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Dextromethorphan (DXM) Addiction

Dextromethorphan or DXM is a common cough suppressant that is often added to many OTC - over the counter - cold medications. However, you may find yourself abusing this drug for the hallucinogenic high that it creates. Over time, this form of substance use could lead to addiction and other health complications.

About Dextromethorphan (DXM)

Dextromethorphan (DXM) is classified as an antitussive medication - or a cough suppressant - that is added to more than 100 types of over the counter medications. It was created for use in controlling the coughing that is associated with illnesses like lung disorders, bronchitis, common cold, the flu, and allergies.

The drug is also available in various forms. These include but are not limited to capsules, syrups, lozenges, chewable tablets, and dissolvable strips that you can place under the tongue.

Examples of medications that contain Dextromethorphan include familiar drugs like Vicks Formula 44, NyQuil, and Robitussin. These drugs are often cold either with just dextromethorphan or with other chemicals like pseudoephedrine and acetaminophen. They are used for the relief of:

  • Coughing
  • Itching of the nose
  • Runny nose
  • Sinus congestion
  • Sneezing
  • Throat itching
  • Watery eyes due to flue, allergies, fever, and cold

Although medications containing dextromethorphan are known for their safety and effectiveness, they can cause a couple of side effects. If you start abusing them for any reason other for medical treatment or in high doses, you may suffer additional effects.

Other Names for Dextromethorphan (DXM)

On the streets, people refer to dextromethorphan by a wide variety of names to avoid detection by law enforcement officials and other authority figures. These street names include but are not always limited to:

  • CCC
  • Cousin
  • Dex
  • Double cup
  • DXM
  • Lean
  • Orange crush
  • Poor Man's PCP
  • Purple drank
  • Red devil
  • Red devils
  • Robo
  • Sizzurp
  • Skittles
  • Triple C
  • Triple Cs

Some users also refer to the abuse of dextromethorphan as robo-tripping. This is typically in reference to the fact that they consume it in cough syrups. The term robo comes from the Robitussin cough medicine.

Signs and Symptoms of Dextromethorphan (DXM) Addiction

The signs and symptoms of dextromethorphan addiction largely depend on the severity of your substance use disorder, how much of the drug you have been taking, and whether you mixed it with other substances like marijuana and alcohol. Often, these symptoms are comprised of:

  • Abandoning former clubs and hobbies
  • An altered sense of time
  • An altered state of apparent consciousness
  • Anger
  • Antagonism
  • Appearing intoxicated without smelling like alcohol
  • Appearing somewhat sedated
  • Avoiding family members
  • Behavior problems at school
  • Being unable to cut down or control your dextromethorphan use even if your wish to do so
  • Blotchy skin
  • Changes in activities
  • Changes in appearance
  • Changes in eating patterns
  • Changes in habits
  • Changes in sleeping patterns
  • Coma
  • Confusion
  • Depression
  • Developing significant tolerance to the drug
  • Difficulty speaking
  • Dilated pupils
  • Disappearance of money
  • Disorientation
  • Dizziness
  • Double vision
  • Drowsiness
  • Euphoria
  • Evasiveness
  • Fast heart rate
  • Feeling detached from your body
  • Frequent urges to use the drug due to feeling happy, stressful events, feeling happy, needing to socialize, and a desire to escape
  • Hallucinations
  • Having difficulty seeing obvious aspects in the environment.
  • Hostility
  • Hot flashes
  • Impaired ability to walk
  • Impaired senses
  • Impaired short-term memory
  • Impaired vision
  • Inability to focus
  • Involuntary movements (or ataxia)
  • Isolation from family and friends
  • Issues with coordination and walking
  • Itching
  • Liver damage
  • Losing contact with your body
  • Loss of coordination
  • Loss of interest in family and social activities and hobbies
  • Lower grades
  • Lying
  • Mild hallucinations
  • Mild inebriation that is similar to being drunk
  • Mood changes without any apparent reason
  • Nausea
  • Negative moods
  • Numbness of toes and fingers
  • Periods of withdrawal
  • Poor coordination
  • Poor hygiene
  • Racing heart
  • Repetitive use of the drug for non-medicinal purposes
  • Secretive behavior
  • Seeming relatively hyperactive
  • Seizures
  • Silence
  • Slurred speech
  • Spending long hours using the drug
  • Stomach pain
  • Sudden drop in your academic performance
  • Sudden or gradual change in friends
  • Sullen mood
  • Symptoms of psychosis
  • Uncooperative nature
  • Using dextromethorphan in dangerous situations or ways
  • Visual hallucinations
  • Vomiting

Short and Long-Term Effects of Dextromethorphan (DXM) Abuse

Ongoing dextromethorphan abuse can also be accompanied by a wide variety of both short and long term side effects. Examples of these effects include:

  • A sensation of floating
  • Altered perceptions of time
  • Coma
  • Confusion
  • Disorientation
  • Dissociation from your body
  • Dizziness
  • Drowsiness
  • Euphoria
  • Fast heart rate
  • Feelings of stimulation
  • Hallucinations
  • High blood pressure
  • Hot flashes
  • Hypertension
  • Hyperthermia
  • Impaired judgment
  • Impaired motor coordination and functioning
  • Inability to focus
  • Intoxication symptoms (such as slurred speech)
  • Itchy skin
  • Lethargy
  • Liver damage
  • Liver failure
  • Loss of coordination
  • Loss of memory
  • Loss of sense perceptions
  • Muscle twitches
  • Nausea
  • Numb extremities
  • Nystagmus (or rapid eye movements)
  • Panic attacks
  • Paranoia
  • Rashes
  • Red and blotchy skin
  • Reduced cognitive ability
  • Respiratory depression
  • Sedation
  • Seizures
  • Significant perceptual distortions of visual objects
  • Slow and labored breathing
  • Slurred speech
  • Stomach spasms
  • Sweating
  • Tachycardia, or fast heart rate
  • Visual hallucinations
  • Vomiting

Dextromethorphan (DXM) Overdose

If you take dextromethorphan in extremely high doses, you may experience many other side effects that could turn out to be potentially dangerous. This is particularly true because of the high risk of suppressed breathing and extreme sedation that could turn out to be fatal or lead to a heart attack. Other signs and symptoms of dextromethorphan overdose include:

  • Bluish tint on the lips, under the fingernails, or on the tip of your nose
  • Blurred vision
  • Changes in blood pressure
  • Coma
  • Constipation
  • Depressed, irregular, or shallow breathing
  • Dizziness
  • Drowsiness
  • Hallucinations
  • High body temperature (or hyperthermia)
  • Impulsive behavior
  • Intestinal or stomach spasms
  • Involuntary twinges
  • Muscle twitches
  • Nausea
  • Perceptual disturbances
  • Poor judgment
  • Seizures
  • Vomiting

However, it might be difficult to overdose on dextromethorphan. This is because if you take a dose that is large enough to cause death will instead cause you to vomit - which would effectively eliminate the drug from your body before you have had enough time to absorb it into your system.

Deaths resulting from dextromethorphan overdose are often as a result of mixing this drug with other intoxicating substances like alcohol. They might also occur because you sustained an injury or were involved in an accident while intoxicated on the drug.

To this end, you should always be careful of any of the following formulations that have dextromethorphan:

  • Alka-Seltzer Plus (Cold and Cough)
  • Benylin DM
  • Coricidin
  • DayQuil
  • Dimetapp DM
  • Drixoral
  • NyQuil
  • Robitussin DM
  • Rondec DM
  • St. Joseph Cough Suppressant
  • TheraFlu
  • Tylenol Cold

If you suspect that you may be overdosing on dextromethorphan, it is recommended that you call 911 or your local poisons control center as soon as possible. This is because dextromethorphan overdose could potentially turn out to be fatal.

Dextromethorphan (DXM) Withdrawal Symptoms

If you have been taking this drug over the long term and you significantly reduce your usual dose or suddenly stop using it, there is a high risk that you could experience some withdrawal symptoms.

These symptoms would occur because you would already have developed tolerance to the drug. Tolerance would also be accompanied by physical and psychological dependence on dextromethorphan.

When you stop taking DXM, you could suffer the following withdrawal symptoms:

  • Anxiety
  • Cravings for more dextromethorphan
  • Diarrhea
  • Fatigue
  • Flashbacks
  • Gastrointestinal distress
  • Insomnia
  • Intense cravings
  • Memory issues
  • Nausea
  • Nightmares
  • Panic attacks
  • Restlessness
  • Toxic psychosis
  • Upset stomach
  • Vomiting
  • Weight loss

It is recommended that you only stop abusing dextromethorphan or reduce your normal dose of it after having enrolled in a medically supervised detoxification program so that your withdrawal symptoms can be properly managed.

The Best Options for Dextromethorphan (DXM) Addiction Treatment

The best way to overcome your dextromethorphan abuse and addiction is by checking into a professional addiction treatment and rehabilitation program. Often, this will allow you to enjoy treatment that is based on various components, including but not limited to:

  • 12-step programs
  • Additional treatments for any co-occurring disorders
  • Initial admission
  • Inpatient treatment
  • Medically assisted treatments
  • Medications for the various symptoms you display
  • Outpatient treatment
  • SMART recovery
  • Social support
  • Special interventions for any specific needs, including job training, tutoring, speech therapy, and occupational therapy, among others
  • Substance use disorder therapy


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