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Dextromethorphan (DXM) is an over-the-counter drug, found in cough syrup. In the United States, it’s the most common ingredient in cough syrup, since it was first approved by the FDA in the 1950s. In the 1960s, tests were done that showed that there was no chance of physical addiction to this drug; however, the drug can have toxic effects on those who take it, and it can be psychologically addictive.
It is considered safe to take DXM as directed by a doctor or per the labeling instructions. DXM creates a problem when people take it more often than recommended or take the drug in an effort to achieve a high. It’s popular among young adults who want to get high, but don’t want the results to show up on a drug test. It has also become a popular recreational drug for teenagers.
Those who do develop an addiction to DXM find it hard to stop using the drug. They like the euphoria they can experience with high doses of the drug. Many people who are addicted to cough medicine don’t realize they have an addiction, or that the drug is as strong as it is.
The intended use of DXM is to treat colds and coughs. It is classified as a dissociative drug, however, and those who abuse it tend to purchase extra-strength cold medicine, which contains higher amounts of the drug, usually 15 milligrams. It can be taken in liquid or pill form.
There are numerous slang names for this type of drug use, such as robotripping and dexing, which are names derived from the drug itself and one of the brand name medicines that contains the drug. It’s a popular drug among teens and adolescents in particular. One in 30 teens reports abusing DXM to get high.
With such a variety of medications carrying this drug – over 100 different medicines – DXM is easy to find and easy to buy. Not all cough and cold medicines have DXM in them. It also needs to be the only active ingredient to deliver the high abusers crave from it.
Any medication that contains DXM can be abused. Some common brand name medications that contain DXM include:
This is just a sampling of medications that contain DXM. Other brands that contain the drug include Alka-Seltzer Plus Cold & Cough Medicine, Theraflu Daytime Cough & Cold, Tylenol Cold, Vicks Formula 44, and many others. Any medication that lists DM in its title, such as Mucinex DM, carries DXM as its primary ingredient. However, if it isn’t listed as part of the name, it does not mean that ingredient isn’t present, which is why it is important to read all labels when purchasing over-the-counter medication.
Anyone who takes a cough suppressant or cold medication containing DXM beyond the labeling instructions (either more frequently or in higher doses), who takes a DXM medication when it is not needed, who combines DXM with other substances of abuse like alcohol, or who takes DXM with the goal of getting high, is abusing the medication. While DXM abuse is common among teenagers and young adults, people of all ages abuse the drug.
Symptoms of abuse vary. They depend on how much was taken, the person’s physical makeup, and if other drugs were used at the same time. The high comes in different stages:
The normal medical dosage for DXM is only 10-30 milligrams every four hours. Those abusing the medication are more likely to take a dosage of 250-1,500 milligrams, up to 50 times more than an acceptable medicinal dose. Some people use certain chemicals to separate the ingredients, thus getting a straight DXM high. In addition, some users combine DXM with use of other substances in an effort to intensify the high. Mixing substances increases the likelihood that an overdose will occur.
Signs that someone is abusing DXM are generally similar to signs of substance abuse in general. People may experience changes in appearance, including a decline in personal hygiene. Schedules may change, and people may beginning missing or performing poorly at work or in school. In addition, overall attitude may change, as people become more isolated and secretive in an effort to hide the abuse. Those who live with the individual who is abusing DXM may find empty medicine bottles around, and the individual may frequently complain of sickness to justify medication purchases.
If a person continually abuses DXM, addiction treatment may be needed. While addiction to DXM is not generally physical in nature, psychological addiction can keep a strong hold on a person. Comprehensive addiction treatment will identify and address the root causes of the substance abuse and help individuals establish healthier coping mechanisms to enable them to resist future substance abuse.
Co-occurring mental health disorders can also be diagnosed and effectively treated in addiction care. The best treatment addresses the entire person on an individual basis, not just the behavior of DXM abuse.