DXM Misuse: Effects, Addiction, & Treatment

Dextromethorphan (DXM) is a cough suppressant that is found in several over-the-counter (OTC) medications.¹ In the United States, approximately 1.6 million people misused OTC cough and cold medications in 2021 alone.² While DXM can be helpful when taken as directed, the misuse of it can lead to several health problems and can even be deadly.¹

This page will explore what DXM is, dangers of misusing DXM, DXM effects, DXM addiction and overdose, and how to get help if you or a loved one are struggling with substance misuse or addiction.

What Is DXM?

DXM is an antitussive (a medication used to prevent or alleviate cough) that is a main ingredient in many OTC cough and cold medications, including Coricidin, Robitussin, and Nyquil.^1,3 In high doses, DXM can cause dissociation, euphoria, and hallucinations.¹ Due to its accessibility, adolescents and young adults often engage in hallucinogenic or dissociative drug use by misusing DXM.¹

DXM can be found in more than 120 OTC cold medications either individually or with other OTC drugs (such as acetaminophen, guaifenesin, and pseudoephedrine) and is available in syrups, tablets, capsules, oral strips, and lozenges.^1,4 DXM can also be purchased in illicit formulations online either on its own or combined with other illicit substances like ecstasy or methamphetamine.¹

Individuals can consume DXM by swallowing it by itself, mixing it with soda (known as “robo-tripping” or “skittling”), or injecting it.³ It is also common to misuse DXM alongside alcohol, marijuana, or other drugs.³ DXM is often referred to by a variety of street names, including Triple C, Dex, and Poor Man’s PCP.⁵

DXM (Dextromethorphan) Side Effects

Dextromethorphan is relatively safe when taken as intended, but misuse can cause side effects.³ Some DXM misuse side effects can include:³

• Diminished motor control.
• Hyperexcitability.
• Stomach pain.
• Changes in vision.
• Increased blood pressure.
• Sweating.

When consumed in high doses, DXM can produce additional effects, including:^1,3

• Hallucinations.
• Extreme panic.
• Paranoia.
• Anxiety.
• Aggression.
• Loss of motor coordination.
• Dissociative sedation.

Dangers of DXM Misuse

Additionally, DXM misuse puts a person at risk for dangerous side effects. Serious health effects associated with DXM misuse include:^1,5

• Increased heart rate and blood pressure.^.
• Toxicity to the heart and circulatory system.
• Dangerously slowed breathing.
• Central nervous system toxicity.
• Seizures.
• Psychosis.
• Coma.

The types of dangers and the severity of them depend on the dose of DXM that is consumed and if it was consumed alongside other substances.⁵ For example, misusing DXM combined with acetaminophen can cause liver damage, while DXM found in an antihistamine can lead to anticholinergic toxicity when misused.¹ Additionally, it is not always possible to know the contents of DXM if it is purchased on the street or from other illegal or unregulated sources, increasing these dangers even further.¹

Dextromethorphan Overdose

DXM overdose can occur when a person takes enough of the drug to cause life-threatening symptoms or death.³ Some of the most common symptoms of DXM overdose can include:⁵

• High blood pressure.
• Increased heart rate.
• Hyperthermia.
• Confusion.
• Extremely slow or frequently paused breathing.
• Repetitive eye movements.
• Agitation.
• Psychosis.
• Seizures.
• Coma.
• Death.

If you suspect that you or someone you are with has overdosed on DXM, call 911 immediately.³ Then, if they have stopped breathing, begin CPR and administer naloxone if it is available.³

Is DXM Addictive?

Misuse of DXM can lead to addiction.³ An addiction is recognizable by the effect DXM use has on aspects of a person’s life.³ The Diagnostic and Statistical Manual of Mental Disorders (5th edition) lists several criteria that are used to diagnose a substance use disorder, the clinical term for addiction.⁶ Some of the criteria commonly observed in addiction include, but are not limited to, the following:⁶

• A persistent desire to reduce or stop DXM use but being unable to
• Strong desire, or cravings, for DXM
• Continuing to use DXM despite failure in home, work, and/or school responsibilities
• Giving up previously important activities in lieu of DXM use
• Continuing to use DXM despite knowing that it causes or worsens physical or psychological problems

Does DXM Have Withdrawal Symptoms?

Withdrawal symptoms have been reported with DXM misuse, but have not been thoroughly studied.^3,7 As a result, it is not clear whether DXM misuse alone can cause withdrawal symptoms. Some of the symptoms that have been reported after ending DXM use, however, have included:⁷

• Difficulty sleeping.
• Nausea.
• Excessive sweating.
• Elevated blood pressure.
• Increased heart rate.

While these symptoms have been reported with the cessation of DXM after long-term use, withdrawal symptoms are not included in the criteria for hallucinogen use disorder by the DSM-5.⁶

DXM Addiction Treatment in Nevada

If you or a loved one are struggling with DXM misuse or addiction, help is available. For those looking for treatment, Desert Hope Treatment Center is an inpatient rehab in Las Vegas that may offer what you need. With several types of rehab care available and multiple levels of addiction treatment, Desert Hope provides healing to people from many backgrounds and stages of healing.

Admissions counselors are available to answer your questions 24/7 by phone or online. Call today and start treatment, find out how to use insurance plans that cover treatment, or discover other ways to cover the cost of treatment.