Dextromethorphan Abuse

Dextromethorphan (DXM) is an over the counter cough suppressant. It functions by reducing activity in the area of your brain that is responsible for coughing. Although dextromethorphan cannot cure illness, the symptom relief that the drug provides may help you get the rest you need for recovery.

When taken in higher than recommended doses, dextromethorphan can cause euphoria and disassociation. It can also cause difficulty breathing, coma and death.

Dextromethorphan must always be taken according to the instructions on the package. Taking a larger dose, or taking dextromethorphan more frequently or for a longer period of time than recommended, will lead to serious health consequences.

Understanding Dextromethorphan Abuse

Because dextromethorphan (DXM) is available over the counter, it can be purchased in any drug store without a prescription. This makes it a popular drug of choice for young people who may not understand how dangerous it is to abuse dextromethorphan.

According to the National Institute on Drug Abuse, “when taken in high doses, DXM acts on the same cell receptors as dissociative hallucinogenic drugs like PCP or ketamine. Users describe effects ranging from mild stimulation to alcohol- or marijuana-like intoxication, and at high doses, sensations of physical distortion and hallucinations.”

DXM powder is also available for sale over the internet. Dextromethorphan is extremely dangerous in this form, partly because the potency of these powders can vary so much that appropriate dosage and the intensity of effect cannot be known until after you have already consumed the drug.

Signs and Symptoms of Dextromethorphan Abuse

According to the Drug Enforcement Agency’s publication Drugs of Abuse, some of the many psychoactive effects associated with high-dose DXM include:

  • confusion
  • inappropriate laughter
  • agitation
  • paranoia
  • hallucinations
  • sensory changes, including the feeling of floating and changes in hearing and touch

Bodily signs of DXM intoxication include:

  • over-excitability
  • lethargy
  • loss of coordination
  • slurred speech
  • sweating
  • hypertension
  • involuntary spasmodic movement of the eyeballs

Behavioral signs and symptoms of dextromethorphan abuse may include:

  • purchasing the drug without having a cough
  • empty bottles or used up packets of tablets
  • changes in appearance or hygiene
  • changes in eating habits
  • isolation from family and friends
  • secretive behavior
  • changes in mood
  • apathy and lack of interest in previously enjoyed activities

Dangers of Dextromethorphan Abuse

In order to get high from DXM, you must take extremely high doses that are incredibly risky. There is no way to predict how your body will react, even if you’ve used DXM before.

According to Medline Plus from the U.S. National Library of Medicine, dextromethorphan can cause a number of unpleasant side effects, even when taken as directed.

Tell your doctor if any of these symptoms are severe or do not go away:

  • dizziness
  • lightheadedness
  • drowsiness
  • nervousness
  • restlessness
  • nausea
  • vomiting
  • stomach pain

If you experience any of the following symptoms, call your doctor immediately:

  • rash

Overdose of dextromethorphan can easily occur when the medication is abused. Call 911 if you or a loved one experience any of the following symptoms described by the Medline Plus page on dextromethorphan overdose:

  • breathing problems, including slow and labored breathing, shallow breathing, no breathing
  • bluish-colored fingernails and lips
  • blurred vision
  • coma
  • constipation
  • convulsions (seizures)
  • drowsiness
  • dizziness
  • hallucinations
  • high or low blood pressure
  • muscle twitches
  • nausea and vomiting
  • pounding heartbeat (palpitations)
  • raised body temperature
  • rapid heartbeat
  • spasms of the stomach and intestines

Drinking alcohol with dextromethorphan or taking it in combination with other drugs will increase the risk of fatality, and is a clear sign of a substance abuse problem.

Who Abuses Dextromethorphan?

When used appropriately, according to directions, dextromethorphan can help you get the rest you need to recover from illness by suppressing a cough that keeps you from sleeping. When abused, DXM can be very dangerous. You may abuse dextromethorphan to experience euphoria, a sensation like you’re floating, and/or visual and auditory hallucinations. However, in order to induce these effects, you must ingest a much higher than recommended amount of the drug.

Don’t fool yourself into thinking dextromethorphan is safe just because it is available over the counter. When consumed in the large amounts necessary to get high, DXM can cause a fatal reaction. Every time you use, you run the risk of overdosing not only from the DXM, but from other medications that are frequently sold in combination with it, such as pain relievers, decongestants, antihistamines and expectorants.

Dextromethorphan Addiction

Although anyone could potentially become hooked to the effects of dextromethorphan, DXM abuse is much more common among teenagers, due to how easily the drug can be obtained. You can find it in stores everywhere, it’s cheap, and your parents won’t be suspicious if they find an empty bottle in your room. In fact, a 2008 study revealed that one in ten teenagers have abused dextromethorphan to get high.

Like most hallucinogens, dextromethorphan is not thought to be especially addictive physically, but it can be psychologically addictive. You may become dependent upon the escape the drug can provide, continuing to use it even in the face of unpleasant side effects and other consequences.

Am I Addicted to Dextromethorphan?

If you fear that you are addicted to dextromethorphan, read and honestly answer the questions below:

  • Do I feel like I can’t get through the week without using dextromethorphan?
  • Do I abuse the drug in order to combat feelings of unhappiness, loneliness, depression, etc.?
  • Do I use as an attempt to escape issues and conflicts in my life?
  • Have friends or family members mentioned more than once that they are worried about changes in my behavior?
  • Do I become hostile or angry when they do so?
  • Have I begun to withdraw from people and activities that used to interest me?
  • Am I secretive about my drug use, and/or do I lie about when I use or how much I take?
  • Do I feel like I can’t have fun, be normal, or be social without dextromethorphan?
  • Have I experienced any major problems in the last year, such as a breakup, job loss, car accident, injury, family problems, financial problems, or getting arrested as a result of my drug use?
  • Despite these problems, do I feel unable to stop using dextromethorphan on my own?

If you answered yes to one or more of these questions, you may be addicted to dextromethorphan and in need of professional substance abuse treatment.

Dextromethorphan Addiction Treatment

Your addiction to dextromethorphan may not be physical, but psychological addictions can be just as serious. You need the help of qualified specialists with the training and tools necessary to guide you to a better way of life.


The first phase of overcoming addiction is to give up your drug of choice. Most drugs cause unpleasant withdrawal symptoms when you try to quit, and dextromethorphan is no different—although there is no official medical consensus about what those symptoms are. Still, users report suffering a variety of unpleasant symptoms, including rapid heart rate, anxiety, depression, fatigue, and more.

Just like there is no official list of DXM withdrawal symptoms, there are no FDA approved drugs to treat DXM withdrawal. Still, having the guidance of addiction treatment professionals as you go through the process of giving up DXM can be very helpful for avoiding relapse.


Your recovery plan will likely include:

  • Cognitive Behavioral Therapy: CBT can be key to overcoming psychological addiction. With DXM, your craving to use is likely to be in response to certain environments, situations, or events. Behavioral therapy can teach you how to rewrite old negative thinking patterns and reactive behaviors so that you respond to triggers with new ways of thinking, and healthier coping mechanisms.
  • Treatment for Co-occurring Conditions: It’s likely that you became vulnerable to drug use in part due to an undiagnosed mental disorder. Problems like these must be addressed if your recovery is going to succeed.
  • Recreational therapy: According to the American Therapeutic Recreation Association, “Research supports the concept that people with active, satisfying lifestyles will be happier and healthier. RT/TR provides services which are based on the individuals’ interests and lifestyle and allows them to better engage in therapy and apply these functional improvements to all areas of their life.” Having positive physical outlets can be big help when you are feeling tempted to use, and exercise can release endorphins that will improve your overall mood and outlook.