/meds/a682492.html
University of Rochester Medical Center. (n.d.). Cough Medicine Abuse by Teens. Retrieved from https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=1&contentid=2617
WebMD. (n.d.). Cough Medicine and DXM (Dextromethorphan) Abuse By Teenagers. Retrieved from https://www.webmd.com/parenting/teens-cough-medicine-abuse#1
Exhibit 2-6DSM-IV-TR Criteria for Substance Abuse and Substance Dependence. Center for Substance Abuse Treatment.Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2012 from https://www.ncbi.nlm.nih.gov/books/NBK92053/table/ch2.t5/