Robotripping is not some form of futuristic, robot-aided travel. Rather, it is the highly dangerous practice of quaffing large doses of cough medicine — as in Robitussin — to get high. Hence, the slang term “robotripping.” 

Dextromethorphan or DXM is the active ingredient found in over-the-counter (OTC) cough medicines such as Robitussin. It is the ingredient that causes recreational “robotrippers” to trip or experience that high. Large amounts of it can produce a litany of effects, where euphoria can quickly morph to nausea, vomiting or worse.   

When taken at extremely high doses and combined with stimulants and alcohol, robotripping can be deadly. 

Read on to learn more about the particular dangers of this practice. 

What is Dextromethorphan?

The U.S. Food and Drug Administration (FDA) approved DXM in 1958 after researchers could substantiate its efficacy as a cough suppressant. After DXM was approved, it was brought to market as an OTC medication under the brand name of Romilar. Romilar became popular but was removed from the shelves after reports of rampant misuse dogged the product. 

In its place, drug manufacturers introduced DXM cough syrups such as Robitussin, Vicks-44, and Dextro-Tussin. These products were designed to thwart recreational use because of their unpleasant taste. 

However, other formulations of DXM products included more palatable flavors, leading to upticks in abuse. The advent of the internet in the 1990s allowed users to disseminate information about the effects of DXM. This sharing of information also contributed to spikes in dextromethorphan abuse. Bulk quantities of powder DXM allowed recreational users to partake in the drug without having to consume cough syrups. 

Today, DXM is available in syrup, tablet, capsule, solution, suspension, lozenge, and spray forms. It is also sold under a variety of brand names, including Delsym, Vicks, Dimetapp, NyQuil, and Theraflu, along with Robitussin.

While DXM has no discernible psychoactive effects when taken at recommended doses, large amounts of it can produce hallucinogenic and dissociative effects. In large enough doses, DXM intoxication can produce serious side effects. 

DXM abuse has been enough of a problem that in recent years lawmakers from various states have worked to restrict access to bulk quantities, which are widely available via the internet. 

The Danger of ‘Robotripping’

Man holding his hand over his face

People who abuse DXM tend to take more than 100 mg (milligrams) of it. A single dose for recreational users ranges from 240 to 1,500 mg. Heavy users of DXM cough syrups can ingest up to three or four bottles a day. 

When you engage in robotripping by ingesting large doses of DXM, you open yourself to experiencing a multitude of potent psychedelic effects.

The 4 Plateaus of DXM 

DXM has effects that manifest in four plateaus. These effects resemble the kinds produced by phencyclidine (PCP) and ketamine. 

When users hit the first plateau of DXM’s effects, which occurs at between 1.5 to 2.5 mg per kg body weight, they will experience euphoria, auditory and perceptual changes. The second plateau, which occurs at 2.5 to 7.5 mg/kg (milligram/kilogram), includes effects such as intense euphoria, vivid imaginings, and closed-eye hallucinations. The third and fourth plateaus (7.5 mg/kg and over) feature profound effects like altered consciousness. Users also report experiencing psychosis and out-of-body experiences. 

DXM Side Effects 

However, those experiences also come with side effects that range from uncomfortable to distressing, if not life-threatening.

The less serious side effects of DXM include: 

  • Drowsiness
  • Restlessness
  • Nervousness
  • Nausea
  • Dizziness
  • Diarrhea
  • Constipation
  • Vomiting

Severe side effects associated with heavy DXM use or robotripping includes:

  • Skin rash
  • Double vision
  • Blackouts
  • Hypo- and hypertension
  • Respiratory depression
  • Hallucinations
  • Vomiting

Very high doses can produce absolutely harrowing effects like hypertension and seizures. 

Robotripping and Overdose

The effects that come from ingesting extreme doses of DXM cough syrups via robotripping are in essence signs of an overdose. Most DXM overdose symptoms do not result in severe medical complications and death. The symptoms can be treated in an emergency room. 

DXM overdose symptoms include: 

  • Unsteadiness
  • Drowsiness
  • Dizziness
  • Hallucinating (seeing things or hearing voices that do not exist)
  • Changes in vision
  • Difficulty breathing
  • Fast heartbeat
  • Nausea
  • Vomiting
  • Seizures
  • Coma (loss of consciousness for a period)

Deaths from robotripping can occur, particularly when high doses of DXM are mixed with alcohol. DXM deaths can also occur when medications are taken with stimulants such as caffeinated beverages, energy drinks, and prescription drugs for ADHD (attention-deficit/hyperactivity disorder).

Other dangers involve impairment and hyperactivity. For example, DXM cough syrups can impair movement to such a degree that being out in public can be dangerous. The substance can also spur the hyperactive movement that can lead to accidents. 

How to Tell If You Have an Addiction

Substance addiction is driven by compulsive behaviors centered around seeking and obtaining drugs or alcohol. DXM misuse is no different.

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), there are 11 criteria for drug addiction. These guidelines allow clinicians to diagnose addiction disorders. If someone shows at least two of these symptoms over 12 months, they may have a substance use disorder:

  • Taking more of the drug than intended, for a longer period than intended
  • A persistent desire to stop taking drugs or repeated unsuccessful attempts to quit taking drugs
  • A lot of time spent trying to get drugs, abuse them, and/or recover from their effects
  • Intense cravings or urges for specific drugs
  • Failing to go to work or school, or to meet obligations to friends and family because of drug abuse
  • Ongoing drug abuse despite physical, mental, emotional, or social problems associated with the abuse
  • Giving up hobbies or activities to abuse drugs
  • Ongoing abuse of drugs in inappropriate situations, such as using them in the morning before work, driving while intoxicated, or abusing drugs around children
  • Experiencing physical or psychological problems as a result of substance abuse but continuing to abuse drugs anyway
  • Physical tolerance, meaning the body needs more of the drug to experience the original level of intoxication
  • Experiencing symptoms of withdrawal when trying to quit the drug

Professional Treatment for Cough Medicine Addiction

If you or a loved one has a substance abuse issue involving DXM cough medications, then professional treatment can help you avoid the distressing symptoms and effects associated with use. 

What you can expect in professional treatment, is an individualized plan that takes into account your age, medical history, drug use history, and the severity of your DXM misuse.  

If you have a mental health disorder along with an addiction to DXM medications, then treatment for that condition will be incorporated into your plan.   

If your addiction is severe or if you abuse DXM medications with alcohol or other drugs, intensive services will be administered. Those services include medical detoxification and residential treatment. With detox, the substances will be removed from your body, and any withdrawal symptoms, effects, or medical issues will be attended to and alleviated.

A residential treatment program will allow you ongoing care at a treatment facility, where you will also reside for a specific period. You will receive therapy and counseling that are designed to get to the root cause of your addiction. In addition, you will be equipped with strategies that can serve as a hedge against relapse. With polysubstance abuse cases, where multiple substances are being abused, a 90-day stay in residential treatment is highly recommended

In general, you will be offered evidence-based therapies and programs as part of your treatment plan. The therapeutic approaches offered are:

  • Behavior therapy
  • 12-Step facilitation therapy
  • Family therapy
  • Relapse prevention education
  • Aftercare services
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