Dextromethorphan (DXM) Abuse

Dextromethorphan, also called DXM, is the active ingredient in more than 120 over-the-counter cold medications. The cough suppressant is sold on its own or in combination with other drugs, such as acetaminophen and pseudoephedrine.

Dextromethorphan medications have a long history of effectiveness and safety. When taken as recommended, the products have few side effects. But they can compromise health and safety when taken in high doses or used illicitly.

In recent years, reports of dextromethorphan abuse have increased. Many young people misuse the drug for its psychoactive properties. And a lack of federal regulations for DXM has led countless people to easily purchase and abuse products containing the drug.

How Is Dextromethorphan Abused?

Recommended doses of DXM cough syrups range from 10 to 20 milligrams every four to six hours or 30 milligrams every six to eight hours. When used illicitly, recreational users may consume 240 to 1,500 milligrams in a single dose.

The drug is also sold over the internet as a capsule, pill or powder. These forms of the substance can be snorted or ingested. Unlike syrups, powder and pill forms of DXM produce a high without requiring people to consume large quantities of the drug.

Some people who abuse the drug inject dextromethorphan after extracting it from gel capsules and cough syrups.

Dextromethorphan Effects

The effects of dextromethorphan vary. Abusing the substance can lead to psychedelic effects similar to those of ketamine and PCP.

Abusing dextromethorphan is also known as “robotripping“. The hallucinogenic high is characterized by confusion and a distorted sense of reality. People who regularly robotrip may develop a number of psychological and behavioral problems.

The severity and duration of effects vary based on how much DXM a person consumes. Lower doses cause mild side effects, such as euphoria, restlessness and visual hallucinations. At higher doses, the drug can impair coordination and make people feel completely disconnected from their body.

The effects of dextromethorphan typically last six hours, but the duration can vary depending on the dose taken and the presence of other drugs in a person’s system.

Is Dextromethorphan Addictive?

In 1958, the Food and Drug Administration approved dextromethorphan as a nonaddictive cough suppressant to replace codeine. But the National Institute on Drug Abuse states that the drug can lead to an addiction to the drug. In fact, many people have attended rehab for a substance use disorder involving DXM.

A 2010 case report published in the journal Deutsches Arzteblatt International cited a case of DXM abuse that affected a 44-year-old man’s ability to complete everyday tasks. After regularly abusing the drug for six years, he had an increasing number of work absences and spent large amounts of money on the substance.

These characteristics meet the criteria for a moderate substance use disorder. The patient attended an outpatient addiction clinic for treatment, which included detoxification and behavioral therapy.

He then completed inpatient therapy to continue his recovery. The patient was discharged from the program in good general health after 21 days, and the authors noted he had the potential for complete rehabilitation.

While dependence on DXM can cause significant impairment that requires professional treatment to correct, most people who use the substance do not become addicted to it.

Preventing Dextromethorphan Abuse

DXM is a popular drug of abuse among teens. According to a 2017 survey conducted by the University of Michigan, about 3.2 percent of high school seniors reported misusing cough or cold medications in the past year. Abuse of these products was more common among 12th-grade students than abuse of sedatives or Ritalin.

Coricidin HBP Cough & Cold is a popular brand of dextromethorphan misused by teens for its euphoric properties. The medication, known by the street name triple C, is available over the counter. Many parents do not realize its potency.

If you suspect your child is abusing dextromethorphan, look for common signs of abuse. Adolescents who use these products recreationally may exhibit slurred speech, irregular eye movement, lethargy, sweating and coordination problems. They may also experience mood swings and other behavioral changes.

Treating Dextromethorphan Abuse

If your child is addicted to dextromethorphan, consider seeking treatment. At qualified rehab facilities, addiction experts can create a treatment plan catered to your child’s specific needs.

No FDA-approved medications for treating DXM abuse exist, but a variety of treatment options and therapies are available.

Evidence-based treatments such as cognitive behavioral therapy and contingency management can help people overcome dextromethorphan abuse. CBT aims to modify expectations and behaviors associated with drug use. Contingency management provides tangible rewards for abstinence and other positive behaviors during treatment.

To learn more about the dangers of dextromethorphan, contact the Substance Abuse and Mental Health Services Administration’s National Helpline. This 24/7 hotline provides information about a variety of drugs, including DXM.