Dextromethorphan Addiction and Abuse

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What is Dextromethorphan?

Dextromethorphan (DM or DXM) is a drug used to treat coughs.1 DXM is one of the most common ingredients found in over-the-counter (OTC) cold medicines.1 Learn more about addiction to DMX and the therapies and treatments available for recovery.

Is Dextromethorphan Addictive?

There is a potential for someone to become dependent on DXM if they abuse it because of its psychoactive drug properties.2 Because it’s sold in stores without a prescription, DXM’s popularity as a drug of misuse and abuse has grown.

How is it Used?

Dextromethorphan is used to treat coughs. It’s found in many OTC medications that treat colds.

Dextromethorphan’s Class of Drug

It’s an antitussive (cough suppressant) found in many different over-the-counter medications either alone or in combination with other drugs such as pain relievers, antihistamines, decongestants, and/or expectorants.3

Where is it on the Schedule of Drugs?

DXM is not scheduled under the Controlled Substances Act.4

Dextromethorphan Safe?

It’s safe when taken as directed for most people. About 5 to 10% of people do not metabolize DXM well, which puts them at a higher risk for overdoses and deaths.4 Also, it should not be taken with antidepressants, because the combination can produce life-threatening situations.

Like any other OTC drug, DXM can be harmful when misused. Misuse of an OTC medicine means:

  • Taking the medicine in a way other than as directed on the package
  • Taking a dose different from that specified on the package
  • Taking the medicine for an effect it causes other than the purpose stated on the package (for instance, taking it “to get high”)
  • Mixing the OTC medicine with others to make new products

Misuse and abuse of dextromethorphan can be dangerous.

One report by the DEA stated that among a sample of poison control cases:4

  • 12,077 mentioned DXM
  • 9,223 were single exposures to DXM
  • One death was related to dextromethorphan

Street Names

Street names include:5

  • Dex
  • Triple C
  • Orange Crush
  • Poor Man’s PCP
  • Red Devils

DXM misuse is known as:1

  • Going pharming
  • Robotripping
  • Dexing

These terms are related to the most commonly abused DXM products: Coricidin and Robitussin.

Effects and Overdose

What are the Short-term Effects of Dextromethorphan?

DXM, when taken in prescribed doses by people who metabolize it well, simply acts as a cough suppressant for several hours. When it’s abused, it can produce the following short-term effects:4

  • A feeling of increased perception
  • Euphoria
  • Changes in how time is perceived
  • Hallucinations
  • High excitability
  • Agitation
  • Lack of energy
  • Impaired coordination
  • Slurred speech
  • Sweating
  • Elevated blood pressure
  • Uncontrolled repetitive movements of the eyes
  • What are the Long-term Effects of Dextromethorphan?

DXM abuse can result in health complications. Abuse of common OTC cough/cold medications which combine DXM with antihistamines, pseudoephedrine, or acetaminophen can be especially problematic, causing additional adverse long-term effects including:4

  • High blood pressure
  • Liver damage
  • Nervous system damage
  • Cardiovascular damage
  • Overdose

Taking high doses of DXM with alcohol or other drugs is particularly dangerous and has resulted in death.4

Is It Possible to Overdose on Dextromethorphan?

Yes, it is possible to overdose on dextromethorphan, and overdoses can be fatal.1 Each year in the United States, dextromethorphan abuse results in about 6,000 emergency room visits.3 Half of all these visits are by people between the ages of 12 and 20.3

If someone has overdosed, medical help should be sought immediately.

How to Stop Using Dextromethorphan

People who need professional help from a doctor or drug treatment center to stop taking DXM include those with:

  • Cravings or compulsions to take the drug
  • Loss of control over taking the drug, and over the amounts taken
  • Inability to stop taking DXM
  • Physical withdrawal symptoms if the DXM dose is stopped or reduced
  • Tolerance (more of the drug is needed to gain the same previous effects)
  • A tendency to neglect other areas of life to take DXM

What Is Withdrawal from Dextromethorphan Like?

Once someone is dependent on dextromethorphan, the withdrawal from DXM can include:2

  • Slowed thinking
  • Delayed responses
  • Depression
  • Impaired coordination
  • Elevated blood pressure
  • Sweating

Treatment for Dextromethorphan Abuse

A medically supervised detoxification can help with the physical withdrawal symptoms. Behavioral therapies such as cognitive-behavioral therapy (CBT) can help clients maintain sobriety by changing their thoughts and behaviors related to drug use and teaching ways to manage stress and triggers better without resorting to drug use.


Resources

  1. https://www.ncbi.nlm.nih.gov/books/NBK538216/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925345/
  3. https://www.ncbi.nlm.nih.gov/books/NBK538502/#article-307.s8
  4. https://www.deadiversion.usdoj.gov/drug_chem_info/dextro_m.pdf#search=dextro
  5. https://www.ncbi.nlm.nih.gov/pubmed/30860737

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