May 11, 2022

Effects, side effects, recognizing the signs

Dextromethorphan, or DXM, is a cough suppressant that is an ingredient in over-the-counter (OTC) cold medicines. When people take DXM in high doses, it can cause hallucinations and feelings of euphoria. However, an overdose of DXM can be dangerous.

When people take the correct dosage of a cough medicine, DXM poses no risk. However, some people abuse it in hopes of achieving a “high”. In these cases, the side effects can be serious.

Read on to learn more about DXM, its effects, and how to recognize when someone is abusing it.

DXM is a drug found in many over-the-counter cold and cough medicines. It is a cough suppressant – that is, a cough suppressant – that helps a person stop coughing by blocking the cough reflex in their brain.

With proper use, experts consider drugs containing DXM to be sure. Many pharmacies and supermarkets sell drugs containing DXM. These are available in many forms, including:

  • tablets
  • cough syrups
  • capsules

DXM is neither illegal nor a controlled substance in the United States because it has legitimate health uses and is not intended for recreational use.

People can use different street names for DXM, including:

  • CCC
  • Dex
  • poor man’s PCP
  • Robot
  • Red
  • Skittles
  • Triple-C
  • Velvet
  • Orange Crush
  • red devils

People can abuse DXM in several ways. Traditionally, DXM abuse involved drinking large amounts of cough syrup. However, DXM drugs are now available in tablet or capsule form, which makes it easier for a person to ingest large amounts of the drug.

A person can also get DXM in powder form on the internet, which they can sniff through their nostrils. Buying DXM powder online is very dangerous because a person may not know what the powder actually contains.

The amount of DXM a person needs to experience a high may depend on their body weight. The recommended medicinal dose of DXM for an adult is 15⁠–⁠30 milligrams (mg) three or four times a day. However, someone who wants to use DXM to get high can take 250-1500mg in a single dose.

There are many different terms for misusing DXM, such as:

  • robot tear
  • bowling
  • explanation
  • robodosage
  • robotize

When a person takes DXM at the dose recommended by a doctor or pharmacist, it rarely has side effects.

However, in large amounts, DXM can produce serious and potentially dangerous side effects.

the Drug Enforcement Administration (DEA) provides a table identifying the effects of DXM at different doses:

Additionally, the DEA notes that high doses of DXM can produce various side effects, as:

  • confusion
  • inappropriate laughter
  • hustle
  • paranoia
  • sensory changes, such as the feeling of floating
  • overexcitability
  • fatigue
  • slurred speech
  • sweat
  • high blood pressure
  • nausea
  • vomiting
  • involuntary eye movements

Research from 2021 notes that at doses of 600 mg or more, DXM can cause complete dissociation and coma. Researchers also claim that an overdose of DXM can cause:

  • seizures
  • increased heart rate of more than 100 beats per minute
  • psychosis
  • dilated pupils
  • difficulty breathing
  • rhabdomyolysis, a breakdown of muscle tissue that can lead to kidney failure

In some cases, it can even be fatal.

Emergency personnel can usually treat most DXM overdoses successfully. the DEA notes that the majority of DXM-related deaths are due to mixing the drug with other substances, such as alcohol.

If a person abuses DXM, they exhibit certain signs or behaviors. Anyone concerned that someone they know is misusing DXM can search for the follow the signs:

  • loss of interest in activities or hobbies
  • empty cough and cold medicine containers
  • medicinal smells
  • drop in teen grades
  • loss of coordination
  • slurred speech
  • hustle
  • hallucinations
  • dizziness

the National Capital Poison Control Center indicates that people between the ages of 12 and 25 account for about half of DXM-related emergency room visits each year. This may be due to its availability, as well as online information on how to successfully “stumble upon” DXM.

Although it is not an illegal substance, at least 12 states have legislation that prohibits the sale of drugs containing DXM to persons under the age of 17.

A person can help prevent their child from DXM abuse by telling them about its harmful effects. the Addiction and Mental Health Services Administration suggests doing the following when talking with a child about drug or alcohol use:

  • let them know that drug abuse is something people disapprove of
  • show compassion and let them know that their health and safety is important
  • provide a safe space where they can talk about any concerns or questions they have about drug use
  • provide them with information about drug abuse and its effects
  • address the issue of peer pressure and discuss how to say no

Anyone who abuses DXM and wants to quit should speak with a doctor. The doctor can offer advice on which treatments are best for them.

A person who has abused DXM for an extended period may experience withdrawal symptoms once they stop taking it. During the first week Withdrawal from DXM, symptoms may include:

Over the next 3 weeks, a person exiting DXM may experience:

Withdrawal symptoms can make it difficult to quit DXM. However, it is important for a person to stay strong during this time. A doctor may be able to provide a person with medication to relieve withdrawal symptoms.

Therapy may benefit someone with a substance use disorder. the National Institute on Drug Abuse suggests the following forms of therapy:

  • Cognitive-behavioral therapy (CBT): CBT can help a person identify and avoid any triggers to their drug use. This may mean avoiding certain people or places.
  • Multidimensional family therapy: This form of therapy helps teenagers who are addicted to drugs, as well as their families. It aims to explore all patterns of drug abuse in the family and to improve family functioning.
  • Contingency management: Contingency management uses positive reinforcements to help a person stop using drugs.
  • Motivational interview: This form of therapy helps encourage and motivate a person to abstain from drug use.

If a person experiences serious side effects after abusing DXM, they should seek emergency medical attention. It is possible to treat DXM overdoses with success with supportive care.

Once a person has received successful treatment for an overdose of DXM, they can usually go home if they have no symptoms after 6 hours.

People with complications may need to stay in an intensive care unit until they recover. Examples of complications include rhabdomyolysis, in which the death of skeletal muscle tissue releases substances that cause kidney failure into the blood, and abnormally high body temperature.

DXM can cause a person to develop psychosis. This can lead to suicidal thoughts or violent outbursts. A person who develops psychosis as a result of misuse of the DXM may need psychiatric help.

DXM is a drug that is an ingredient in many over-the-counter cough and cold medicines. DXM can be taken safely in recommended doses. A person can take DXM in various forms, such as syrup, tablets, or powder.

People who abuse DXM take large doses to experience a high. It can be dangerous and lead to serious side effects, such as coma, psychosis, or death.

If a person is concerned that someone they know is using DXM incorrectly, they can look for certain signs. A person may be able to prevent their child from taking DXM by telling them about its dangerous effects.

Anyone who abuses DXM and wants to quit should talk to a doctor, who can offer advice on the best treatment approach.

If a person experiences serious side effects while taking DXM, they should seek medical attention immediately.


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