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Dextromethorphan (DXM) Abuse Symptoms, Side Effects, and Addiction Treatment

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What Is Dextromethorphan Used For?

What Is DXM?

Dextromethorphan (DXM or DM) is a cough suppressant and opioid derivative used in more than 100 over-the-counter medicines.

Dextromethorphan is safe for ingestion and not habit-forming when taken as directed; however, illicit and excessive use of DXM has recently risen, and this type of use has negative effects.

While not physically addictive when taken in recommended doses, DXM has the potential to be addictive if:

  • Taken in large doses.
  • OR
  • Administered via an alternate method (such as snorting or injecting).

Additionally, a user may also begin to obsessively crave using the drug between bouts of compulsive use or repeated intake of large amounts.

Some users will drink cough syrup containing dextromethorphan (which is known as lean) in combination with alcohol or in the absence of the availability of alcohol (e.g. in some Robitussin formulations). Also, some users will actually purchase DXM in pill or powder form—such as in the case of Coricidin HBP Cough and Cold tablets—and snort or inject it.

When taken in excess doses and via alternative methods, DXM can actually act as a dissociative anesthetic, mimicking the effects of drugs like PCP and Ketamine, a “date rape” drug.


Signs and Symptoms of DXM Abuse

Physical Signs and Symptoms

  • Euphoria.
  • Feelings of detachment from the body.
  • Blotchy skin.
  • Depression.
  • Difficulty speaking.
  • Dilated pupils.
  • Dizziness.
  • Hallucinations.
  • Involuntary movements (ataxia).
  • Double vision.
  • Drowsiness.
  • Impaired ability to walk.
  • Itching.
  • Numbness of fingers and toes.
  • Symptoms of psychosis.
  • Racing heart.
  • Vomiting.

Lifestyle and Social Signs

  • Changes in appearance.
  • Changes in eating patterns.
  • Changes in sleeping patterns.
  • Gradual or sudden change in friends.
  • Loss of interest in hobbies, family, or social activities.
  • Disappearance of money.
  • Poor hygiene.
  • Sudden drop in academic performance.
  • Uncooperative nature.


Dextromethorphan Side Effects

There are several health problems that can occur as a result of dextromethorphan abuse. The most alarming risks are serious illness or death.

Severe illness or death is not necessarily caused by the misuse of dextromethorphan by itself. However, serious illness and death can result from the effects of the combination of DXM with other active ingredients found in multi-symptom cold medications.

These ingredients include acetaminophen (Tylenol), chlorpheniramine (an antihistamine), pseudoephedrine (a decongestant), and phenylephrine. Abuse of medicines that contain these active ingredients in combination with DXM can cause the following:

  • Liver failure.
  • Tachycardia (rapid heart rate).
  • Seizures.
  • Hyperthermia.
  • Respiratory depression.
  • Coma.

Learn more about the side effects of dextromethorphan use.

Dextromethorphan Withdrawal Symptoms

Typically, someone who has been using dextromethorphan long-term and suddenly quits will experience withdrawal symptoms, including:

  • Fatigue.
  • Gastrointestinal distress (vomiting, diarrhea).
  • Insomnia.
  • Nightmares.
  • Memory issues.
  • Panic attacks.
  • Intense cravings.
  • Flashbacks.

Those who have abused dextromethorphan at high doses for a long period of time may experience toxic psychosis and other permanent psychological issues.


Dextromethorphan Abuse Treatment

There are several treatment options available for dextromethorphan addiction, including:

American Addiction Centers (AAC) is a leading provider of addiction treatment programs. To learn how to begin the process of healing, please call us free at .


Who’s Abusing DXM?

  • teen-abusing-cough-syrupAccording to the Drug Abuse Warning Network’s Dawn Report, persons between the ages of 12 and 20 years old accounted for more than half of emergency room visits for non-medical use of dextromethorphan.
  • SAMHSA’s 2008 National Survey on Drug Use and Health (NSDUH) states that in 2006, 3.1 million Americans between 12 and 25 years old had ingested cough and cold medicine recreationally.
  • Per the DAWN Report, when taken in large doses, DXM can produce a high similar to that of PCP and certain other psychotropic drugs.
  • According to a 2010 study by the University of Michigan, cough medicine was the most abused drug by high school seniors, next to marijuana and Vicodin.

Teen Dextromethorphan Abuse

The statistics above illustrate the danger of dextromethorphan, as well as the fact that its use is common amongst young people. DXM appeals to teens due to its ease of access and low cost. In fact, 10% of teenagers have abused cough medicines (many of which contain Dextromethorphan) to get a high.

You can prevent dextromethorphan abuse by taking the following actions:

  • Talk to your teens and younger children about the physical and mental health risks of DXM abuse.
  • Reinforce to your teen that the fact that a drug is prescription does not mean is not dangerous or addictive.
  • Set clear rules that your child must not take medicine without your knowledge.
  • Keep medicines away from the reach of teens and young children.
  • Pay attention to medicine quantities and watch for significant changes.
  • Protect your kids from websites that encourage abuse of DXM.
  • Know where your child is spending time and with whom they are spending it.

Discussing the negative effects of dextromethorphan abuse (and drug abuse in general) is one of the best ways to prevent teen drug abuse.

Find DXM Treatment Programs

If you or a loved one is struggling with an addiction to DXM, help is available and recovery is possible. Professional addiction treatment can start anyone battling a substance use problem on the path to a healthier and happier life. Rehab facilities are located throughout the U.S., and many offer specialized treatment that can cater to individual needs. You can use SAMHSA’s Behavioral Services Locator to search for treatment centers. Many state government websites will also provide local drug and alcohol resources to those in need. To find your state government’s website, do a web search for your state name and ‘.gov.’ Once your state website is located, substance use resources shouldn’t be hard to find, and they should provide further phone contacts for your assistance.

American Addiction Centers (AAC) is a leading rehab provider and has trusted facilities across the country. You can contact our 24-hour helpline free at for helpful advice, information, and admissions.


Dextromethorphan Addiction Treatment Levels of Care

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Patrick Condron, M.Sc., M.A.C., is an addiction specialist and drug and alcohol counselor. He is Executive Director of Lazarus House, Inc., a transitional residential program for men and women who continue to work on their recovery towards independent living.
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