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Concurrent Alcohol and DXM Abuse

Table of Contents

DXM misuse

Alcohol and DXM are both potentially addictive substances. Problematic use of each can lead to a range of negative health effects. When taken together, their effects are heightened, and the dangers of each are potentiated, and so is the danger.

The Problem of Alcohol and DXM Abuse

Mood changes

DXM is short for dextromethorphan. It is an antitussive medication found in many over-the-counter cough and cold medications. Most commonly, it is available in liquid and capsule forms at retail locations.

Alcohol and DXM share the commonality of being legal substances that, when used appropriately and in moderation in the case of alcohol, or as prescribed as with DXM, have little to no ill effects.

Problems arise when they are abused and/or used excessively and/or concurrently. Since both substances are CNS depressants, their effects are intensified when used simultaneously.

Signs and Symptoms

Gaining awareness of the signs and symptoms of alcohol use, DXM abuse and the combined effects of both substances will provide you with the ability to monitor and detect whether someone is abusing one or both substances.

Signs of DXM abuse include:

  • Confusion.
  • Misperception of time.
  • Hallucinations.
  • Poor decision making.
  • Feeling of dissociation from one’s body.
  • Impaired memory.
  • Dilated pupils; constricted pupils in overdose situations.
  • Nystagmus or other involuntary eye movement.

Signs of alcohol abuse include:

  • Slurred speech.
  • Mood changes.
  • Impaired decision making.
  • Diminished coordination.
  • Trouble walking.
  • Poor attention or memory.

Effects of Concurrent Use

Alone, these substances can lead to negative effects when abused. Together, the consequences are often increased in inconsistent ways depending on the usage and individual differences of the user. Negative effects of alcohol combined with DXM include:

  • Nausea and prolonged vomiting.
  • Sweating.
  • Hot flashes.
  • Agitation.
  • Numbness.
  • Dizziness.
  • Hypertension (raised blood pressure).
  • Quickened heart rate.
  • Increased anxiety and panic.
  • Seizures.
  • Fear of being permanently disconnected from reality.
  • Delusional thinking, including paranoia.
  • Coma.

If you or someone you know is experiencing symptoms and signs of DXM abuse, alcohol abuse or the combination, seek treatment immediately. Call to talk to someone about finding appropriate treatment.

Effects of Alcohol and DXM Abuse

NauseaCombining alcohol and DXM leads to a number of negative side effects, as seen above. In addition, you also severely increase your risk of overdose by abusing these drugs simultaneously.

While there is debate about the physically addictive potential of DXM, psychological addiction can occur in the form of cravings for the substance. Additionally, long-term, excessive usage of DXM has been linked with persistent psychotic symptoms that may last beyond use. And there is no debate about the potential for addiction and potentially life-threatening effects of alcohol.

You put your health at extremely high risk when you abuse these drugs concurrently.

Alcohol and DXM Abuse Treatment

If you or someone you love is suffering from addiction to one or both of these substances, treatment may be necessary to begin the process of recovery.


While there is no risk to suddenly ceasing use of DXM, the same is not true with alcohol. Abrupt withdrawal from consistent alcohol use can result in:

  • Headache.
  • Nausea.
  • Insomnia.
  • Agitation.
  • Fever.
  • Confusion.
  • Hallucinations.
  • Seizures.

Because of the risks, it is best to seek treatment prior to ending your use. Completing an assessment at a medical or addiction facility will provide one with a professional recommendation based on usage.

A hospital or detoxification center will aid in your withdrawals by prescribing medications to reduce your symptoms while increasing your comfort. Also, medical staff will monitor your physical condition to maintain your health and safety.

Treatment Components

Following a period of detoxification, someone may be referred to outpatient treatment or continue their recovery in a residential rehabilitation program based on the level of addiction. Regardless of the setting, treatment options include:

Meeting Of Support Group

  • Medication treatment. For alcohol dependence, some programs may utilize prescribed medication to aid in recovery. Available medications can:
    • Block the rewarding effects of alcohol.
    • Reduce withdrawal symptoms.
    • Trigger uncomfortable results after alcohol is consumed.
  • Therapy. Therapy, which can take place in inpatient our outpatient settings, will take many forms following detox.
    • Cognitive-behavioral therapy will focus on identifying the impact of your thoughts, feelings and behaviors on one’s addiction, while teaching skills to maintain abstinence from the drug use.
    • Family therapy will assess the role of family interactions towards drug abuse, and can promote a healthy environment for those in recovery to return to, post-treatment.
    • Motivational interviewing encourages the addict to engage fully in their recovery.
  • 12-Step Programs. Outside of professional treatment, people in recovery can benefit from peer-assisted addiction programs like AA and NA. These programs have helped millions of people achieve and maintain sobriety, and can be part of a larger recovery program.
  • Aftercare/Relapse Prevention. Recovery is an ongoing process. With abstinence the goal, relapse prevention will be a focus late in addiction treatment and a constant in mental health treatment. Relapse prevention plans will include helpful support to contact and alternatives to use.

With appropriate treatment, ending use of DXM and dependence to alcohol can be safe and effective. Call to talk to someone about how to leave addiction behind and begin a healthy, happy life.

Alcohol and DXM: Key Statistics

Alcohol use is much more prevalent than DXM abuse. However, DXM is more commonly abused than many think, especially among teens.Reports from the American Association of Poison Control Centers claim that:

  • More than 38,000 cases related to DXM were documented by poison control centers in 2013. 13,500 cases were related to DXM alone.
  • The remaining cases were DXM used in conjunction with other substances. DXM was related to 3 deaths in 2013.

Concurrent Alcohol and DXM Abuse in Teens

Teens comprise the majority of DXM abusers. Over-the-counter medicines containing DXM and alcohol are two of the easiest substances for teens obtain, as they are cheap and easy to find. The National Institute on Drug Abuse (NIDA) finds that:

  • Teenagers use DXM at a rate 3 times higher than all other age groups.
  • 4.1% of high school seniors abused DXM in the last year.
  • 60.2% of high school seniors abused alcohol in the last year.

Preventing Teen DXM and Alcohol Abuse

As mentioned, DXM is frequently found in home medicine cabinets, as it is a commonly found ingredient in over-the-counter cough and cold formulations. As such, it is something that parents should be vigilant about monitoring in their homes.

Preventing DXM abuse in your own house can be essential to keeping your teen safe and healthy. Consider these prevention strategies:

teenagers drinking in the park

  • Check for which medications in your house have dextromethorphan, keeping in mind that DXM comes in both cough syrup and pill/capsule form. (Many formulations that include dextromethorphan are labeled with ‘DM’, ‘DXM’ or ‘cough’ in the name.)
  • Monitor the levels of medicines in the home with DXM.
  • Avoid buying excessive amounts of over-the-counter cough medicines, or keeping them in the medicine cabinet unless needed.
  • Keep medicines in a safe place; consider storing them in a hidden or secure location should you be concerned they are being misused.
  • Talk to your teen about the dangers of abusing prescription and over-the-counter medicines, as well as the risk of mixing alcohol with other drugs. Emphasize that being available over-the-counter or by prescription doesn’t equate to being safe, especially if proper dosing schedules aren’t adhered to.

Resources, Articles and More Information

To learn more about the dangers of these two substances, visit the following pages:

Or visit our Community Forum to join the conversation on alcohol and DXM abuse.

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