Dextromethorphan (DXM) is a widely used over-the-counter cough suppressant that has recently overtaken codeine cough syrups (now carefully regulated as Schedule III substances) in popularity. It’s easy to produce, effective and at directed doses, and very safe to use.
However, there’s another side to DXM’s growing prevalence. As with many other over-the-counter drugs, DXM has been pressed in some settings beyond its directed usage into the function of a recreational drug. On the club scene, it’s been called by various names, including Skittles, triple-C, and robotripping, and while directed use would restrict daily doses to 120 mg, recreational use often involves daily doses of anywhere from 200 up to 1500 mg. For those who find themselves using the drug regularly at this level, it can become an addiction with noticeable health effects.
DXM Drugs
DXM’s recreational use originally tended to focus on drinking large volumes of liquid cough syrup, although more recently the popularity of use in tablet or gel cap form has grown — consuming large doses in this way is significantly easier and less unpleasant. There are a number of different ways[1] that this medicine makes its way into recreational drug culture:
- Regular over-the-counter DXM medications are fairly accessible since they can be purchased without a prescription
- Illicit tablets that are either pure DXM or mixed with other substances like methamphetamine
- Internet sales of DXM powder
The uncertain composition of the illicit options can pose health risks in itself, and over-the-counter medications can include other ingredients, like acetaminophen, that can have long-term health effects such as liver damage. A simple chemical extraction process is presently in circulation on the internet that removes these other ingredients from cough syrup, but even with this in play, there are still well-known long-term dangers from DXM abuse.
What Are the Effects of Long-Term Use of DXM?
The biggest dangers of DXM come from psychological dependency and its associated behavioral effects, as well as the related physical risks posed by its effects on the user’s judgment.
DXM taken in large enough quantities is a dissociative, hallucinogenic drug much like ketamine or PCP. It produces mild stimulation, euphoria and visions, distorted perception, and even out-of-body experiences. Long-term users can find that the effects of DXM plateau at certain dosage levels and that they have to take larger and larger quantities to get high. As these larger doses take effect, their distortion of the user’s personality and perceptions gets more pronounced.
As a result of this, users who had previously been cautious about mixing DXM with other substances can lose that caution. Most fatalities from DXM abuse involve both overdosing and mixing it with alcohol or other drugs, with antidepressants being especially dangerous. In other cases, users may find themselves doing things they would not normally do — long-term DXM abuse can be linked to disordered behavior and paranoia.
As far as its physical effects go, DXM suppresses the central nervous system and can produce a variety of symptoms that include loss of motor control, stomach pain, slurred speech, sweating, hyperexcitability, and increased blood pressure. Permanent physical damage from DXM use alone is relatively rare, however; most of its physical effects can be remediated with the right treatment. Perhaps the most perilous physical symptom is distorted vision, which can lead users to misjudge speeds and distances and get into otherwise avoidable traffic accidents or other mishaps.
How Long Is DXM Supposed to Be Used?
Put to its intended use as a cough suppressant, DXM should be used in directed doses only for the period recommended on the label or by a doctor. Within those parameters, this medicine is perfectly safe to use for most people provided they’re not allergic to it.
Used over the recommended parameters, however, it can easily become habit-forming. If you find yourself exceeding the recommended doses or tempted to extend its use beyond the recommended timespan, you may be developing an addiction to DXM.
How Many People Are Abusing DXM?
Much of the public concern about DXM abuse centers on teens, some 4.6%[2] of whom admitted to using cough syrup recreationally in a recent study. Its popularity among teens is generally connected to the fact that DXM is more accessible than alcohol or illicit drugs, but it would be a mistake to assume that only teens and young people are at risk.
Adults on the club scene can become hooked on both over-the-counter and more illicit forms of DXM, for example, and DXM is even more accessible for adults with seemingly quiet and ordinary lives than it is for teens. In other words, substance use disorders that revolve around DXM are far from being limited to any particular demographic; anyone can become a victim of DXM addiction.[3]
The precise figures for the larger American population aren’t easy to isolate, given that much DXM abuse masquerades as legitimate medical purchases. It wouldn’t be surprising, however, to find abuse rates among the wider American population comparable to those among teens.
What to Do If You Can’t Get Off DXM on Your Own
Substance use disorders can be extremely difficult to tackle alone. That’s particularly true for substances like DXM that encourage a powerful psychological dependency and alter perception while driving a constant cycle of escalating doses to get high. If you’ve become the victim of a DXM use disorder that you are struggling to kick and that’s negatively affecting your life and health, you’re not alone. And there is help.
If you’re struggling to free yourself from DXM addiction or any other substance use disorder, you can start your journey to recovery by reaching out to the compassionate team of counselors at FHE Health. Call us any time at (833) 596-3502 and learn how our sophisticated addiction treatment programs can help you reclaim your life.
